Chapter 12: Families at Risk and Families Coping with the Death of a Family Member

Question 1

Child Maltreatment – Factors

The risk for child maltreatment is influenced by what? What is this based on?

Answer 1

based on developmental-ecological model:

• individual-level child and parental characteristics
• family-level factors
• the broader social context

Question 2

Child Maltreatment – Parental Characteristics

What are characteristics associated with child maltreatment?

Answer 2

• their own maltreatment during childhood
• witnessing abuse during childhood
• depression
• stress
• alcohol abuse
• teenage parenthood

Question 3

Child Maltreatment – Parental Characteristics

Is there a type-specific intergenerational transmission of neglectful and physically abusive parenting?

Answer 3

yes

• parents who had been neglected during their childhood were more likely to be neglectful toward their children
• those who were physically abused during their childhood were more likely to be physically abusive toward their children

BUT most typical outcome for both men and women who were abused as children is to be nonviolent in their adult families

• therefore, more appropriate to consider previous childhood abuse as a RISK FACTOR for future parental abuse instead of stigmatizing parents based on their own childhood victimization

Question 4

Child Maltreatment – Parental Characteristics

Ex-drinkers vs. Recurrent Heavy Drinkers vs. Non-drinkers

Answer 4

both ex-drinkers as well as recurrent heavy drinkers use physically abusive parenting practices more frequently than nondrinkers do

Question 5

Child Maltreatment – Parental Characteristics

Why are a large number of children in foster care removed from their homes?

Answer 5

they were abused and/or neglected by alcoholic or drug-addicted parents

Question 6

Child Maltreatment – Parental Characteristics

What paternal factors are associated with teen maternal harsh parenting?

Answer 6

• paternal coercion against the mother

- father’s use of spanking

Question 7

Child Maltreatment – Familial Risk Factors

What are some risk factors?

Answer 7

• interparental violence
• family isolation
• residential mobility
• presence of a stepfather in the home
• low income and poverty

Question 8

Child Maltreatment – Child Characteristics

What are the risk factors for child abuse and neglect? (2)

Answer 8

• child’s age

- presence of a disability in the child

Question 9

Child Maltreatment – Child Characteristics

What is pediatric abusive head trauma (AHT)?

Answer 9

most common type of infant abuse occurs when an adult becomes angry and shakes the baby to stop the crying

abusive head trauma in children – forms of head trauma are intentionally inflicted

can be fatal
causes significant disability for 2/3 of survivors

Question 10

Child Maltreatment – Child Characteristics

What is abuse of children with a disability related to?

Answer 10

responsibilities of caring for a child with a disability is related to compromised parent-child relationships, and problems with attachment between the parent and the child

Question 11

Effects of Maltreatment on Children’s Lives

What are the main problems for children?

Answer 11

• insecure attachment, lower levels of self-esteem, anxiety, depression
• cognitive deficits and poor academic performance
• problems related to peer relationships and identity development
• developmental challenges
• risk-taking behaviours

Question 12

Effects of Maltreatment on Children’s Lives

What are the developmental challenges for adolescents who have been victims of abuse?

Answer 12

their experience of abuse as well as their problems related to making and keeping friends interferes with their identity development

menarcheal transition is particularly difficult and anxiety provoking for girls with a history of child sexual abuse

Question 13

Interventions for Parental Maltreatment of Children

What type of interventions are there for parents who are at risk for abusing their children?

Answer 13

informal

formal

Question 14

Interventions for Parental Maltreatment of Children

What are informal interventions for parents who are at risk for abusing their children?

Answer 14

• support from family members, friends, and community members in the form of respite child care, transportation, or financial assistance might relieve the stress of parents
• community supports, such as family therapy and provision of food and clothing, can go a long way toward mediating the stress of parents
• programs that teach basic parenting skills are particularly helpful in reducing child maltreatment

Question 15

Interventions for Parental Maltreatment of Children

What are formal interventions for parents who are at risk for abusing their children?

