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Skip Navigation Links > Competency 3: Treatment Strategies for Working with Clients with an FASD > 5g. Counseling Strategies: History of Abuse

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Competency 3: Treatment Strategies for Working with Clients with an FASD


Counseling Strategies, Continued

History of Abuse

Children with physical, psychological, and sensory disabilities are known to be more vulnerable to violence and maltreatment, or to be at a greater risk of these forms of abuse. 5 Children of parents who abuse alcohol are also at high risk of abuse and neglect. 6 In addition, children in foster care face a risk of maltreatment, which can affect their physical health and lead to attachment disorders, compromised brain functioning, inadequate social skills, and mental health difficulties. 7 Many children come into foster care because of parental alcohol and drug use which resulted in neglect and abuse. Children with FASD may experience multiple foster home placements related to the behavioral problems associated with their placement.

Childhood abuse can lead to posttraumatic stress and place the person at risk of substance abuse problems as an adult. Preliminary data from a cross-site evaluation of demonstration grants funded by the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment finds that 76 percent of clients in treatment programs for women with children report a personal history of abuse, neglect, or trauma. About one-fourth report physical abuse by a parent, one-third report emotional or psychological abuse by a parent, and slightly over one-tenth report sexual abuse by a parent. Many more report physical, emotional, or sexual abuse by a nonparent (over three-quarters report physical and emotional abuse and about one-half report sexual abuse).8

Given the risk of abuse among persons with an FASD and substance abuse problems, it is likely that clients with an FASD will have a history of abuse. This abuse can cause long-term damage to mental health and further impair the person’s already compromised ability to form healthy relationships. The counselor working with persons with an FASD needs to be sensitive to the possibility of childhood abuse and other forms of victimization and their impact on the counselor-client relationship.

A common theme that counselors need to be attentive to in this respect is powerlessness.  This theme is often carried in the following types of client communications and behaviors:

  • Clients undervaluing their own competencies
  • Clients viewing others’ needs and goals as more important than their own
  • Clients’ inability to obtain nurturance and support for themselves
  • Clients’ feelings of depression, anger, and frustration about their lives
  • Clients’ low expectations for their own success

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