members and people that are in long-term recovery, as it were, to get all of those services covered. we have a long ways to go, but we are working very hard to get the country ready for 2014 when health reform will actually take hold in a bigger way and we'll have so many more thousands of americans that will have health insurance coverage that they've never had. we know from the research that when family therapy is integrated with substance abuse treatment, outcomes are enhanced. we know that we have better rates of engaging people in treatment, better rates of keeping people in treatment when they would otherwise drop out, improve long term outcomes, lowering societal costs of addiction, actually decreasing rates of domestic violence in families and decreasing or lessening the effects of addiction on children, and, therefore, interrupting that intergenerational cycle. well, that's wonderful. nancy, talk to me about the children and family futures and

what they're doing to really help to integrate new approaches to reduce the number of individuals that lose their children. well, we work with community members and the child welfare system, the addiction treatment and the mental health service system to ensure that they are communicating. that when a child is identified as having a parent with either a mental or a substance use disorder that that child is put-i loved the way that erica framed that she wasn't there and able-wasn't present to be able to take care of her children. and i resonate with that because i am the child of a mother with a serious mental illness, and i think we sometimes think of this as only being about addicted families. and yet those children in which parents have a mental health issue are also those that exhibit some of those same kinds of things.

so when we're looking at what is happening in the life of that child, when is the issue of neglect such that a formal system has to step in. and yet, there are many things that community members, church members, the faith community, school staff, you know, the individual that takes a young child and mentors that child can play just as an important role as the formal system. we are going to take a look at exactly that. how do we take a young person and how does society insulate that young person that may be experiencing a dysfunctional family scenario. we'll be right back. [music playing]

before, addiction and depression kept me from living my life. and now, every step i take in recovery benefits everyone. there are many options that make the road to recovery more accessible. it begins with the first step. join the voices for recovery. for information and treatment referral for you or someone you love, call 1-800-662-help. brought to you by the u.s. department of health and human services. [music playing]

i think the exodus program is a rare opportunity to, it's one of those one-in-a-million shots where you don't think that a place like this exists. the exodus program is a all-around supportive environment providing a safe and nurturing atmosphere for the families. we feel that the families progress through the program living life on life's terms because they experience everyday living. they take care of their children. they cook for their children. they get their children up to go to school. so the benefit of being in a one-shop model where everything is onsite is such a benefit to the families. i think, overall, the families here at the exodus program respond really well to just the genuine concern that our staff displays to them on a day-to-day basis.

one of the things that we try to do as early on as possible is to try to have our clients develop a real positive support system. whether it be through church, through meetings, through other peers that are here at the program, reconnecting with their family members. i think that's definitely the first step. well, having a place to live and being around other families that are like ours is very helpful because i feel like we get to help each other. and it's not just me getting help. i see that i am not alone. i enjoy that all of our family is together. everybody is focused and doing what they are supposed to do. i mean, it just makes us feel comfortable knowing that we have somewhere safe to be. i would say the most important things that i'm learning about my recovery is that there is hope, there is help. you learn something new every day especially when you are doing it under a clean and sober mind; it's a big difference. you learn how to deal with life situations as they come at you, in a positive manner, in a positive aspect, and

that's the best thing that i seem to learn every day. i learn how to be a mother the way a mother should be. the heros and sheros youth prevention program was developed to serve the 5- through 18-year-old youth of the parents that are receiving substance abuse services through shields for families. that program is a culturally enriched environment in which the children come to an afterschool program when they leave their elementary school and are provided tutoring, mentoring, one-on-one homework assistance. it's just a wonderful supportive leg for the families to have. we want to encourage these youth to go to school and further their education and let them know that anything that they want is obtainable. we also want to bring back the families. you know, we want to make sure that they are cohesive and they work well with each other and in addition we also want to build the community as a whole. we respect our clients, we value our clients' opinions about

the services that are provided, and we listen real well to what our clients have in reference to input. and we recognize that our families bring a host of strengths to the table and we try to capitalize on what those strengths are. having a community of people who are also in recovery helps our clients learn to let go of that guilt and shame that they have regarding their addiction and that they are now in recovery and that that is what they should really be proud of. and i go through this and i sit with the women and i talk to them and we go through our individuals and i hear it over and over. the women say all the time, "i need my kids more than they need me," "i need my kids, i need my kids." so that's one of our biggest goals is to reunite family and keep families together. family center treatment is the way to be. i don't understand why everyone's not doing it across the board because it is shown to be more effective.

