Developing Resilience as a tool for Breaking the Cycle of Substance Use

Building Resilience & Reducing Harm, Sanford Inspirations, 2017

Developing Resilience as a tool for Breaking the Cycle of Substance Use

Children and youth with adverse childhood experiences include those that have experienced “all types of abuse and neglect, parental mental illness, substance use, incarceration, and domestic violence.”[1] These children and youth are at an increased risk of “developing both chronic diseases and substance use disorders.”[2] Recent studies reveal that 54% of youth age 12-17 used alcohol at least once and 41% had used marijuana while in care.[3] Additionally, youth currently in foster homes reported using drugs other than marijuana, including “hallucinogens (13.5%), stimulants (12.1%), non-street opiates (9.8%), and powder (5.5%) and crack cocaine (5.2%), all of which were higher than the comparison group.”[4] Additionally, youth in foster care “begin substance use at an earlier age than their peers who had not been in foster care,” placing them at an increased risk for developing substance dependence disorders.[5]

Many youth in the child welfare system turn to substance use as a way to cope with their past trauma experiences.[6] However, this coping mechanism has a detrimental and harmful effect on the lives of many youth who have been in the child welfare system. Substance usage not only puts youth at risk of developing substance disorders, but it also results in an increased risk of academic difficulties, difficulty building lasting relationships, and involvement with the juvenile justice system.[7]

Child welfare systems across the country have sought to address the issue of drug use among foster youth, but “no system has mastered the prevention of drug use among foster kids.”[8] Child welfare systems typically refer children and families to substance treatment programs ex post. Additionally, systems have began  (1) differentiating behaviors from underlying needs in order to better identify and address children’s needs, (2) collaborating with and integrating other systems, including the Department of Mental Health, and (3) placing children with the highest needs in group care with specially trained caregivers.[9] However, at a more granular level, resilience appears to be an underdeveloped tool that may help many youth break the cycle of substance abuse.

Resilience is “the ability to overcome obstacles, preserve through hardships, as well as the ability to balance negative experiences with positive factors that protect [a child’s] overall well-being.”[10] This skill allows youth to bounce back from difficulties and more easily adjust to change. Resiliencies have been grouped into seven categories: 

[1]Insight begins with a sense that life in the troubled family is strange. Such insight

can eventually protect the child from a tendency to internalize family troubles and feel

guilty.

[2] Independence is the child separating herself from the troubled family.

[3] Relationships fulfill needs that troubled families cannot meet.

[4] Initiative is the desire to overcome feelings of helplessness that a child can succumb

to in the troubled family.

[5] Creativity is the ability to take pain and transform it into something artistic and

worthwhile.

[6] Humor allows the child to make the tragic into something comic and laugh at his

emotional suffering.

[7] Morality is developing a set of principles that differentiates bad from good both

inside and outside the family.[11]

Resilience provides children and youth with adverse childhood experiences the ability “to fantasize about another time or place, [be] able to read and learn about a better time and place, realiz[e] that they are not responsible for the abuse directed at them, and hav[e] an adult in their life for a considerable period of time who sees them in a positive way.”[12] Furthermore, a 2012 article published in the Journal of Alcoholism: Clinicial and Experimental Research reported, “that relisiliency is related to lower levels of initial substance use, fewer problems with alcohol, and better working memory.”[13] Several characteristics of resilient youth (including high self-esteem, empathy, help-seeking, and self-awareness) overlap with “factors that deter children from engaging in harmful substances like tobacco, marijuana and alcohol.”[14] Thus, developing resilience in children in foster care could help some children break the cyle of substance dependence.

While resilience should not take the place of other court ordered services, supports, or treatment programs, it should be viewed as a vital skill that every child and youth in foster care is given the opportunity to develop. Furthermore, in seeking the best outcome for children in foster care, every individual (foster parents, attorneys, social workers etc.) in contact with the child should play an active role in helping the child build resilience by encouraging insight, independence, relationships, initiative, creativity, humor, and morality.


[1] Resilience Helps to Prevent Youth Substance Use (Feb. 24, 2020), https://accesshealthme.org/resiliency-helps-to-prevent-youth-substance-use/.

[2]  Id.

[3] Jordan M. Braciszewskia & Robert L. Stout, Substance Use Among Current and Former Foster Youth: A Systematic Review, Child Youth Serv Rev. (2012) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596821/.

[4] Id.

[5] Preventing, Identifying, and Treating Substance Use Among Youth in Foster Care (Oct. 2020), https://www.childwelfare.gov/pubPDFs/bulletins_youthsud.pdf.

[6] Understanding Substance Use Disorders—What Child Welfare Staff Need to Know, https://www.cffutures.org/files/nccan2019/web/usud/CWS_Practices_Tip_Guide%231_bg_cv.pdf.

