Jeff Foote, PhD Shares his Expertise on Parent Coaching for Addiction Treatment
Dr. Foote, Co-Founder and Executive Director at the Center for Motivation and Change (CMC) in New York, spoke during our Addiction Speaker Series about the organization’s national peer-to-peer parent coaching network for treatment of substance use, compulsive behavior disorders and trauma. We had the pleasure of interviewing Dr. Foote about CMC’s work.
What is a peer-to-peer coaching network? Why did you take this approach?
It is a national self-help, peer-to-peer support network for parents that uses evidence-based principles for helping families of loved ones struggling with substances. The Partnership for Drug-Free Kids came up with this great idea.
The number of families facing substance issues is enormous and these families cannot possibly be served adequately by our current health care system. Self-help programs like Alcoholics Anonymous can provide support for people making change. We wanted to both replicate this peer-to-peer support – relying on the enormous experience, strength and willingness of parents who have gone through these difficulties – but also find a way to introduce some of the powerful evidence-based approaches that we know helps families.
Together, CMC and the Partnership for Drug-Free Kids are helping parents and families – many who often feel helpless, hopeless, embarrassed, ashamed and incompetent. This program aims to empower parents to help other caregivers stay connected to their kids and get the support and encouragement they so desperately need.
What are your goals for the peer-to-peer support network for parents?
Overall, the goal was to develop a national self-help, peer-to-peer support network for parents that utilizes evidence-based principles for helping families of loved ones struggling with substances. The hope is that this will:
- Address the huge unmet need for help among families
- Facilitate the dissemination of evidence-based principles of change
- Act as a counterforce to the culturally accepted stigmatizing view of substance use issues
- Contribute to “changing the conversation”
The parent coaching network utilizes a peer-to-peer, shared experience model of helping using evidence-based principles of change, which include the communication, behavioral, and psychological tools and principles found in several EBT approaches:
- Community Reinforcement and Family Training (CRAFT)
- Motivational Interviewing (MI)
- Acceptance and Commitment Therapy (ACT)
The key areas of focus for coaches include a) understanding substance use issues in non-judgmental, behavioral and contextual terms, b) focusing on self-care by parents as a crucial aspect of the family change process c) teaching communication strategies to allow engagement and lower defensiveness and d) teach straightforward behavioral reinforcement strategies to help parents affect behavior change.
What are some of the barriers parents face in helping their children who have addiction?
When confronted with a child struggling with substances, parents are typically both at a loss for effective, clear information, as well as being thrown into emotional turmoil. There are often a slew of black and white solutions thrown at them, but very little advice based on:
- Evidence of what has been proven to work; and
- Approaches that help take in the bigger picture. For example, the type of emotional or psychiatric issues their child is facing; how long and how severe the substance issue has been present; and what function (positive and negative) does it play in their child's life (anxiety reduction, social acceptance, etc.).
Most importantly, substance issues bring with them the cultural baggage of stigma, secrecy and shame, often resulting in families choosing to not discuss these issues, and not seek advice or help. Isolation of this sort typically contributes to a worsening of the situation for everyone in the family.
You mentioned the idea of “willingness.” Why is that so important to the program?
“Willingness” is central to our discussions with new coaches as well as the parents they will be talking with. Basically, the concept is one of acknowledging pain; the pain of having a child struggle, the pain of not being able to fix things, the pain of coaching another parent and not having “the answer.” These are the realities of dealing with substance problems in families, and the ability to allow for this pain and not have to come up with an immediate solution, and make the pain go away is incredibly helpful.
Parents in particular are understandably frantic and want to protect their child. But responding helpfully is not the same as making it all better. Often, it means learning ways to move forward in spite of the troubles, in spite of the pain, so that everyone can remain as constructive as possible.
What are some of the myths of motivation in relation to this topic?
There are many beliefs in our culture that reflect inaccurate understandings of motivation, and how to help with another person’s motivation to change. Some common myths include:
- Confronting someone about their problems helps them change
- It usually takes a crisis, or hitting “bottom,” for someone to become motivated to change
- Motivation hits in one revelatory moment; and once it hits, it sticks
- Until someone is motivated to change, there is nothing that can be done to help them
What we know from a large array of treatment research studies (as well as general research on human motivation) is as follows:
- Confrontation negatively affects motivation
- Motivation can occur whenever the costs of a behavior perceptibly outweigh the benefits
- Motivation is a fluctuating state, based on gradual stages
- Motivation is facilitated by interpersonal interaction
What have been the most inspiring aspects of working with the parent coaches?
The most inspiring aspect about the coaches is the coaches themselves! They are a group who personify the idea of “willingness.” They have been through tremendous pain and struggle in their own families and have still decided to come forward and share their knowledge and strength with others. They have lived through heart-break and instead of breaking (or staying broken) they have grown and committed themselves to change, offering their time and making themselves available to other parents who are frightened, angry and suffering. They are then willing:
- to experience “failure” and loss and keep moving in a direction that matters to them
- to experience the pain of the parents they are coaching, even when it increases their own
- to experience not knowing the “answer” in the face of this pain
Jeff Foote, PhD
Dr. Foote is Co-Founder and Executive Director at the Center for Motivation and Change