Conversation with Brandy Mechling, APNA 33rd Annual Conference Presenter

APNA News: The Psychiatric Nursing Voice  |  July 2019 Members' Corner Edition

Brandy Mechling, PhD, RN, PMHCNS-BC is the primary presenter of Piloting the Children's Program Kit: Supportive Education for Children of Addicted Parents: Addressing the Needs of and Promoting Resiliency for Youth Experiencing a Parent with Opioid Use Disorder to be presented at the APNA 33rd Annual Conference. We spoke with Brandy about her research, the importance of intervening on behalf of children with a parent with opioid use disorder, and more.

Brandy Mechling

 

Q: Why should nurses learn more about providing care to children of parents with Opioid Use Disorder?

A: In the US, there are 2.3 million individuals with Opioid Use Disorder (OUD), an addiction to prescription pain pills and/or heroin (Substance Abuse and Mental Health Administration [SAMHSA], 2018). The National Survey on Drugs and Health (NSDUHs) reported that from 2009 to 2014, 1 in 8 children (age ≤17) were residing in a home where one or both parents had a Substance Use Disorder (SUD) (Lipari & Van Horn, 2017). These children experience their parent under the influence, in withdrawal, and/or in detox. They encounter a mother and/or father who is preoccupied with obtaining and using opioids and who may be physically and emotionally absent to them. Children growing up with a parent with OUD tend to face accompanying adversities, including but not limited to: domestic violence, child abuse, poverty, and learning difficulties/academic struggles (Lipari & Van Horn, 2017). Outcomes for these children include increased risks developing mental illness (e.g. conduct disorder, attention deficit hyperactivity disorder, depression, and anxiety), and/or developing a SUD (including OUD), or alcoholism themselves (DiPirro, 2017; Lander, Howsare, & Byrne, 2013). The number of these children entering kinship and foster care is still rising as parents with OUD may be in and out of treatment facilities, become homeless or incarcerated, or overdose and die (Radel et al., 2016).

 

Q: What are the current practices for providing care to this population and what needs should be addressed?

A: Interventions have been either parent-focused or family focused; meanwhile, few interventions exist that focus on the child of a parent with OUD to enhance their protective factors and resiliency. It is imperative that nurses and other health professionals use the evidence regarding protective factors that seem to build resiliency in children of parents with SUDs. Finally, most interventions that do exist are from the late 1980s to early 2000s are not specific to growing up with a parent with OUD. Little evidence exists showing the long-term impact of these interventions.

Parental OUD may be a different experience in comparison to other SUDs, perhaps partly due to the parent’s OUD beginning with prescription pain medications and then often leading to abuse of heroin, methadone, or poly-substances. This further strengthens the argument for tailored interventions to meet the specific needs of this population of children. To our knowledge, no evidence exists to date of utilization and evaluation of the Children’s Program Kit.

 

Q: What is the most important thing you’d like attendees to take away from your presentation?

A: The population of children growing up with a parent with OUD face great risks given the genetic predisposition of mental illness and SUD and the environment in which they are exposed to compromised parenting and additional adversities. Interventions that already exist for children of parents with SUDs can be tailored to meet the needs of children growing up with a parent who has an OUD. These interventions should be developmentally appropriate, strength-based/resiliency building in nature, interactive, and targeted toward the population in need instead of school-wide/based. Our interdisciplinary team was trained by one of the original developers of the Children’s Program Kit: Supportive Education for Children of Addicted Parents (SAMHSA, 2005), a community intervention originally developed for children (grades K-12) in residential settings in which the parent had drug and/or alcohol addiction. Our team tailored the curriculum to be parental OUD specific and found some success in piloting the intervention. As mental health nurses, we are in a prime position in working with these families and identifying the need for the children to receive their own psychoeducation and support regarding their parent’s OUD.

 

Want to see this session? Register now for the APNA 33rd Annual Conference in New Orleans, Louisiana on October 2-5!
 



References
 

DiPirrio, D. (2017). Children of addiction: A single bullet point in the opioid crisis. National Association for Children of Addiction. Retrieved from https://nacoa.org/children-of-addiction-a-single-bullet-point-in-the-opioid-crisis/
Lipari, R. N., & Van Horn, S. L. (August 24, 2017). Children living with parents who have a substance use disorder. The CBHSQ Report. Center for Behavioral Health Statistics and Quality. Substance Abuse and Mental Health Services Administration, Rockville, MD. Psychopathology, 12(2), 235–253.

National Institute on Drug Abuse (NIDA). (2018, January 17). Principles of drug addiction treatment: A research-based guide (3rd ed.). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition

National Research Council and Institute of Medicine. (2009). Risk and protective factors for mental, emotional, and behavioral disorders across the life span. Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press. Retrieved from http://dhss.alaska.gov/dbh/Documents/Prevention/programs/spfsig/pdfs/IOM_Matrix_8205x11_FINAL.pdf

Park, S., & Schepp, K. G. (2015). A systematic review of research on children of alcoholics: Their inherent resilience and vulnerability. Journal of Child and Family Studies, 24(5), 1222-1231. http://dx.doi.org/10.1007/s10826-014-9930-7

Peisch, V., Sullivan, A. D., Breslend, N. L., Benoit, R., Sigmon, S. C., Forehand, G. L., Strolin Goltzman, J., & Forehand, R. (2018). Parental opioid abuse: a review of child outcomes, parenting, and parenting interventions. Journal of Child and Family Studies, 27(7), 2082-2099.

Radel, L., Baldwin, M., Crouse, G., Ghertner, R. & Waters, A. (2018, March 7). Substance use, the opioid epidemic, and the child welfare system: Key findings from a mixed methods study. Washington, D.C.: Office of the Assistant Secretary of Planning and Evaluation, USDHHS. Retrieved from https://www.opressrc.org/content/substance‐use‐opioid-epidemic‐and‐child‐welfare‐system‐key‐findings‐mixed‐methods‐study‐0

Substance Abuse and Mental Health Services Administration (SAMHSA) (2005). Children’s Program Kit: Supportive education for children of addicted parents. DHHS Pub. No. (SMA) 03-3867. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Behavioral health barometer: United States. (2015). HHS Publication No. SMA–16–Baro–2015. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/2015_National_Barometer.pdf

Substance Abuse and Mental Health Services Administration (SAMHSA). (2018). SAMHSA/HHS: An update on the opioid crisis. Retrieved from https://www.samhsa.gov/sites/default/files/aatod_2018_final.pdf

Velleman, R., & Templeton, L .J. (2016). Impact of parents’ substance misuse on children: An update. BJPsych Advances, 22, 108-117. doi: https://doi.org/10.1192/apt.bp.114.014449

Velleman, R., & Templeton, L .J. (2007). Understanding and modifying the impact of parents’ substance misuse on children. Advances in Psychiatric Treatment, 13, 79-89. doi: https://doi.org/10.1192/apt.bp.106.002386

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