The role of cognitive factors in the development of psychological disorders among children and adolescents affected by parental alcohol problems

Kinder und Jugendliche aus alkoholbelasteten Familien stellen eine besondere Risikogruppe für die Entwicklung eigener suchtbezogener Störungen sowie anderer psychischer Auffälligkeiten dar. Derartig pathologische Entwicklungsverläufe resultieren aus einem Zusammenspiel aus Risiko- und Schutzfaktoren, welche zum Einen in der Umgebung des Kindes, zum Anderen in der Person des Kindes zu finden sind. Wenig beachtet wurde bislang die Rolle kognitiver Faktoren, die für die Entwicklung psychischer Auffälligkeiten bei Kindern und Jugendlichen aus suchtbelasteten Familien bedeutsam sein können; der Fokus der vorliegenden Studie wurde daher hierauf gelegt. Hierzu wurde eine Fragebogenuntersuchung mit 72 Kindern und Jugendlichen aus suchtbelasteten Familien und 109 unbelasteten Kindern und Jugendlichen durchgeführt. Ferner wurden zwei Kasuistiken alkoholbelasteter Familien näher betrachtet. Die Ergebnisse zeigen, dass belastete Kinder und Jugendliche in Hinblick auf verschiedene psychische Auffälligkeiten eine höhere Belastung aufweisen als Kinder und Jugendliche aus unbelasteten Familien. Hinsichtlich kognitiver Muster unterscheiden sich Kinder und Jugendliche kaum von unbelasteten Kindern und Jugendliche. Es stellte sich jedoch heraus, dass kognitive Faktoren dennoch eine besondere Bedeutung für die Entwicklung psychischer Auffälligkeiten besitzen. Eine ähnliche Ergebnislage zeigte sich in Hinblick auf zusätzlich untersuchter Variablen der Eltern-Kind-Beziehung. Diese Befunde stellen jedoch kein Spezifikum für Kinder und Jugendliche aus alkoholbelasteten Familien dar, sondern sind auch für Kinder und Jugendliche aus unbelasteten Familien zutreffend. Der Bearbeitung kognitiver Muster und familiärer Faktoren kann somit eine besondere Bedeutung sowohl in der selektiven Präventionsarbeit mit Kindern und Jugendlichen aus alkoholbelasteten Familien, als auch in der universellen Präventionsarbeit mit Kindern und Jugendlichen aus unbelasteten Familien zukommen.Children and adolescents affected by parental problems are at particular high risk to develop substance-related problems and other psychological disorders. This phenomenon roots in an interplay between risk and protective factors that are to be found either in the child’s environment or in its personality. Little attention has been paid to the role of cognitive factors that might be important for the development of psychological problems; hence, this study concentrates on this issue. A questionnaire study was undertaken with 72 children and adolescents affected by parental alcohol problems and 109 unaffected children and adolescents. In addition, two case studies were examined. Results show that affected children and adolescents suffer from more symptoms of psychological disorders than unaffected children and adolescents. However, they barely differ from each other regarding cognitive factors. Nevertheless, cognitive factors play an important role for the development of psychological problems. Similar results were found for family variables that were examined additionally. However, these results were not specific for children and adolescents with alcoholic parents, but are also valid for unaffected children and adolescents. Thus, the treatment of cognitive factors and family variables is important for both selective and universal prevention

Working with children from substance-affected families: the community-based group intervention TRAMPOLINE.

