Core Competencies for Social Workers in Addressing the Needs of Children of Alcohol and Drug Dependent Parents

Core Competencies for
Social Workers in Addressing the
Needs of Children of Alcohol and Drug
Dependent Parents
A Project of NACoA’s Social Work Initiative
National Association for Children of Alcoholics
11426 Rockville Pike, Suite 301
Rockville, MD 20852

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Acknowledgments
This report was prepared by the National Association for Children of Alcoholics under a contract
for the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for
Substance Abuse Prevention (CSAP), part of the U.S. Department of Health and Human Services
(DHHS). Patricia Getty, Ph.D., served as the CSAP Government Project Officer.
Disclaimer
The views, opinions, and content of this publication are those of the expert panel participants and
authors and do not necessarily reflect the views, opinions or policies of SAMHSA or DHHS.
Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced or copied
without permission from SAMHSA. Citation of the source is appreciated. However, this publication
may not be reproduced or distributed for a fee without the specific, written authorization of the
Office of Communications, SAMHSA, DHHS.
Originating Office
Center for Substance Abuse Prevention
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road
Rockville, MD 20857

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Table of Contents
Introduction ..................................................................................................................................1
Core Competencies for Social Workers in Working with Children and
Families Affected by Parental Substance Use Disorders .....................................................3
Scope of the Problem: Impact of Alcohol and Drug Disorders ........................................5
Substance Use Disorders Initiatives for Social Workers ....................................................6
COA Education Needed by Social Workers .........................................................................6
Council on Social Work Education: Status of Education Policy Statement ....................7
Dissemination and Infusion of the Core Competencies into Social Work Schools
and Continuing Education .........................................................................................................7
Next Steps ....................................................................................................................................9
References ...................................................................................................................................11
Appendix .....................................................................................................................................13


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Core Competencies for Social Workers in Addressing the
Needs of Children of Alcohol and Drug Dependent Parents
A Project of NACoA’s Social Work Initiative
Introduction
The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance
Abuse Prevention (CSAP) is committed to reducing the likelihood that children initiate alcohol and
illicit drug use and to increasing the resiliency of children at-risk for using alcohol or illicit drugs.
SAMHSA/CSAP seeks to build the community’s capacity to identify and provide brief interventions
to at-risk children by working with key segments of the community.
SAMHSA/CSAP identified social workers as one of the key groups crucial to the task of preventing
substance abuse and building resilience in children. Social workers are found in many different
settings and systems of care including primary health, family agencies, child welfare, welfare-to-work
agencies, schools, mental health, employee assistance programs, and substance abuse treatment
agencies. In these capacities, they have multiple opportunities to intervene with families and
children. The approximately 400,000 social workers in the United States are in a unique position to
support families and children impacted by substance use disorders.
In 2005, SAMHSA/CSAP contracted with the National Association for Children of
Alcoholics (NACoA) to develop core competencies1 for social workers on children
The approximately
of substance using parents. NACoA was asked to undertake this assignment based on 400,000 social
the organization’s experience working with multi-disciplinary professionals on similar workers in the United
projects and its extensive experience working with families and children impacted by States are in a unique
substance use disorders (SUDs)2. It has overseen the development of competencies
position to support
for primary care medical staff, early childhood professionals, and clergy and other
families and children
pastoral ministers. These core competencies are being infused into the educational
impacted by substance
and training systems of these respective professions through the development of
use disorders.
curricula for pre-service and in-service education, distance education courses and
community training programs.
To develop the core competencies, NACoA convened two meetings of leading social work
educators and clinicians, one on June 6, 2005 and the other on January 18, 2006. The purpose of
these meetings was twofold: to articulate the knowledge and skills needed by social workers to
address COA3 issues; and to develop strategies to disseminate this information to schools of social
work and continuing education programs. This report is a synthesis of the two expert panels
meetings. Panelists at the meetings represented social work educators, practitioners, student
assistance professionals and staff from both the National Association of Social Workers (NASW)
and the Council on Social Work Education (CSWE). (A list of attendees of both meetings is in
Appendix.)
 For this report, competencies are defined as measurable human capabilities required for effective performance.
Elements of competencies are knowledge, skills and attitudes.
 When used in this report, the term substance use disorders (SUDs) includes alcohol or drug abuse, and alcohol
or drug dependence as defined by the Diagnostic and Statistical Manual-TR put out by the American Psychiatric
Association (000).
 For the purpose of this report, the abbreviation COA will include all children impacted by parental SUDs.