Answer 15

involvement with protective services

• given a service plan to assist them in developing non-abusive relationships with their children
• remove children from the home and place them in foster care

Question 16

Interventions for Parental Maltreatment of Children

When placed with foster parents, children often typically suffer feelings related to what?

Answer 16

(despite being abused or neglected)

• separation from the only parents they have ever known
• loss of a familiar environment
• loss of a number of established and ongoing relationships with other family members, friends, and teachers

children and adolescents who are grieving the separation from their parents need understanding and support as they work through the grief process

Question 17

Interventions for Parental Maltreatment of Children – Formal

What might alleviate the anxieties experienced by foster children?

Answer 17

interventions designed to reduce loyalty conflicts

Question 18

Interventions for Parental Maltreatment of Children – Formal

What is the honeymoon phase of children in foster care placement?

Answer 18

children are on their best behaviour

several weeks or months after a child has seemingly adapted to the new environment, that child might suddenly begin to display behaviour problems (a testing of the limits) or emotional withdrawal

Question 19

Interventions for Parental Maltreatment of Children – Formal

What are some supportive elements that appear to assist youth who are transitioning from group care to foster care?

Answer 19

• visits between youth and prospective caregivers prior to placement
• providing foster parents with adequate information regarding the adolescents and their background
• support from agency staff

Question 20

Interventions for Parental Maltreatment of Children – Formal

What processes contribute to adolescents’ resilience once children are placed with foster families?

Answer 20

• increasing self-efficacy
• distancing themselves from the risks of maltreatment
• having new opportunities
• having multiplication of benefits

Question 21

Exposure to Violence

What do mothers who experience interparental violence (IPV) experience?

Answer 21

• higher levels of stress

- more likely to abuse or neglect their children

Question 22

Effects of Interparental Violence on Development – Age

How do infants exhibit trauma symptoms related to mothers victimized by domestic violence?

Answer 22

• increased arousal
• unusual fears
• increased aggression
• more distress related to conflict

Question 23

Effects of Interparental Violence on Development – Age

What are some changes that have been observed in the behaviours of young children exposed to IPV?

Answer 23

• irritability
• sleep disturbances
• emotional distress
• fear of being alone
• increased aggression

Question 24

Effects of Interparental Violence on Development – Age

How does IPV affect school-age children and adolescents?

Answer 24

• compromises their ability to regulate emotions, show empathy, and attend to increasingly complex cognitive material
• exceedingly challenging to accomplish the developmental tasks of achieving in school and establishing positive relationships with their peers
• increases the risk of being a victim of bullying for both adolescent boys and girls, and gender differences have been observed in these risks (girls much greater than boys to be victims of bullies)

Question 25

Interventions for Domestic Violence

What is important for intervention?

Answer 25

• need to refer battered women and their children to community services
• intervention programs need to be culturally relevant
• need safety planning strategies for both women and children and treatment programs for male batterers

Question 26

Interventions for Domestic Violence

What do safety planning strategies consist of?

Answer 26

ongoing assessments of risks, resources, and priorities and the adoption of strategies to maximize safety

women use a wide variety of strategies in response to IPV, but no one strategy is effective for everyone or across all circumstances

Question 27

Interventions for Domestic Violence

What are the 4 dimensions of safety plans?

Answer 27

• staying strategies
• leaving strategies
• protection strategies
• time frames

Question 28

Interventions for Domestic Violence

What do contemporary approaches to safety planning emphasize the importance of?

Answer 28

holistic, relational, culturally sensitive, and respectful process accomplished in partnership between a domestic abuse advocate and an IPV survivor that respects the uniqueness of each individual, and includes accepting the survivor’s perspectives on risk and safety as well as safety efforts

Question 29

Interventions for Domestic Violence

What are the safety plans recommended for children and youth who may have unsupervised visitation with batterers as well as those in shelter settings?

Answer 29

• offering empowerment
• handling fear and anxiety
• teaching critical thinking
• developing skills that lessen the potential for violence

Question 30

Interventions for Domestic Violence

What is the purpose of batterer intervention programs (BIPs)?