i just think it should be more programs like heros and sheros in order for many more families to be touched. so kim, we were talking about the adolescent and other institutions that can actually come in and act as a beginning of a buffer for that adolescent. talk to us a little bit about that. sure. well, i think in just about every setting, a child exists in there are caring adults available, or there can be caring adults available who can be a protective factor to a child and help that child access their own inner resilience. so including things like helping children realize that they can use humor, that they can develop close relationships with safe adults. teaching children ways that they can be safe. okay, if you can't bring friends home because crazy things are happening there and you can't study there how can we put something in place so that

you have a safe place to go after school? if you're concerned about your siblings then how can we make sure that their needs get met? so really, i think we just need to encourage adults to not ignore signs that a child is struggling and reach out to children and to kids to say if you have one caring adult in your life who is in your corner that can make all the difference for you. absolutely. i absolutely think so and you know the issue is that today the school systems are really so overburdened by so many budget considerations and cuts, you know, to social workers and cuts to this and that. and yet, you know, as you mentioned, just that one person because oftentimes-and correct me if i'm wrong, you're the experts-the child may think that it's their fault what's happening in the home. absolutely. i think the messages that we give children about what's happening, i think children can handle straight talk about their problems at home if we deliver it to them in ways that are age appropriate. so we often talk in the context of children who have

an addicted parent or children who have a parent with mental illness problems. we talk about the three cs, making sure the children understand that the three cs are you did notcause this, you cannotcontrol it, and you cannotcure it. so that they understand that they neither have the power nor the responsibility to fix this problem, but they can communicate about what's happening. they can take care of themselves. they can be healthy and successful despite the difficulties that are happening at home. erica, i want to go to the point that you made, at the point where your children are taken from you. how did that reintegration occur and what did you do as a parent to really begin to heal your family? i think what was most important for me was to realize that i needed to help-i needed help to forgive myself before i could really begin to heal in order to help heal my children.

i had to acknowledge that i had to take care of myself before i could take care of them and that was what i feel was most important. and then when i really got the opportunity to talk about it with them to explain to my children that it wasn't their fault and that i was sick and that, you know, there was things that i had to learn how to cope with, and that no matter what i loved them and that they are my world. and they are what's important, but in no way was it their fault. and it wasn't until i had that conversation with them that we really began to heal and become a family again and move on with our lives. and then, they could begin to trust again? definitely. you know, they've learned that they have confidence, that there wasn't anything they could have done differently. and that it's okay for them to have the feelings that they're feeling and i've opened up an environment for them where it's okay for them to tell me how they feel and talk about what they experienced during my time of addiction and

that-validate their feelings. and that it's okay. and they have learned how to trust and move on and are doing fantastic in school and have just really become amazing children, despite the trauma that they experienced at a young age. and this is a key word, fran, trauma. that is really the main issue here. the notion that the kids are traumatized and the trauma really does take a long time for folks to heal. correct? correct. and trauma has a lot of-there's an extended definition of trauma. we used to think of trauma very narrowly and now we're seeing that both in several different cultures and, in this situation of families with young people living with addictions and mental illness, the trauma can be very subtle and doesn't show up until they are adults. the trauma can be very severe and needs to be

intervened with right away. so there are all different levels of trauma, but the good news is we also know so much more and we are-all of these services that are being described today, the key factor for all of them for me in prevention is collaboration. we must continue to collaborate and to bring these services together to bear and that it takes more than just one intervention, one person in treatment, one school that's attentive to be able for the entire community to wrap themselves around it. talk a little bit about the protective factors that folks need to be aware of in terms of providing that preventive approach to families. ok. well, first the protective factors, as kim was saying, it's in the family itself and you have to find where that is. and family therapy, as was described, as well as having a faith-based organization come in and having the contact,

depending upon who you are, where you live, what your culture is. we'll identify what are the strengths. what are the protective factors which are the strengths and the resilience? then you continue to build that out because every member of the family has a strength. it doesn't always kind of coordinate well sometimes when the family is disruptive. that's when you bring in the other sources. so there is several, you know, parenting skills, young people skills of knowing when to say "i need help." knowing when to say i can't do this anymore and go to that protective adult, a trusting adult. there is the schools are a protective factor, the community is a huge, faith based, there is many of them. endless. endless sources. kim, i want to go back. we had a conversation off camera about military families. as we look at the returning members of the military, the veterans that are coming back, what special challenges