[ES] : Introducción. Hijos de familias drogodependientes pone de manifiesto que existe un elevado riesgo de que los niños desarrollen sus propios trastornos relacionados con las drogas u otros problemas mentales. Sufren a menudo violencia, malos tratos y abandono en sus familias. Por ello constituyen un objetivo importante de los programas de prevención. En Alemania se calcula que aproximadamente 2,65 millones de niños y jóvenes se ven afectados por el consumo o dependencia de las drogas de sus padres. Tan sólo un 10% de ellos reciben tratamiento a la vez que sus padres. Hasta la fecha, no existe en Alemania ningún programa evaluado para hijos de familias afectadas por las drogas. Métodos: se desarrolló una nueva intervención grupal para hijos de familias con problemas de drogas y actualmente se está evaluando en un estudio aleatorio-controlado en múltiples centros financiado por el Ministerio de Sanidad alemán. El proceso de desarrollo se orientó simultáneamente en la teoría, los datos de investigación existentes y los informes de expertos. Uno de los objetivos clave del programa es fomentar la resiliancia en los hijos de padres drogodependientes. Resultados: el manual TRAMPOLINE expone un programa grupal modular de 9 sesiones, centrado en la adicción, para niños de 8 a 12 años con al menos un progenitor que consume drogas. Las sesiones semanales duran 90 minutos y combinan elementos psicopedagógicos con ejercicios y juegos de rol. Asimismo se integra en el programa un componente de intervención con los padres de dos sesiones. Se exponen el contenido, la estructura y los fundamentos teóricos de la intervención. Discusión: TRAMPOLINE es un nuevo planteamiento de intervención que se dirige a los hijos de familias drogodependientes. Se basa en la teoría y la práctica. Los resultados del estudio ofrecerán información crucial sobre la eficacia de un programa preventivo grupal estructurado para hijos alemanes de familias drogodependientes. De este modo, el estudio contribuirá a crear un sistema de ayuda preventiva más amplio y eficaz para este grupo de alto riesgo. [EN] : Introduction: Children from substance-affected families show an elevated risk for developing own substance-related or other mental disorders. Frequently, they experience violence, abuse and neglect in their families. Therefore, they are an important target group for preventive efforts. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated program for children from substance-affected families exists in Germany. Methods: A new group intervention for children from substance-affected families was developed and is currently being evaluated in a randomized-controlled multicenter study funded by the German Ministry of Health. The development process was simultaneously guided by theory, existing research knowledge and expert opinion. Promoting resilience in children affected by parental substance abuse is a key goal of the program. Results: The TRAMPOLINE manual describes a 9-session addiction-focused, modular group program for children aged 8 to 12 years with at least one substance-using parent. Weekly sessions last for 90 minutes and combine psychoeducational elements with exercises and role play. A two-session parent intervention component is also integrated in the program. Content, structure and theoretical background of the intervention are described. Discussion: TRAMPOLINE is a new interventive effort targeting children from substance-affected families. It is grounded in theory and practice. The results of the research in progress will provide fundamental information on the effectiveness of a structured group prevention program for German children from substance-abusing families. Thus, the study will contribute to creating a broader and more effective system of preventive help for this high-risk target group

Trabajar con hijos de familias afectadas por toxicodependencias: la intervención grupal comunitaria TRAMPOLINE

Introducción: Hijos de familias drogodependientes pone de manifiesto que existe un elevado riesgo de que los niños desarrollen sus propios trastornos relacionados con las drogas u otros problemas mentales. Sufren a menudo violencia, malos tratos y abandono en sus familias. Por ello constituyen un objetivo importante de los programas de prevención. En Alemania se calcula que aproximadamente 2,65 millones de niños y jóvenes se ven afectados por el consumo o dependencia de las drogas de sus padres. Tan sólo un 10% de ellos reciben tratamiento a la vez que sus padres. Hasta la fecha, no existe en Alemania ningún programa evaluado para hijos de familias afectadas por las drogas. Métodos: se desarrolló una nueva intervención grupal para hijos de familias con problemas de drogas y actualmente se está evaluando en un estudio aleatorio-controlado en múltiples centros financiado por el Ministerio de Sanidad alemán. El proceso de desarrollo se orientó simultáneamente en la teoría, los datos de investigación existentes y los informes de expertos. Uno de los objetivos clave del programa es fomentar la resiliancia en los hijos de padres drogodependientes. Resultados: el manual TRAMPOLINE expone un programa grupal modular de 9 sesiones, centrado en la adicción, para niños de 8 a 12 años con al menos un progenitor que consume drogas. Las sesiones semanales duran 90 minutos y combinan elementos psicopedagógicos con ejercicios y juegos de rol. Asimismo se integra en el programa un componente de intervención con los padres de dos sesiones. Se exponen el contenido, la estructura y los fundamentos teóricos de la intervención. Discusión: TRAMPOLINE es un nuevo planteamiento de intervención que se dirige a los hijos de familias drogodependientes. Se basa en la teoría y la práctica. Los resultados del estudio ofrecerán información crucial sobre la eficacia de un programa preventivo grupal estructurado para hijos alemanes de familias drogodependientes. De este modo, el estudio contribuirá a crear un sistema de ayuda preventiva más amplio y eficaz para este grupo de alto riesgo

Evaluation of the mindfulness-augmented “Trampoline” programme – a German prevention programme for children from substance-involved families tested in a cluster-randomised trial

Abstract Background Children of substance-abusing parents are at a substantial risk of developing substance-use and other mental disorders. Children involved in substance abuse – not diagnosed with substance-use problems but integrated in psychiatric treatment or youth welfare services – constitute a particular high-risk group that is in need of substance use prevention. Emerging evidence indicates that self-regulatory determinants of substance use and other mental disorders, particularly stress reactivity, are modifiable by mindfulness-based interventions, such as mindfulness-based stress reduction. Methods In this ongoing cluster randomised-controlled trial, a mindfulness-augmented version of the modularised evidence-based “Trampoline” programme for children affected by parental substance use problems is evaluated in a sample of 420 children who are from substance-involved families, aged from 8 to 12 and receiving non-substance-specific care in psychiatric or youth welfare services. Larger effects on adaptive stress-coping strategies (primary outcome), internalising and externalising problem behaviours and distress due to parental substance use are expected compared to the standard “Trampoline”-programme version. Mindfulness components will be added and regularly practiced for 30 min in each validated “Trampoline” module. Moreover, the feasibility of mindfulness-based interventions in psychiatric care and youth welfare services for children suffering from emotional and behavioural problems will be investigated in this study. Discussion Despite recruitment challenges, this study provides a unique opportunity to develop and test a promising addiction-specific, mindfulness-based intervention for a target group at risk, i.e. children from substance-involved families. Trial registration The trial was registered in the German Clinical Trials Register on July 16th 2018 (trial registration number (TRN): DRKS00013533). Any important protocol modifications are to be reported immediately. Protocol version v.2.1, 15th April 2019

