In 2005, when Lauren Mausbach was 19, she tried cocaine for the first time. Just a year later, she was introduced to meth, and for the next six years she lived out the too-familiar story of an addict. She bounced between apartments, the homes of relatives and friends, and was caught up in abusive relationships. Eventually, her family turned her away.
When things got really bad in August 2012, Mausbach’s parents took in her 5- and 7-year-old boys while she moved in with her boyfriend and his family. As the abuse Mausbach endured from her boyfriend escalated, she sought help at Terros Health, a local provider of recovery and other behavioral health services in Phoenix, Ariz.
She attended group therapy three times a week, which gave her the courage to leave her abuser. But she continued to get high. A long shadow was cast over the Valley of the Sun for Mausbach when her mother reported her to the Arizona Department of Child Safety (DCS).
That September, when she moved to a halfway house where sobriety was mandatory, Mausbach stopped using. It was two weeks later when she got the call from DCS, which had been unable to track her down sooner because she hadn’t had an address.
“They said my kids were no longer mine, they were a ward of the state,” Mausbach said. “They said ‘You’re an unfit and an unsafe parent, we think you’re a danger to your kids,’ which was terribly upsetting. It was a tough pill to swallow.”
Newly sober, her immediate challenge was not going back to drugs to numb the pain of losing her kids.
Learning to Choose Better
Researchers have tried to better understand addiction by experimenting with rats, placing them in isolation or social settings and observing whether they choose friends, food and other social stimuli, or morphine-laced water.
Other researchers have examined addiction through different lenses. Vincent Felitti collected data from thousands of adults in the 1990s for his paper, “The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study.” He determined that the origin of addiction may lie in childhood trauma, such as abuse and neglect, or loss of a parent through divorce, incarceration or death.
Childhood trauma has been linked to feelings of isolation and numerous behavioral and cognitive issues. Social scientist Brené Brown’s qualitative research points to shame and lack of belonging — also related to trauma — as the origin of not only addiction but dysfunction of all kinds.
All of this suggests that the root of addiction may lie in social conditions, in having too few connections and too few choices in life.
“It’s not uncommon for people with substance use disorder to think it’s just them and to isolate themselves,” said Ron Carpio, chief of health and family services at Terros Health.
Terros and other addiction treatment programs often emphasize community, connection and openness – an approach thought to be the antidote to the shame, guilt and secrecy that can contribute to addiction. People are encouraged to talk about the impulses and obsessive thoughts that push them to cope by using substances.
Carpio says group treatment helps people with substance use disorder understand that they’re not the only ones feeling the way they do and to see that it’s not helpful to beat themselves up. “It creates community and that’s key to getting to behavior change — in recovery they realize they have choices and then can make better choices,” Carpio said.
Terros Health, where Mausbach found help and today works as a peer recovery coach, serves families who have been referred by the Department of Child Safety through a state initiative called Arizona Families FIRST (AFF).
Through Terros, Mausbach participated in group and individual counseling, domestic violence counseling, frequent drug testing, parenting classes, volunteer work, a full-time job, daily 12-step meetings, plus mandatory court dates and visits with her kids. She regained custody of her children 13 months after her DCS case was opened and celebrated her five-year sobriety anniversary in September 2017.
She said busy-ness is critical to recovery. “You’re so in your head in the beginning that it’s imperative that you do something bigger than yourself, outside yourself, otherwise you’ll dwell on guilt and shame. It’s a million times harder to be away from your kids when you’re sober. You have to feel it and accept it,” she said.
Arizona Families FIRST is unique, Carpio says, because it is “dually administered” by the state’s healthcare and child welfare systems. This means that all child-welfare-involved families receive the same program and same services, regardless of which agency foots the bill.
It also means families get other assistance, like transportation to treatment or work, or help paying rent. Some participants have been given bicycles so they could get around on their own.
In fiscal year 2015-16, 12,261 people received a referral to the AFF program, and about 60 percent of those individuals accepted services, according to its annual evaluation. Of those who successfully completed the program, 56.8 percent had no subsequent reports to DCS. Upwards of 50 percent of the children associated with a referral to the AFF program between April 30, 2011 and June 30, 2016 had been reunified with family or adopted by the end of SFY 2016.
According to Carpio, foster parents could play an important role in helping birth parents who are struggling with substance abuse.
“Ultimately kids want to go home, and parents can succeed. Foster parents can show them what stability looks like by role modeling a functional family,” Carpio said. “They can demonstrate for kids that their [birth] parents aren’t bad by being supportive,” he said, rather than judging or stereotyping them.
Mausbach agreed. “My parents made it clear from the start that they didn’t want to raise my kids. They wanted me to get help so I could raise my kids,” she said.