[7] Consequences of Youth Substance Abuse (May 1998),  https://ojjdp.ojp.gov/sites/g/files/xyckuh176/files/pubs/drugid/ration-03.html.

[8] American Addiction Centers Editoria Staff, 3 Risk Factors for Foster Youth Drug Abuse (June 30, 2021), https://rehabs.com/blog/3-risk-factors-for-foster-youth-drug-abuse/.

[9]  Id.

[10] Resilience Helps to Prevent Youth Substance Use, supra note 1.

[11] Braciszewskia & Stout, supra note 3.

[12] Id.

[13] Resilience Helps to Prevent Youth Substance Use, supra note 1.

[14] Id.

Disproportionate Representation of Children of Color in the Child Welfare System

The child welfare system and foster care were initially implemented as tools to help provide assistance to dependent children while the biological parents were temporarily unable to do so either because of neglect or abuse in the home. At face value, this purpose seems commendable. However, families and children of color have been disproportionately represented in these systems and are “more likely to experience negative outcomes compared to white families.”[1] According to 2019 data from The Annie E. Casey Foundation, Black children only comprise 14% of the population, but account for 23% of children in foster care.[2] Similarly, non-Hispanic children with multiple race groups only comprise 5% of the population, but account for 8% of the children in foster care.[3]

The American Bar Association has identified five factors that may explain the disproportionality and disparity surrounding racial groups and low-income families in the child welfare system:

  • correlation between poverty and maltreatment;
  • visibility or exposure bias;
  • limited access to services;
  • geographic restrictions; and
  • child welfare professionals knowingly or unknowingly letting personal biases impact their actions or decisions.[4]

Notably, many of these factors boil down to (1) families lacking resources and access, and (2) child welfare reporter and investigator bias.

At the individual level, addressing the disproportionality and disparities in the child welfare system call for confronting one’s own implicit and explicit biases in reporting, investigating, intervening, and making decisions in the placement process.[5] This is not only important for attorneys, judges, social workers, and other professionals involved in making decisions in child welfare cases, but also anyone who plays a role in referring a child to the system. At the systematic and policy level, other strategies for addressing the disparities include, “developing culturally responsive practices, recruiting and retaining foster families of color, engaging communities of color when developing new policies, and using data to identify and address disparate outcomes.”[6] For a deeper analysis of these strategies see the additional resources linked at the bottom of the Disproportionality and Race Equity in Child Welfare article.

Legislative measures have been enacted at both the federal and state level to address the disparities in the child welfare system. Federal acts include the Family First Prevention Services Act of 2018, the Multiethnic Placement Act of 1994, and the Indian Child Welfare Act of 1978. While state legislation varies, it typically aims to engage communities of color in creating child welfare policies or requires states to examine outcomes for children of color in the child welfare system.[7]

So, why does this matter? Simply put—there is a cost that each child pays for entering the child welfare system, even though they enter the system through no fault of their own. Furthermore, this cost is often higher for children of color. Children of color are “​​more likely to experience multiple placements, less likely to be reunited with their birth families, more likely to experience group care, less likely to establish a permanent placement and more likely to experience poor social, behavioral and educational outcomes.”[8] So long as disparities in outcomes exist for children of color and White children who enter the child welfare system, it cannot be said that the system is working equally for all children. Thus, it is imperative that individual actors and legislatures continue to pursue strategies to address the disproportionality and disparities in the child welfare system.

[1] Disproportionality and Race Equity in Child Welfare, Nat’l Conference of State Legislatures (Jan. 26, 2021) https://www.ncsl.org/research/human-services/disproportionality-and-race-equity-in-child-welfare.aspx#Numbers.

[2] Child Population by race in the United States, The Annie E. Casey Foundation: Kids Count Data Center (2019)

https://datacenter.kidscount.org/data/bar/103-child-population-by-race?loc=1&loct=1#1/any/false/1729/68,69,67,12,70,66,71/424; Children in foster care by race and Hispanic origin in the United States, The Annie E. Casey Foundation: Kids Count Data Center (2019) https://datacenter.kidscount.org/data/bar/6246-children-in-foster-care-by-race-and-hispanic-origin?loc=1&loct=1#1/any/false/1729/2638,2601,2600,2598,2603,2597,2602/12993

[3] Child Population by race in the United States, supra note 2; Children in foster care by race and Hispanic origin in the United States, supra note 2.

[4] Krista Ellis, Race and Poverty Bias in the Child Welfare System: Strategies for Child Welfare Practitioners, Am. Bar Ass’n (Dec. 17, 2019) https://www.americanbar.org/groups/public_interest/child_law/resources/child_law_practiceonline/january—december-2019/race-and-poverty-bias-in-the-child-welfare-system—strategies-f/.

[5] Ellis, supra note 5; Disproportionality and Race Equity in Child Welfare, supra note 1.

[6] Disproportionality and Race Equity in Child Welfare, supra note 1.

[7] See id.

[8] Id.