Children of alcoholics: implications for professional school counseling

Professional School Counseling, Feb, 2005 by Glenn W. Lambie, Shari M. Sias

Children of alcoholics (COAs) need the support of professional school counselors (PSCs). These students" family dysfunctionality places them at high risk for adverse academic, physiological, emotional, and social consequences. This article (a) introduces alcohol abuse as a family illness, (b) describes the possible effects of family alcohol abuse on children, (c) identifies potential indicators of COAs, and (d) offers suggestions that PSCs may implement to support students and their families. Currently, many COAs remain unidentified within schools; therefore, these students may not be receiving the counseling services they deserve and require.

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Alcohol abuse affects the entire family, yet only recently has attention focused on the needs of children with parents or guardians who abuse alcohol and/or other drugs. Professional school counselors (PSCs) must be prepared to identify and address the needs of these students. Parental alcohol abuse presents serious academic, emotional, physical, and social problems to families, schools, and society at large. Alcohol-abusing parents generally are ineffective in meeting their children's educational, developmental, social, and emotional needs (Robinson & Rhoden, 1998). Therefore, early prevention and intervention efforts are essential in these students' lives. For the purposes of this article, the term children of alcoholics (COAs) will encompass children living in families where parental or guardian alcohol abuse, dependence, and/or addiction is present.

The problem of parental alcohol abuse is pervasive in the United States. An estimated 9,700,000 children (or 15% of the 66 million children) 17 years of age or younger are living with an adult diagnosed with alcohol abuse or dependence in the past year. Additionally, findings from a national longitudinal alcohol epidemiologic survey suggest that 1 in 4 children younger than 18 years of age in the United States are exposed to alcohol abuse or dependence in their family (Grant, 2000). Families abusing alcohol are often closed systems; family members are not encouraged to build relationships outside of the immediate family, and the "family secret" of alcohol abuse is hidden from other individuals in the community (Edwards, 2003). Therefore, these statistics on the prevalence of COAs are probably conservative. Consequently, based on these national statistics and the occurrence of underreporting, an average PSC caseload of 477 students (U.S. Department of Education, 2003) may have approximately 120 students who have been or will be exposed to alcohol abuse or dependence in their family.

Further complicating the issues of COAs is that many alcohol-abusing parents have coexisting psychiatric disorders. To describe the condition of a person having both a psychiatric disorder and a chemical dependency, the terms dual disorder, dual diagnosis, comorbidity, and co-occurring disorders often are used. Research findings suggest that an estimated 50% of substance abusers have at least one mental illness (Brooner, King, Kidorf, Schmidt, & Bigelow, 1997; Halikas, Crosby, Pearson, Nugent, & Carlson, 1994). Often individuals with dual disorders are experiencing tremendous psychological pain, which is apparent in their much higher rates of suicide and suicide attempts than the general population. Consequently, caretakers with comorbidity are generally less able to meet the emotional, educational, and social needs of their children.

Alcohol abuse is a multigenerational issue, in which this biopsychosocial disorder often is passed from one generation to the next. This is evident in the research in which COAs have been found to be 4 times more likely than non-COAs to develop alcohol abuse or dependence (Brook et al., 2003; National Association for Children of Alcoholics [NACOA], 1998). Parental alcohol abuse often presents potentially long-term behavioral, social, and psychological problems for these children including depression, anxiety, and conduct disorders, as well as the development of rigid and inflexible coping skills (Bosworth & Burke, 1994; Fals-Stewart, Kelley, Cooke, & Golden, 2003). The trauma the children experience while growing up often results in relationship problems and developmental disabilities (Fields, 2004). Sadly, only a small portion of these young people receive any type of professional counseling services.

Paradoxically, according to the American School Counselor Association (ASCA, 1997), the core goal of professional school counseling programs is to provide "all students with life success skills" (p.1). Furthermore, the ASCA (2004b) position statement At-Risk Students advocates that PSCs employ prevention and consultation strategies while being proactive leaders in the identification of "at-risk" students. However, research on COAs highlights the inconsistency between the advocated PSC objectives and the services these students actually are receiving. This article provides PSCs with information on COAs and, more specifically, an introduction to alcohol abuse as a family illness, a description of the possible effects of family alcohol abuse on children, potential indicators of COAs, and suggestions that PSCs may implement to support COAs and their families.