Answer 30

draw on the influence of the group to challenge the men to accept responsibility for their behaviour and to acknowledge responsibility for the harm they have caused their families

Question 31

Interventions for Domestic Violence

What do batterer intervention programs (BIPs) focus on?

Answer 31

• anger management
• monitoring negative interpretations of discussions in conflict situations
• identification of signs preceding a violent episode
• methods for controlling violence

Question 32

Interventions for Domestic Violence

What does treatment for male batterers also often include (other than BIPs)?

Answer 32

couples’ therapy

Question 33

Parental Alcoholism

Are dynamics within alcoholic families similar?

Answer 33

yes, and the roles that children assume in order to adapt to that family system are predictable

Question 34

Parental Alcoholism

What do dynamics in families in which a parent is an alcoholic include?

Answer 34

• unpredictable or disrupted family routines and rituals
• compromised parenting behaviours
• parentified children
• greater tolerance of adolescent drinking and other substance abuse

Question 35

Parental Alcoholism

What manages how much the alcoholic parent’s drinking influences the lives of the children in the family?

Answer 35

degree to which these spouses manage to maintain routines and rituals

Question 36

Parental Alcoholism

How do compromised, inconsistent parenting behaviours (after consuming alcohol) affect children?

Answer 36

undermines a child’s sense of order, control, and stability in the family relationship, thereby reducing feelings of self-esteem and perceptions of self-competence

Question 37

Parental Alcoholism

How do alcoholic parents affect the behaviour of the non-alcoholic parent?

Answer 37

even when only one of the parents has an alcohol addiction, both the alcoholic parent and the non-alcoholic parent tend to overreact to their children’s behaviours

Question 38

Parental Alcoholism

Is there a difference between parentified children depending on whether mothers or fathers are the alcoholic parent?

Answer 38

those whose mothers are alcoholics experience more parentification than children of fathers with drinking problems

Question 38

Parental Alcoholism

What theory might explain the way in which parents’ alcoholism contributes to their children’s substance usage?

Answer 38

Social Learning Theory

• parents who model such behaviours encourage imitation by their children
• thus, adolescents who believe that alcohol and drug use is normative are more likely to perceive social reinforcement for such behaviour and are more inclined to smoke, drink, or use drugs

Question 39

Parental Alcoholism

What are the roles of family members in a family with an alcoholic parent?

Answer 39

• alcoholic parent
• co-dependent spouse or partner
• family scapegoat
• family hero
• family mascot or clown
• lost child

Question 40

Parental Alcoholism

What are roles of family members developed for?

Answer 40

to help children cope with a dysfunctional family system, HOWEVER they tend to persist into adulthood

Question 41

Parental Alcoholism

How do parents in these families tend to view their children?

Answer 41

in terms of their role positions, rather than in relation to their feelings or developmental potential

Question 42

Parental Alcoholism

What is the family scapegoat?

Answer 42

• troublemaker – traits include hostility, defiance, and sullenness
• these behaviours are designed to draw attention away from the real problem and direct negative attention toward the scapegoat
• instead of admitting that there is a problem in the family system, family members tend to blame the scapegoat for the family’s difficulties

Question 43

Parental Alcoholism

What is the family hero?

Answer 43

• super responsible, overachiever, typically does what is right, and needs everyone’s approval
• often the oldest child, or the first boy
• provides family members with a sense of self-worth
• in their denial that a problem exists in the family, parents point to the family hero as an example of their parenting effectiveness and a symbol of family normalcy

Question 44

Parental Alcoholism

What is the family mascot or family clown?

Answer 44

• child in this role is considered to be especially cute, and will usually do anything for a laugh or to gain attention
• child represents to the family, and why family members play along, comic relief, fun, and humour
• from the perspective of others, the family clown is having a great time and sees life from a fun, laughable point of view
• family clown’s role in the family is to keep everyone laughing

Question 45

Parental Alcoholism

What is the lost child?

