Curriculum for Addiction Professionals > Competency 3: Treatment Strategies for Working with Clients with an FASD > 5g. Counseling Strategies: History of Abuse

Please Select One 1. Competency Description 2. Pretest 3. Learning Objectives 4. Introduction 5. Adults 5a. Assessment and Treatment Plan Development 5b. Chronological Age Compared to Developmental Age 5c. Ways To Modify Facility Treatment Plans and Staff Expectations 5d. Counseling Strategies 5e. Counseling Strategies: Boundaries 5f. Counseling Strategies: Strengths 5g. Counseling Strategies: History of Abuse 5h. Counseling Strategies: Loss and Grieving 5i. Counseling Strategies: Stigma 5j. Counseling Strategies: Self-Esteem and Personal Issues 5k. Counseling Strategies: Resistance, Denial, and Acceptance 5l. Motivational Coaching 5m. Education, Direction, and Support for Families 5n. Appropriate Birth Control and Referral for Pharmaceutical Assessment 5o. Ongoing Assessment for Comprehension of Information 5p. Transitional Planning and Case Management 6. Adolescents 6a. Treatment Plan Development 6b. Treatment Plan Development: Points to Consider 6c. Medical and Mental Health Assessments 6d. Ongoing Assessment for Comprehension of Information 6e. Educational Support (IDEA and FAPE) 6f. Transitional Planning and Case Management 7. Children 7a. Medical and Mental Health Assessments 7b. Educational Support 7c. Case Management 8. Issues Related to Professional Values and Ethics 9. Matching Activity 10. Posttest 11. References

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

Adults

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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