Most of Mausbach’s clients at Terros don’t have the support system that she had in her parents. That void, Mausbach says, is one foster parents could help fill. She said there is a huge difference between her clients who had strong partnerships with the foster parents caring for their children during recovery, and those clients who did not.
Those clients who co-parented with foster parents view the child welfare system differently, she says, and they seem to better understand that other people want to help with their kids, not take them away.
“It is so important that foster parents get involved, otherwise it feels adversarial,” Mausbach said.
A Too Common Scenario
A 2017 study from the Morrison Institute looking at Arizona found that substance abuse by the caregiver was found in 55 percent of the cases where a child was removed from their home within 30 days of a child neglect report.
Last year, in Colorado, an administrator in Pueblo told U.S. News & World Report that parental drug abuse was responsible for a nearly 45 percent increase in kids placed in out-of-home care between 2011 and 2016.
An annual report from the federal Department of Health and Human Services estimated that, nationally, substance abuse was a factor in 34 percent of cases where children were removed from their homes in 2016, up from 28.5 percent in 2012.
The first thing foster parents should understand about addiction is that it’s not what we’re taught to believe it is, according to Terros’ Carpio and numerous researchers.
As Felitti’s research suggested, one of the strongest determinants of whether someone becomes an addict is childhood trauma, such as that experienced by a child when they’re removed from their family, or when they are physically, emotionally or sexually abused.
The first step, according to Carpio, is getting a birth parent to understand how their addiction impacts their family.
Once a birth parent is in the program, they are surrounded by community, reinforcing the message that they are not alone.
Foster parents can offer support to a birth parent by engaging in recovery rituals such as celebrating milestones or going to meetings, by having compassion for the recovery struggle, and just acknowledging to birth parents and their children that they see the birth parents working to overcome their addictive behaviors.
Ultimately, it’s about trying to reduce the trauma for the kids through support of the birth parents, and lowering the risk that the kids will also use down the road, according to Carpio.
Across the country, in North Carolina, Marcia (pronounced Mar-cee-yah) Stott Ballard is exemplary of everything Carpio alluded to.
Ballard’s son was born substance-exposed and placed into her care when he was just a few weeks old. She formally adopted him when he was 13 months.
Now, he’s 11, and Ballard says they both have an open, honest relationship with his birth mother, who has struggled for years with substance abuse but who Ballard believes is sober now.
A former social worker, Ballard sees the foster parent’s role as that of a cheerleader.
“There are some phrases you (almost) cannot say [to a birth parent in recovery] too many times. ‘I’m proud of you, I want to see you succeed at this, little Jane is counting on you, she needs you and there is no replacement of you in her life,’” Ballard wrote in an email to Fostering Families Today.
“It is extremely hard on the foster parent to see a birth parent gain, and then lose ground. You can feel like you’ve invested and invested then you watch them take big steps back,” she said.
Part of what makes the relationship with her son’s birth mother work, Ballard said, is their commitment to respect and honest communication. “You have to speak up when you see them making a bad decision, but you also have to know that they might tell you to butt out,” she said.
If she could advise other foster parents about how to prepare to care for a child with family struggling with addiction, Ballard said the main thing is to remember that there is no book on how to do it. “You’re in charge of the child’s safety, and you have to be ready to make up some rules as you go,” she said.
When it comes to talking to the child about their birth parents’ addiction issues, Ballard says less is more.
With her son, she told him his birth mother had some problems, and that his mother loved him but she couldn’t take care of him. Today, Ballard says she always welcomes questions from her son, but because he’s known his birth mother his whole life, and has a complete narrative, he doesn’t have a lot of questions.
“They’ve got the rest of their life to fill in the details,” she said.
Focus on the positive while acknowledging the truth of the past.
Back in Arizona, Mausbach said her parents and her DCS caseworker never seemed to waiver in their confidence that she could succeed.
“They always treated me like I could do it,” Mausbach said. “That really opened my eyes to see that the department wasn’t there to take my kids. They wanted to help me be the mother they knew I could be.”
There’s just one thing Mausbach would like foster parents to understand about birth parents facing addiction and doing the difficult work of recovery:
“Just because they use drugs doesn’t mean they don’t love their children. No one in their right mind would choose drugs over their children. No one. They must be hurting.”
Carpio, of Terros where Mausbach works, says foster parents can participate in the recovery process to the extent they feel comfortable by attending meetings like Parents of Addicted Loved Ones and just talking with the birth parent about their progress and challenges.
“If we can keep addiction out in the open, people will be better off. I’m not sure who said it, but the opposite of addiction is connection,” Carpio said, referencing a TED Talk by British journalist Johan Hari. “Those who do best are those who are connected to their community. The child welfare community needs to better educate foster parents in this area.”