Answer 45

• loner and a daydreamer who is usually quiet, engages in solitary play, and is generally ignored by other family members
• benefit the lost child provides for this family is relief because this child does not cause any problem or inconvenience

Question 46

Parental Alcoholism

How does this affect the lives of children?

Answer 46

• difficulty with self-regulation very young, caused by lower levels of warmth/sensitivity, which predicts externalizing behaviour in kindergarten
• higher levels of depression/anxiety, which has been associated with alcoholic fathers’ higher levels of aggression
• increased externalizing behaviours, conduct disorders, and disruptive behaviours
• adolescent alcohol abuse and alcohol dependence

Question 47

Parental Alcoholism

How does this affect adult children?

Answer 47

• have not established roles that cultivate their ability to achieve happiness and fulfillment in the adult world
• less positive relationships with mothers, fathers, and peers, which contributes to higher levels of depressed mood
• more anxious and avoidant behaviours in romantic relationships

Question 48

Parental Alcoholism

What are some gender differences?

Answer 48

• daughters of alcoholic mothers reveal significantly greater avoidance in their romantic relationships as compared to daughters of non-alcoholics
• both men’s and women’s appraisals of their marital relationships are associated with alcoholism in the opposite gender parent
• for husbands, maternal alcoholism has been linked with lower levels of marital satisfaction and higher levels of physical aggression
• for wives, alcoholism in the father has been related to lower levels of marital intimacy

Question 49

Parental Alcoholism

What are the 3 distinct patterns that link adults’ understandings of their parents’ alcoholism to the ways they perceived their relationship to them?

Answer 49

• alcoholism as a deliberate choice
• alcoholism as a disease
• alcoholism as socially conditioned

Question 50

Parental Alcoholism

Alcoholism as a Deliberate Choice

Answer 50

• described their alcoholic parents in the most negative terms
• reflected feelings that their parents had abandoned their family and chosen alcohol instead of their children
• wanted nothing to do with their alcoholic parent

Question 51

Parental Alcoholism

Alcoholism as a Disease

Answer 51

• ambivalent feelings toward parents

- reflected belief that alcoholics cannot be blamed for their drinking because they have “lost control” over their lives

Question 52

Parental Alcoholism

Alcoholism as Socially Conditioned

Answer 52

• reflected the most understanding and accepting of their parents’ drinking

Question 53

Parental Alcoholism

What are 2 of the most successful treatment approaches for recover from addition to alcohol or other substances?

Answer 53

Alcoholics Anonymous (AA)

Narcotics Anonymous (NA)

Question 54

Parental Alcoholism

What are 2 closely affiliated programs AI-Anon and Nar-Anon for?

Answer 54

designed to support family members of persons with substance abuse

Question 55

Parental Alcoholism

Alcoholics Anonymous / Narcotics Anonymous

Answer 55

• AA is a total abstinence program; members stay away from one drink one day at a time, and sobriety is maintained through the sharing of experience, strength, and hope and through the suggested Twelve Steps for recovery from alcoholism
• NA operates under the same principles and guidelines as AA, but its goal is to help their members stay clean from drugs
• like AA, NA is a voluntary worldwide fellowship – membership is open to all drug addicts, regardless of the particular drug or combination of drugs used

Question 56

Parental Alcoholism

Al-Anon and Nar-Anon Family Groups

Answer 56

• similar to AA and NA, both groups offer support to members through the sharing of experience, strength, and hope
• both also use a Twelve-Step program, which is designed to help members recover from the effects of living with an addicted relative or friend
• only requirement for membership and attendance at these meetings is that the individual has a friend or relative with alcoholism (for Al-Anon) or a problem with drugs or drug addiction (for Nar-Anon)

Question 57

Death of a Parent During Childhood or Adolescence

What do children and adolescents typically feel?

Answer 57

• experience a sense of unreality or numbness as they are faced with the pain of separation from a parent
• as they move beyond the initial feelings of grief, disorganization is common because familiar routines, habits, and roles become disrupted
• young children have difficulty comprehending what death means (compared to adults)

Question 58

Death of a Parent During Childhood or Adolescence

How do infants and toddlers perceive death of parent?