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Core Competencies for Social Workers in Working with
Children and Families
Affected by Parental Substance Use Disorders
Preamble
Substance use disorders (SUDs) create widespread problems impacting one in four children in the
United States. Children of parents who have SUDs (hereby referred to as COAs) often experience
both short-term and long-term effects in their mental and physical health, emotional and cognitive
development, social adjustment, and spiritual and economic well-being. COAs are a vulnerable,
at-risk population that requires the attention of the social work profession. Working with this
population upholds the profession’s core values of social justice, dignity and worth of the person,
importance of human relationships, integrity and competence, and the ethical principles delineated
in the Code of Ethics of the National Association of Social Workers (1999).
The strengths and needs of COAs are diverse, complex, and unique. Each individual is influenced by
his or her stage of human development and level of individual ability, as well as by family functioning,
social supports, and social context. Operating from a social justice perspective, social workers
endeavor to empower people, and to alleviate oppression and economic inequity. Social workers
also address problems in people’s lives in the context of the social environment. Social work
practice has the potential to have a profound influence on the lives of COAs.
Social workers practice in a variety of community and treatment settings and are ideally positioned
to identify and address the effects of parental SUDs on children and their families. In order for
social workers to work with COAs effectively, they need to have an understanding of the nature of
SUDs and how they affect children in the context of the family system. In addition, social workers
need to be aware of their personal values and experiences regarding SUDs, and to recognize the
impact that these personal circumstances may have on their professional attitudes and actions.
To work effectively with COAs, it is essential for social workers to possess the following core
competencies.
Social Work Competencies
1. Understand substance use disorders (SUDs) including the causes, prevention, progression,
consequences, and recovery.
2. Understand the biopsychosocial, cultural, and spiritual ramifications of SUDs as they impact on
COAs and their families from neonatal development through all stages of life.
3. Understand the impact that SUDs have on parenting abilities and the consequences for
children.
4. Understand the intersection of SUDs and other family, health, and social problems, including:
a. family violence (intimate partner violence and child maltreatment)
b. mental health disorders


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c. physical health
d. crime (vulnerability to victimization and risk for criminality)
e. poverty, unemployment, and homelessness
f. educational and vocational opportunities
g. social/cultural biases (including, but not limited to, race, ethnicity, class, sexual
orientation, and disability)
5. Value the importance of early intervention and prevention of SUDs, and prevention of mental
health and social problems for COAs and their families.
6. Ability to engage COAs in a manner that is respectful and non-judgmental of their parents.
7. Ability to screen and assess COAs using developmentally appropriate assessment tools
and methods.
8. Ability to identify, evaluate, and utilize existing research relevant to COAs and their families.
9. Ability to use developmentally appropriate and empirically supported interventions with COAs
and their families, and evaluate the effectiveness of the interventions being used.
10. Understand the concept of resiliency and how risk factors can be diminished and protective
factors can be facilitated in COAs.
11. Ability to help children identify developmentally appropriate formal and informal supports in
their lives, and work with them to enhance their resiliency and mitigate the impact of parental
SUDs.
12. Knowledge of how to access formal and informal community resources on behalf of COAs and
their families.
13. Ability to provide referrals for appropriate services and supports to COAs and their families.
14. Knowledge of social policies pertinent to COAs and their families.
15. Ability to advocate for individual clients, as well as to identify and advocate for appropriate
policies to help COAs and their families.


