The cycle of change
The parents you work with will be at varying stages in the cycle of change. Some parents will not realise a problem exists, may not be ready to change, may have thought or not thought about change, may be taking active steps towards change or may have taken steps and lapsed or relapsed. They may shift quickly from feeling they want to stop, to not wanting to stop. They may say they want to stop using, but they do not know how, are unable to, or are not ready.
These are all different stages in the cycle of change. Talking about their readiness to change and what may be stopping them will help you get to the heart of the problem. Always meet a parent where they are at in their world to understand their reluctance, so you can support them with choices in getting help and support.
Watch the below short video, which explains the stages of change in relation to alcohol and other drugs use.
Source: Insight Queensland (2019)
Connecting parents to their child’s experience
When you are working with parents, remember how vital the connection between the child and parent is in providing a catalyst for change.
Always be curious and when a parent talks to you, relate it back to what it means for their child. A parent may say: ‘I parent better when I’m on drugs.’ If you take a ‘forensic’ approach and simply see this as evidence to support their lack of insight, you will miss the opportunity to understand what this means for the child. Taking a ‘curious’ approach will allow you to explore why they feel this way.
For example, when a parent says ‘I parent better when I’m on drugs’, ask them:
- ‘I am wondering if you can tell me what you think you do better?'
- ‘Can you tell me a bit more about that? It sounds like your parenting can change depending on whether you're intoxicated or coming down? Or when you are not able to get alcohol or drugs? I really want to understand what it is like for you.'
Use practice tools like the Three Houses or the Future House to elicit the views and wishes of children about their parents’ AOD use. Ask children how you would like them to share these perspectives with their parents. It can be a powerful experience for a parent to hear feedback about their AOD use directly in their child’s voice.
Helping parents get their life back
The biggest barrier for the recovery of parents who use AOD as a way to cope and survive is finding new ways to cope without AOD. Overcoming this obstacle cannot be done alone. Parents need a strong safety and support network, and need to know that you and others supporting them believe that they can make changes and keep their children safe.
Parents want to be good parents. Parents want to keep their children safe. Starting at this place offers dignity and compassion. This gives you some common ground on which to work with them.
Help parents talk about their fears of giving up AOD and make sure case planning includes healing and recovery work that offers them the opportunity to learn new and positive ways of coping. Ask them:
- What would it be like to get your life back from AOD use?
- What would be the best things about having your life back?
- What would be hard, uncomfortable or scary about letting AOD use go?
- What things are going to make it easier for you to do it?
A safety and support network is vital
Since a safety and support network is vital in safety planning and in reducing long-term risks for children, talk with parents about who is and who could be in their lives. Practitioners may need to ask them questions such as:
- When do you feel supported and strong in your life?
- What makes you feel supported and strong?
- Who has supported you in the past?
- What would it take to talk to this person today?
- What would you need? What would they need?
- What would they think and feel if you told them the extent of your use?
- How can I be most useful to you in talking with [person]?
Make sure a parent understands that change can take time, even with the right supports in place. A parent will need a support network and practitioners can start helping them build, repair and connect with people who can help. Developing a safety and support network, safety planning and case planning are perfect opportunities to bring people together to talk about keeping a child safe.
Use the Circles of Safety and Support Tool when engaging with parents to explore who in their life ‘knows nothing, something and everything’ about their problematic AOD issues.
Solution-focused questions can help reveal strengths and the times in a parent’s life that AOD has not been a problem. These conversations are important for your safety assessment, safety planning and case planning. Some examples are in the table below.
Exception questions provide parents with the opportunity to identify times when things have been different for them and AOD use was not problematic for them or their child.
'Tell me about a time when you felt like drinking but you didn’t.'
'Tell me about a time where you would have normally taken [child] to get drugs but you didn’t.'
'Tell me about a time when you reduced or stopped drinking.'
Scaling questions invite parents to look at their AOD use on a continuum. Scaling questions ask parents to consider their position on a scale (usually from 1 to 10, with one being the least desirable situation and 10 being the most desirable).
Scaling questions can be a helpful way to track progress towards goals and monitor incremental change.
'You said that things are between a 5 and a 6. What would need to happen so that you could say things were between a 6 and a 7?'
'How confident are you that you could have a good day like you did last week, on a scale of 0 to 10, where 0 equals no confidence and 10 means you have every confidence?'
These questions are powerful reminders that all clients engage in many useful things even in times of overwhelming difficulties. They can be a great way to explore acts of resistance.
Coping questions can work well when a parent is struggling to contemplate or stay motivated to change.
'You have been through a lot, tell me about other ways you have coped in your life.'
'Tell me more about the times you have stopped using before. How did you cope?'
'What helps you to keep going even though things are really hard?'
'It is admirable how you have been able to keep on going under such difficult circumstances. How did you do that?'
'How have you coped before when you felt like giving up? What stopped you from giving up before?'
This type of question helps the parent create a picture of what things could look like or how they would like it to look if they did not use AOD. The key lies in exploring the details of what things would be like for them and those around them, particularly their child.
This can be useful in talking about what the first step would be towards the future vision.
'If you were able to be the parent you wanted to be, what would it look like?'
'If AOD were no longer an issue in your life, what would things look like? How would it be different for you? For [child]?'
'What would be the first thing you noticed? What would [child] notice? How would others tell something had changed?'
With this type of question, the parent does most of the talking. Questions prompt a narrative to learn more about the parent’s thoughts, feelings and behaviours.
'I’m wondering how alcohol has become such a big part of your life.'
'I understand you have some concerns about your drinking. I’m curious—tell me about them.'
'Tell me more about that.'
Affirming statements can take the form of compliments or statements of appreciation and understanding. They help build rapport and validate and support a parent during the process of change. They are most effective when they focus on parents’ strengths and efforts for change.
'I just want to acknowledge how hard that must have been making that phone call. That was really brave to do that when you're feeling so flat.'
'I appreciate that it took a lot of courage for you to talk about your drinking today.'
'You appear to have lots of different ways you have coped with these difficulties for the past few years.'
'Thank you for hanging in there with me. I appreciate this is not easy for you to hear.'
Reflecting involves rephrasing a statement to capture the implicit meaning and feeling of a parent's statement
It encourages continual personal exploration and helps people understand their motivations more fully.
It can be used to amplify or reinforce a desire for change.
'You feel that alcohol is what has got you through and it's really hard to stop now.'
'You feel that you have to break away from some of your friends because they make it hard to stop using.'
'You have enjoyed the way alcohol helps you cope with life and you thought you had it under control. But you are starting to worry that you don’t. Has having me here today made you question how bad it actually is?'
Summarising links discussions, checks in with the parent and ensures mutual understanding of the discussion so far.
Summarising can point out discrepancies between the person’s current situation and future goals.
It also demonstrates listening and understanding of the parents’ perspective.
|'If it is okay with you, just let me check that I understand everything that we’ve been discussing so far. You have been worrying about how much you’ve been drinking in recent months but you have not been able to stop and you are worried that you can’t stop. How am I doing?'|
Rolling with resistance
Use this approach to explore their resistance to change rather than trying to change their mind for them.
'What is it about your drinking that others may worry about?'
'What would be different for your children if you stopped using?'
'What has using ice stopped you doing?'
'I wonder what makes other people think your drug use is a problem?'
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