Answer 58

equate parental death with parental separation

Question 59

Death of a Parent During Childhood or Adolescence

How do preschoolers perceive death of parent?

Answer 59

• saddened by the loss of a family member
• at a disadvantage when they attempt to understand why a parent has disappeared from their lives
• do not comprehend that death is permanent

Question 60

Death of a Parent During Childhood or Adolescence

How do older children and adolescents perceive death of parent?

Answer 60

• have a clearer understanding about death, they nevertheless struggle to come to grips with the loss of a parent
• fear of abandonment – associated with depressive symptoms that influence relationships with caregivers, peers, and romantic partners

Question 61

Death of a Parent During Childhood or Adolescence

How do most children and adolescents feel with time?

Answer 61

• eventually, a period of reorganization or recovery occurs
• even though the sadness still is felt, its intensity is somewhat diminished
• with time, most children and adolescents find that they carry that parent with them in numerous memories

Question 62

Loss of a Parent to Suicide

What are children and adolescents especially vulnerable to?

Answer 62

• depression in the months following the death

- greater risk for alcohol or substance abuse

Question 63

Loss of a Parent to Suicide

What contributes to depression for those who lose a mother through suicide?

Answer 63

• blaming others
• low self- esteem
• negative coping
• complicated grief

Question 64

Loss of a Parent to Suicide

What might improve the outcomes of bereaved children and adolescents?

Answer 64

interventions that target complicated grief and blaming of others

Question 65

Death of a Sibling During Childhood and Adolescence

Why do sibling relationships affect personality development?

Answer 65

siblings are a central part of everyday family experience and social adjustment

Question 66

Death of a Sibling During Childhood and Adolescence

What is the painful and traumatic loss of a sibling through death further complicated by?

Answer 66

the fact that children and adolescents are at high risk for failing to grieve that loss

Question 67

Death of a Sibling During Childhood and Adolescence

What does the future of a child or adolescent who has experienced sibling death depend on?

Answer 67

successful journey through the grief process

• unfortunately, a major challenge these children and adolescents face as they attempt to navigate the grief process is that their parents, to whom they typically turn for support, are also grieving

Question 68

Comforting Grieving Children and Adolescents

What circumstances are children’s and adolescents’ adjustment to a family member’s death affected by?

Answer 68

• need to be able to express their grief and receive comfort from surviving parents and/or other adults
• need help as they struggle to adapt to the many changes that occur in the family system during a time of grief and confusion
• helpful when adults are willing to talk with children and adolescents about the feelings they are having

Question 69

Comforting Grieving Children and Adolescents

In discussing death of a family member, what is it important for parents to do?

Answer 69

• important to attempt to get a sense of what they are thinking about the loss they have experienced and to try to find out how they view death in general
• grieving children and adolescents also need to be given information about the circumstances of a family member’s death according to their ability to understand
• might need to repeat the same information because children have difficulty processing information in the midst of a stressful experience
• helpful for grieving children and adolescents when adults avoid the tendency to do most of the talking
• let the child or adolescent take the lead as to when, how long, and how much is discussed

Question 70

Comforting Grieving Children and Adolescents

What should surviving parents or other adults do?

Answer 70

• exercise caution in making decisions related to the deceased parent or sibling (ie. about disposal of possessions of the deceased)
• proceed carefully in making further changes in the family during the days, weeks, and months following a family member’s death (ie. changing residences)

Question 71

Grief of Parents When Their Child Dies

What does a child’s death cause for parents?

Answer 71

• intense personal suffering
• affects family reorganization and reintegration into community life
• grief that encompasses their lives in a variety of ways, including every aspect of day-to-day living

Question 72

Grief of Parents When Their Child Dies

The inescapable feeling of pain contributes to what reactions from parents?

Answer 72

• some panic and run in all directions in an attempt to return to a normal life
• some are inclined to sit and wait for the hurting to subside

Question 73

Grief of Parents When Their Child Dies

What process is a significant aspect of recovery for grieving parents?