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Scope of the Problem: Impact of Alcohol and Drug Disorders
Alcohol and drug dependence are the nation’s most pervasive health problems with an estimated
22.5 million (9.4 percent) Americans over 13 years of age classified with substance use disorders in
2004. Of these, 15.2 million suffered from alcohol dependence or abuse, 3.9 million abused or were
dependent on drugs, and 3.4 million had disorders related to both alcohol and drugs (SAMHSA
2006). However, only 3.8 million people received any treatment for alcohol or drug disorders. In
addition, a high incidence of co-occurring mental illness and substance dependence or abuse was
reported. Approximately 21 percent of people with serious mental illness also abused or were
dependent on alcohol or other drugs (SAMHSA 2006).
Substance use disorders impact far more than just the alcoholic or drug dependent individual.
They dramatically affect the families and children living in households with people who have SUDs.
Research supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found
that nearly one in four children live with alcohol abuse or dependence in their family (Grant 2000).
Many other children are exposed to families where there is illicit drug use.
The impact of exposure to parental alcohol and other drug dependence on children is staggering.
Parents who abuse alcohol or illicit drugs are three times more likely to abuse their children and
four times more likely to neglect their children than parents who do not abuse alcohol or use
drugs (Reid et al. 1999). In fact, 80 percent of parents with children in the child welfare system
have alcohol or drug problems that interfere with their caretaking (Reid et al. 1999). Without help,
COAs are at a greater risk for a myriad of problems including physical and emotional abuse, mental
health problems, health problems, poor school performance, truancy, and encounters with the law
(Famularo et al. 1992; Duke et al. 2001; Anda et al. 2002; Earls et al. 1988; Sher 1997; Moss 1995).
They are also more likely to experience depression, conduct disorders, or anxiety and have a higher
risk of abusing alcohol or drugs to self-medicate (Anda et al. 2002; Kumpfer 1999).
Research shows that with appropriate help and support, COAs can develop
Therefore, professionals
resilience and lead productive lives (Werner & Johnson 2000; Werner 1986).
who encounter COAs
Therefore, professionals who encounter COAs in their work must have basic
in their work must have
knowledge about SUDs and their impact on developing children. They must possess basic knowledge about
the appropriate skills necessary to intervene early in these children’s lives in order
to minimize the damage associated with children’s familial exposure to SUDs and
SUDs and their impact
promote resilience in these children.
on developing children.
Social Work and Its Relation to COAs
Dr. S. Lala Ashenberg Straussner, Professor of Social Work at New York University, served as Chair
of the two NACoA panel meetings. She described the historical interest of social workers in
working with individuals with alcohol problems and their children. This began in 1917 when the
“mother of social work,” Mary Richmond, called inebriety a disease that could be treated and
not a moral failing. This set the foundation for the continued social work interest in alcoholics
and their families by Margaret Bailey, as reflected in her publication “Alcoholism and Family
Casework” (1968), and by Margaret Cork, who wrote the classic, “The Forgotten Children” in 1969
(Strausssner, S.L.A. 2001).
As noted earlier, social workers provide services in many systems of care. Given the extensive
nature of alcohol and drug problems in the population, and the many problems associated with


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substance use disorders, all social workers need to have basic competencies in screening, brief
interventions and referral for both the individual suffering these disorders and the impacted
children to reduce the inter-generational transmission of SUDs.
Substance Use Disorders Initiatives for Social Workers
A number of organizations and Federal agencies have focused on increasing social workers’
knowledge and skills in dealing with SUDs. This growing attention to SUDs is evidenced by a
number of initiatives which started in the 1990s. An important step was the formation of NASW’s
specialty practice section on Alcohol, Tobacco and Other Drugs (ATOD) in 1996. Shortly thereafter,
NASW developed a certification for social workers specializing in the ATOD field. In 2001, a peer
review publication, the Journal of Social Work Practice in the Addictions was introduced.
The Association for Medical Education and Research in Substance Abuse (AMERSA) developed
a Strategic Plan for Interdisciplinary Faculty Development (2002) which included a set of core
competencies for 14 distinct healthcare disciplines, including social work. In addition, the chapter of
the AMERSA strategic plan devoted to educating social workers about SUDs included a set of core
competencies for generalist social workers (Straussner & Senreich 2002).
Within the federal government, NIAAA, the National Institute on Drug Abuse, SAMHSA/CSAP,
SAMHSA Center for Substance Abuse Treatment, and the Health Resources and Services
Administration have supported various SUD research and educational projects in social work.
SAMHSA/CSAP produced Curriculum Modules on Alcohol and Other Drug Problems for Schools
of Social Work in 1995. The intent of this project was to expand the content of social work
education in the area of alcohol and drug disorders prevention. NIAAA has an online curriculum,
the NIAAA Social Work Education for the Prevention and Treatment of Alcohol Use Disorders,
which can be found at http://pubs.niaaa.nih.gov/publications/Social/main.html (accessed on June 12,
2006), designed specifically for social work educators to use in their course work. The panelists
recommended the NIAAA curriculum as an excellent science-based resource.
COA Education Needed by Social Workers
The consensus of the panelists was that, although substance use problems permeate the social
systems and client populations that social workers serve, social work education and practice pays
minimal attention to these issues. Therefore, the panelists recommended that content on COAs
be taught in the foundation social work curriculum to ensure that all social workers possess the
knowledge and skills to work effectively with COAs.
When asked to define broadly the critical knowledge that social workers should receive as part of
their basic education to support COAs, there was consensus on these areas:
•
Understand the effects of SUDs and their impact on children, families and community
•
Knowledge of SUDs prevention strategies
•
Knowledge of SUDs treatment strategies
•
Knowledge of the impact of substance use on child and adult development.
These general knowledge areas were the basis for the competencies.


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