should service delivery systems be on the lookout for? well, i'd say first of all when military service people come back they've had -especially if they have been in combat-they've had experiences that may be extremely horrific and they are very invested in protecting their family from the impact of that. which often leads them to a kind of secrecy or isolation around that. both because they think no one can understand their experience and because theyey want to prott their loved ones from it. it's hard enough to reintegrate into your family after being through that, but then to feel like you have to-you can't talk about it with family or with other people makes that reintegration even more difficult. while the soldier has been or the service person has been away, the family has also adapted to their not being present. the other parent, if they have children, has learned to do a lot of things on their own. maybe he or she has taken financial responsibility on all by themselves and now the service person returns and

they have to kind of share that role. there are a lot of shifts and changes in roles. the service person may be dealing with psychological wounds or physical wounds or brain wounds that make services, professional services, necessary for them and the service providers have to understand the unique military culture that they need in order to heal. very good. nancy, let me shift a little bit about and let's start talking about the family drug court. talk to us a little bit about that and what that does to really facilitate a positive process within dysfunctional families. yeah, you asked earlier about some of the things that the national center is doing and we're happy that there is this kind of approach, that is relatively new, just starting in 1996, but it really takes the child protective service system and the family court and the substance abuse treatment

providers and addresses the whole family. so, just as fran was saying, the importance of collaboration. what does that actually mean when you're working with a particular family and importantly what does that mean for all of the families. so it uses some key concepts about making sure that we can identify families with substance abuse and mental health problems as they're entering the child protective service system quicker, getting them access to services quicker. making sure that each of the family members has a support system, has a treatment plan when needed. uses the court, the family court to more carefully monitor what is going on in the treatment plan, particularly around the parent and their substance use disorder and the child and how the child's permanency and the relationships that they must develop are being provided for them. so that the child and the parent is seen as the unit of

intervention, which is so important. very good. when we come back, i want to continue on and identify other sources that families can go to in order to get help. we'll be right back. [music playing] for more information on national recovery month to find out how to get involved or to locate an event near you, visit the recovery month web site at recoverymonth.gov. [music playing] where's mom? did she forget me? i wonder what happened to her. what if i get left here? drugs and alcohol may make you forget your problems for a moment, but that's not all you forget. my mother worked hard to be in recovery and i love her for that. for drug and alcohol treatment for you or someone you love, call 1-800-662-help. brought to you by the u.s. department of health and human services.

[music playing] bridging resources in communities, bric, is the acronym. we, as the name implies, we bridge resources in communities with a prevention focus. our primary role is to partner with great organizations like the far southeast family strengthening collaborative. the mission of the far southeast family strengthening collaborative is to be a catalyst for the ward 8 community, really helping the community coalesce around issues of families and children and the issues that they deal with. i think that anytime there is an issue within the family, the entire family is impacted. whether it is mental health, substance abuse, hiv, whatever it is. if one family member is impacted, then it impacts the entire family. family really is anybody that you can rely on.

any resource that you have at your disposal to build your own strengths. you do have to look at the whole picture because if you're constantly just focusing on the children or the youth and not their parents or other caregivers, then when they go home there's going to be a disconnect. and if you have a youth that is using a substance, that can be dramatic on the parents and on the whole entire family as well because that individual can impact the family. the family is a part of the treatment process. the person that's getting the treatment themselves is just one individual, but the family has actually been impacted, you know, by the substance abuse or mental health abuse or whichever one it is. i think it's important to have the family together as a whole so the treatment plan can work well for the family and the individual that's getting the treatment. within this community right now there's a poverty rate of close to 50 percent. the unemployment rate is the highest in the country at 35 percent. we have a huge rate of hiv and aids.

pcp is huge in this community. violence is huge in this community. so really, it starts with the family unit and we believe that youth and families are key to the success of this community. one thing that bric has been very successful in doing is fostering really good relationships with our federal and local partners. the goal is to establish, with as many partners in the community as possible, because that builds the coalition, builds the reputation, and builds the relationships. one of those programs is what we call community-diverted cases. a lot of times, there are issues in families with cfsa has to be involved. but it's not raised to the level where youth has to automatically be removed or something like that. so one of our jobs here is to work with that family to try to keep them together and provide the services that help them and support them in staying together. we do job placement. we do education stuff. we do all the things that a family might need in order to become self-sufficient. there are some very talented, very passionate people, very

educated, very intelligent people, but they're just living in an environment with lack of resources. i have five girls and three boys and they help me get-they helped me get them into afterschool programs and also after care and summer programs for them in the summer so they won't have to be around the neighborhood so much. ward 8 is a really strong community and it has a lot of strengths within this community and a lot of times the people within this community aren't given credit for that. and so our job is to really try to build those families up. remove any barrier to them being successful because a lot of times there are enough barriers in people's lives. so just the distance can be a barrier. travel can be a barrier. unfamiliar areas can be a barrier. eliminating those at all costs because eventually we don't want to have to be here. we want to be able to just utilize the resources that were in this community for them to rely on. the strength of our partners, the strength of