Working with children from substance-affected families: the community-based group intervention TRAMPOLINE

Introduction: Children from substance-affected families show an elevated risk for developing own substance-related or other mental disorders. Frequently, they experience violence, abuse and neglect in their families. Therefore, they are an important target group for preventive efforts. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated program for children from substance-affected families exists in Germany. Methods: A new group intervention for children from substance-affected families was developed and is currently being evaluated in a randomized-controlled multicenter study funded by the German Ministry of Health. The development process was simultaneously guided by theory, existing research knowledge and expert opinion. Promoting resilience in children affected by parental substance abuse is a key goal of the program. Results: The TRAMPOLINE manual describes a 9-session addiction-focused, modular group program for children aged 8 to 12 years with at least one substance-using parent. Weekly sessions last for 90 minutes and combine psychoeducational elements with exercises and role play. A two-session parent intervention component is also integrated in the program. Content, structure and theoretical background of the intervention are described. Discussion: TRAMPOLINE is a new interventive effort targeting children from substance-affected families. It is grounded in theory and practice. The results of the research in progress will provide fundamental information on the effectiveness of a structured group prevention program for German children from substance-abusing families. Thus, the study will contribute to creating a broader and more effective system of preventive help for this high-risk target group

Pedagogía social : revista interuniversitaria

Monográfico con el título: "Programas eficaces de trabajo con familias"Título, resumen y palabras clave también en portuguésResumen basado en el de la publicaciónSe desarrolló una nueva intervención grupal para hijos de familias con problemas de drogas y se está evaluando en un estudio aleatorio-controlado en múltiples centros financiado por el Ministerio de Sanidad alemán. El proceso de desarrollo se orientó simultáneamente en la teoría, los datos de investigación existentes y los informes de expertos. Uno de los objetivos clave del programa es fomentar la resiliencia en los hijos de padres drogodependientes. El manual TRAMPOLINE expone un programa grupal modular de 9 sesiones, centrado en la adicción, para niños de 8 a 12 años con al menos un progenitor que consume drogas. Las sesiones semanales duran 90 minutos y combinan elementos psicopedagógicos con ejercicios y juegos de rol. Asimismo se integra en el programa un componente de intervención con los padres de dos sesiones. Se exponen el contenido, la estructura y los fundamentos teóricos de la intervención. Los resultados del estudio ofrecerán información crucial sobre la eficacia de un programa preventivo grupal estructurado para hijos alemanes de familias drogodependientes.ES

Evaluation of a family-oriented parenting intervention for methamphetamine-involved mothers and fathers – The SHIFT Parent Training

Introduction: A large number of people who use crystal methamphetamine in Germany are parents of young children. In the context of methamphetamine use, family situations and parenting are frequently impacted, and children are at risk of developing behavioral or emotional difficulties. SHIFT Parent Training was developed as a parenting intervention targeted specifically to the needs of methamphetamine-involved parents. The eight-session group training is delivered in substance use treatment settings and aims to foster abstinence and improve parenting skills and resilience within the families. Methods: The primary goal of this pilot study was to assess the initial effectiveness and acceptance of the SHIFT intervention. The quasi-experimental study design included pre-, post- and 6-month follow-up measurements. Sixty-eight methamphetamine-involved parents participated in all stages of the study. Substance use, parenting practices, and family functioning and resilience were primary effectiveness outcome measures. Additionally, acceptance was assessed by participants' and professionals' feedback. Results: Substance use problems were significantly lower in the intervention condition at the 6-month follow-up. Positive parenting of mothers and fathers also increased in the intervention group directly after participation. Both the intervention and control groups showed significant improvements in family functioning, parenting stress and children's behavioral issues. Participants and facilitators reported that they were highly satisfied with the program. Conclusion: Our findings suggest that SHIFT Parent Training is an effective intervention and is well-accepted among parents and health professionals. The program improves relevant aspects of substance use-related issues and parenting and therefore poses a valuable addition to support services for methamphetamine-involved families. Keywords: Substance use, Addiction, Crystal meth, Children, Family, Parent