Answer 73

process of meaning making

• many parents express the belief that their lives have a different meaning following the death of their child

Question 74

Grief of Parents When Their Child Dies

What additional symptoms of distress do parents whose children died from suicide have?

Answer 74

horror, fear, extensive blaming, shame, isolation, and an intense search for meaning

Question 75

Grief of Parents When Their Child Dies

What type of social support do parents whose children died from suicide receive?

Answer 75

the nature of the traumatic death and associated stigma often leads to these parents receiving less social support than those bereaved in other ways

• experience of this stigmatization has been linked to grief difficulties, depression, and suicidal thinking
• some families have reported withdrawing from social networks because of real or perceived stigmatization
• some parents have indicated that they derived solace from a caring work role, or have considered a career change that would help others

Question 76

Helping Parents Cope with the Death of a Child

What are the main guidelines suggested for assisting parents in dealing with the death of a child?

Answer 76

• understanding a parent’s unique response to death
• reinforcing the child’s identity
• expecting to deal with a bereaved parent’s anger
• providing support for the other children

Question 77

Helping Parents Cope with the Death of a Child

Understanding a Parent’s Unique Response to Death

Answer 77

• people tend to deal with loss based on how their family of origin coped with loss
• most helpful approach others can take to assist grieving parents is to allow them the freedom to express their grief according to their individual way of coping

Question 78

Helping Parents Cope with the Death of a Child

Reinforcing the Child’s Identity

Answer 78

beneficial for family members and friends to always refer to the baby or child by name, and to call parents mother or father and siblings brothers and/ or sisters

Question 79

Helping Parents Cope with the Death of a Child

Providing Support for a Bereaved Parent’s Other Children

Answer 79

• important but often overlooked step is to talk to those children about the death of their sibling
• when talking to these children, it is valuable to reassure them that although their parents are very sad, they still love their children, will continue to take care of them, and will be available to talk with and play with them soon

Question 80

Helping Parents Cope with the Death of a Child

Expecting to Deal with a Bereaved Parent’s Anger

Answer 80

anger is a natural expression of anguish when one’s child has died

Question 81

Death of an Older Parent

Why is the loss of a parent during adulthood significant?

Answer 81

due to the importance of the parent-child relationship at any age

Question 82

Death of an Older Parent

What do adult children do following the deat?

Answer 82

• grieve the loss

- undergo alterations in family interaction patterns

Question 83

Death of an Older Parent

What changes in family interaction patterns following parental death occur?

Answer 83

• negatively affects the relationships adults have with their siblings
• although siblings typically rally following the death of a parent, after the initial period of grieving, there tends to be a decline in sibling closeness and in some families a reactivation of childhood power struggles
• persons who have experienced the death of at least one parent are more likely to report that they do not get along with at least one sibling in comparison to persons with two living parents

Question 84

Death of a Grandparent

When there has been a close grandparent-grandchild relationship, what are the typical responses of bereaved children?

Answer 84

loss of interest, loss of appetite, sleep disturbances, agitation, declining school performance, guilt, headaches, and stomach upset

Question 85

Death of a Grandparent

What are common manifestations of grief displayed by adolescents who have experienced the death of a grandparent?

Answer 85

shock, depression, fear, loneliness, sleeping difficulties, feelings of emptiness, disbelief, a sense of hopelessness, and guilt

Question 86

Death of a Grandparent

How does this affect adolescents compared to children?

Answer 86

because adolescents (unlike children) are usually confronting beliefs about life and death, the death of a grandparent might also contribute to their death anxiety level

Question 87

Death of a Grandparent

What do children’s grief often show up in?

Answer 87

behaviour problems or physical symptoms

Question 88

Death of a Grandparent

When an aging parent dies, adults’ experience of their own grief might cause them to overlook or minimize the grief of grandchildren.

Answer 88

-

Question 89

Legacy That Older Persons Leave for
Their Adult Children and Their Grandchildren

What are the 3 categories of legacies for one’s children and grandchildren?