the relationships in our community to me is the crux of what we do. it is why we're able to do what we do. i love the fact that i can meet a person and the person can be unemployed. he can be homeless. he can have mental health issues. he can be on substance abuse and i can still see him and say, "you can still be what you want to be in spite of that." the collaborative have helped me and my family. they're still continuously helping me and my family. and the resources here, if a lot of other people knew about it, they would feel the same way i do. at far southeast family strengthening collaborative, we're here as a family and we treat you as a family when you come in. if your heart is there, you're willing to help the families, i think we can make a great impact in the ward 8 community. erica, talk a little bit about what you do and how families can access your services.

so what i do is i am a family support specialist and what my program does is we provide peer engagement workers. we're all in recovery ourselves and we go out to the family and we talk with the mother and we really-we get on her level and we assess her needs and what the family needs and what we can do to help them continue in their recovery and we really work on making sure that they have access to all of the resources in the community. and on top of that, we do our best to coordinate care with all their other services like you were talking about with collaborating. you know, i think it's really important for our families, most of them have involvement with the department of children and families, and you know, so we stay in close contact with the department, with their worker and with their therapist and with their treatment providers and we make sure that everybody stays on the same page. and in doing that, our families have been very successful. we have 91 percent of our families stay in our program and

stay engaged and they have done a wonderful job. and on top of that, we provide parenting classes and which is the biggest piece because being a mother in recovery myself, it's so hard to balance your recovery and staying sober and then you want to be the best parent you can possibly be because you're trying to make up for lost time and all of these other things. so to-the fact that our program offers parenting classes, i think it amazing and it really teaches the person in recovery how to parent their child and when to ask for help and what to do with your children while you're in recovery. and kim, talking about when to ask for help, a lot of families do not ask for help because they feel they would be stigmatized. right. and it would either affect their job status or their community status or their neighborhood status. talk to us a little bit about that. well, i think that stigma is a huge problem that keeps people from seeking services and so one of the things that

i love so much about-what erica and i were talking about in the green room is how she as a person in recovery can reach out to other mothers to really bust through this stigma and say treatment works and i'm living proof of it and i am your peer. so reducing the sense of hierarchy. and just, i think that we constantly need to be aware that people are bigger than their problems. we need to see the humanity in the families that come before us and say, "i know that you have difficulties, but you also have resources and strengths, so come and get the help that you need." and fran, exactly that, from a prevention standpoint when people start seeing some of the warning signs, where can they seek help? they can seek help by going to our web site. i think it's the fastest way for them to find out throughout the country. because we're a federal web site, we're nationally known, we have the ability to go into every state, every territory,

every jurisdiction, and point you to directions like the programs that we're talking about today instead of listing them out. i think it's important for us in prevention to help our families and our individual, our young people to know that those resources are out there for them and its easy access. this is the day and the time for everything to be on the web. it's very easy now. it's much more difficult to motivate yourself to make that-push that button on the computer then it is to actually access help. and what they will be accessing is help with coalitions that can help them? for prevention, it's all of the above. but i would highly recommend looking at the whole continuum of services. because what we're talking about here is a family with multiple parts and there are people that would need some coalition attention, being able to feel useful again by being a member of a community organization.

young people wanting to become part of a group in their school. whether it is a group because their family got separated, which is very common in our business or whether it's just a group to be a leader and to bring out some of those skills. and then, of course, our array of treatment services on multiple levels and then, of course, at last, all of the resources and the services are coming alive and supported around recovery support. i think recovery support is going to help us quicker than everything we've done so far in helping to reduce this discrimination against people with substance abuse and mental health disorders. getting back to the court system. i think that the more the courts get engaged, really, they have helped tremendously in the whole issue of stigma. they've almost got it to a point where people begin to see that it's not a moral issue. it's not a really criminal issue, but it's an issue of

a disease that-diseases both mental and substance use-that have to be managed. i think we have a lot of hope that before families get to the court system-either the family court or the criminal court-that they're reaching out to others. the power of mutual help and peers helping peers, both within adolescence and younger children but parents helping other parents. you know, the formal system is extremely important to be there with treatment and with recovery supports, but the power of what erica is doing with reaching out and really offering that "i've been there, i understand. you can do it. i did it." and someone said to me that what they really got when they were engaged with the parent partner was hope. that their life could change. that their family could change.