But not all children of alcoholics succumb to the potential negative consequences. In fact, studies suggest that, despite the odds, a large proportion of children of alcoholics do not develop serious problems.
In an often-cited longitudinal study of children of alcoholics born on the Hawaiian island of Kauai, psychologist Emmy Werner, Ph.D., of the University of California, Davis, reported on 49 children of alcoholic parents who were raised in chronic poverty from birth to 18 years. Although 41% of the study participants had developed coping problems by age 18, 59% appeared to cope well and had not developed serious problems. Among the shared characteristics of the “resilient” children were adequate communication skills, average intelligence, a desire to achieve, and the ability to get positive attention from other people (J. Stud. Alcohol. 1986;47:34–40).
A later report on the same cohort showed that study participants who effectively coped with the trauma of growing up with an alcoholic parent and became competent adults by age 32 had relied on more sources of support in their childhood than did those offspring of alcoholics with coping problems (Subst. Use Misuse 2004; 39:699–720).
In a separate 3-year study of 267 adolescents, including 127 children of alcoholics, self-awareness, a perceived control over one's environment, and the possession of cognitive coping skills were all identified as having a buffering effect against potential negative consequences associated with having an alcoholic parent (J. Stud. Alcohol 1997;58:272–9).
Although resilience in children of alcoholics is still not fully understood–a recent study by the University of Michigan, Ann Arbor, that has identified differences in neural activation mechanisms between vulnerable and resilient children of alcoholic parents adds a new dimension to the research in this arena (Alcohol Clin. Exp. Res. 2008;32:414–26)–the available evidence suggests that building resilience is a critical intervention goal.
For example, in a school-based prevention intervention called Students Together and Resourceful (STAR)–identified as a model program by SAMSHA–children of alcoholics gain self-efficacy through education about alcoholism and its effects on the family as well as group exercises that allow participants to recognize and express their feelings and to practice problem-solving, stress-management, and alcohol-refusal skills. In randomized trials comparing outcomes of children of alcoholics who did and did not participate in the intervention, participants attained improved self-concept as well as decreases in depression (Pediatrics 1999;103:1112–21).
Certain elements of the STAR program should be universal to all interventions for this population, according to lead author James Emshoff, Ph.D., professor of psychology at Georgia State University, Atlanta. These include “skill building in the areas of coping and social competence, social support, an outlet for the safe expression of feelings, and healthy, alternative activities.”
Perspective
Children of alcoholic parents are at risk for negative mental health outcomes. But many overcome the genetic, biologic, and, often, environmental odds that are stacked against them and become competent, mentally healthy adults. Whether innate or acquired, resiliency keeps risk factors from morphing into predictive factors.
Resilient adolescents share several well-defined characteristics. They include:
▸ Curiosity and intellectual mastery.
▸ Compassion, with detachment.
▸ The ability to conceptualize.
▸ The conviction of one's right to survive.
▸ The ability to remember and evoke images of good and sustaining figures.
▸ The ability to be in touch with affects.
▸ A goal to live for support, and the ability to attract and use it.
▸ A vision of the possibility and desirability of restored civilized moral order.
▸ The need and ability to help others.
▸ Resourcefulness.
▸ The capacity to turn traumatic helplessness into learned helpfulness.
Resiliency in at-risk youth can be cultivated. The best way is to strengthen these individuals is through family-based interventions. The most researched family-based intervention is found in the Strong African-American Families (SAAF) program, which increases protective factors that should prevent adolescents from using drugs. Interventions based on this premise also can be useful for children of alcoholics.
The SAAF intervention teaches parents how to communicate with their children in ways that nurture connectedness. The intervention guides parents on how to train their children to be responsive–but not overly reactive–to situations in their lives. The intervention also teaches children how to have a sense of power by resisting peer pressure to use drugs and alcohol.
Some children of alcoholics may be in situations that are not amenable to family-based interventions, in which case society has to provide support in the form of activities that occur out of the family context, through school- or church-based interventions, for example.
Involvement in activities such as sports teams, scouting, music programs, and martial arts training also can help children build a sense of achievement, acceptance, and self-efficacy. Positive role models with whom the children can identify also foster resiliency.