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Competence 5: Continuing Care of Families Affected by FASD

Continuing Care for Clients with an FASD or Possible FASD, Continued

One-on-One Counseling and Structured Group Involvement

Group counseling session with several people with infants sitting around in a circle

Recovery, which is a lifelong process, transcends treatment, which is finite in time and scope. Ongoing counseling can help in the transition from treatment to ongoing recovery. The addiction professional can provide counseling or refer the client to a mental health professional. Although some group settings may be difficult for persons with an FASD, the addiction professional may want to consider some type of structured group involvement. A support group for youth or adults with an FASD might help, as well as social and recreational programs that can accommodate individuals with an FASD.

Clients and family members with an FASD face several issues, to which counselors should be aware of. The addiction professional can provide support to the individual and family in addressing these issues or can make appropriate referrals.

  • Anxiety and depression. Medication may be helpful, as well as counseling or encouraging the child to participate in sports, clubs, or other structured activities.
  • Victimization. It is crucial to monitor the child’s activities and discuss dealing with strangers. Youth with an FASD tend to be very trusting and may go places with strangers just because it sounds fun.
  • Lying, stealing, or antisocial behavior. Family counseling is helpful, as well as setting simple and consistent rules with immediate consequences.
  • Poor peer or social relations. It can help to enroll the individual in classes or social clubs for adults with disabilities.
  • Mental health issues. Structure, routine, and plenty of activities are important. Medication and counseling options should also be explored, particularly for co-occurring disorders.

Guidelines for providing ongoing counseling2 include:

  • Keep counseling session times flexible so that sessions can be shortened, lengthened, or increased in frequency, depending on the individual treatment plan.
  • Ask simple questions, repeat questions, and ask the client to repeat, in her own words, what has been said. Keep discussions concrete. People with an FASD do not understand abstract concepts. They should be asked to provide specific examples of a general principle.
  • Use verbal and nonverbal cues to increase participation and learning and make group sessions run more smoothly. The counselor and the person with an FASD can work together to decide the cues. The cues should be simple, such as holding up an index finger and saying a code word (e.g., “interrupting”).
  • Use various methods to share information and address issues, such as drawing, music, and role playing.
  • Find alternatives to written assignments or assignments that require a lot of reading. Persons with an FASD often have memory problems and difficulty writing. Use videos or break up reading and writing assignments.
  • Systematically address what has been learned in the program and how it will be applicable in the next stage of treatment or aftercare. People with an FASD have problems applying information from one setting to another. Do not assume that lessons learned in treatment will be applied in aftercare.

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