Answer 89

• biological legacy
• material legacy
• legacy of values

aging parents identify with at least one form of legacy, and the majority express all three with the legacy of values viewed as the most important

Question 90

Legacy That Older Persons Leave for
Their Adult Children and Their Grandchildren

Is bond intensity with parents diminished by parental death?

Answer 90

no – affective bonds of adult children toward their parents transcend parental death and mourning

Question 91

Compare historical and contemporary responses to child abuse and neglect and describe the effects of child maltreatment.

Answer 91

Public objection to child maltreatment is relatively new. The first documentation of the damaging effects of child abuse occurred in 1962, and the first documented use of the phrase family violence occurred a decade later. Those publications led to laws in the United States to protect children from violence and to mandatory reporting laws for mental health and other professionals who work with children. Children who experience abuse and/or neglect have a variety of psychological, social, and academic problems. Parents who abuse or neglect their children need both informal and formal intervention. When child maltreatment has been reported and substantiated, protective services become involved and parents might be assisted in developing non-abusive relationships with their children and/or those children might be placed in foster care.

Question 92

Discuss the impact of children’s exposure to interparental violence and recommend interventions.

Answer 92

• children exposed to IPV are at high risk for having social, behavioural, and health problems
• their health problems often include physical symptoms (such as headaches or stomachaches) and PTSD
• effects of IPV differ according to children’s ages
• recommended interventions for IPV include referring battered women and their children to shelters and other community services and making sure intervention programs are culturally relevant
• ensuring cultural relevance includes delivering public service messages about domestic violence in different languages and involving community leaders in helping challenge views that tend to play down the scope of the problem of IPV
• these families also need safety planning strategies for both women and children and treatment programs for male batterers

Question 93

Describe the effects of parental alcoholism on children’s lives and the various pathways for recovery from addiction to substances.

Answer 93

• dynamics in families in which a parent is an alcoholic include unpredictable or disrupted family routines and rituals, compromised parenting behaviours, and a greater tolerance of adolescent drinking and other substance abuse
• living in a family with an alcoholic parent also affects children’s development of healthy family roles
• roles that children assume in order to adapt to the dysfunction in this family include the super hero, the clown, the lost child, or the scapegoat
• pathways to recovery for parents with alcohol or other substance abuse problems include AA or NA
• for individuals with a family member who is addicted to alcohol or drugs, Al-Anon and Nar-Anon are programs that are closely affiliated with AA and NA

Question 94

Explain the challenges families face in coping with the untimely death of a family member and ways to support these individuals.

Answer 94

• when children and adolescents grieve the loss of a parent, disorganization is common because familiar routines, habits, and roles become disrupted
• although children feel profound sadness and grief, their conceptions of death differ from adults, and young children have difficulty comprehending what death means
• when children and adolescents lose a sibling through death, they are at risk for not being supported through the grief process since their parents are also grieving
• child’s death causes parents intense personal suffering and affects family reorganization and reintegration into community life
• despite the cause of death, parents typically feel responsible for their child’s deaths
• when a parent, child, or sibling experiences the unexpected loss of a family member, it is important to have supportive individuals to assist them in the grief process

Question 95

Show an understanding of the effect of an older person’s death on their children and grandchildren.

Answer 95

• due to the importance of the parent-child relationship throughout one’s life, the death of a parent during adulthood is a significant loss
• following the death of an older parent, adult children not only grieve the loss but also undergo alterations in family interaction patterns
• after the initial period of grieving, there tends to be a decline in sibling closeness and in some families a recurrence of childhood power struggles
• when children lose a grandparent with whom there has been a close relationship, typical responses include loss of interest, loss of appetite, sleep disturbances, agitation, declining school performance, guilt, headaches, and stomach upsets
• reactions of adolescents to the death of a grandparent include shock, depression, fear, loneliness, sleeping difficulties, feelings of emptiness, disbelief, a sense of hopelessness, and guilt