Sis Wenger made a presentation on the effects of alcohol and drug dependence on the family, titled Family Impact-Family Intervention. She described the family dynamics of alcoholism and drug dependence and their impact on the emotional development of children in those families. She pointed out that, at times, these family dynamics play out in faith systems and congregations, impeding their capacity to assist those affected in a meaningful way. She asked the panel to promote the development of faith community environments in which all members of families affected by addiction know that their pastors under- stand what they are experiencing, care about them, are available to them, can help them find emotional and physical safety, and can support their healing and spiritual growth.

Rev. Mark A. Latcovich, Ph.D., Vice President, Vice Rector, and Academic Dean, Saint Mary’s Seminary and Graduate School of Theology, Cleveland, Ohio, in a presentation titled Spiritual Components and Signposts, discussed the spiritual dimension of alcohol and drug dependence. He called substance dependence a “systematic deconstruction” of the personality, characterized by a loss of interest in life, feelings of guilt and self- resentment, and anger toward self, others, and God. He suggested that clergy and other pastoral ministers can contribute to individual and family recovery by helping them address the fundamental meaning of their lives and reshape how they think about God by leading them through a process of recon- ciliation, personal reformation, and reinte- gration into the community.

In the dinner address, Hoover Adger, Jr., M.D., M.P.H., Director of Adolescent Medicine, Johns Hopkins Hospital School of Medicine, recalled incidents from his pediatric practice that crystallized for him the harmful impact of parental alcoholism and drug dependence on the health of their children. He described how a consortium of major primary health care associations with members specializing in the care of children and families developed a set of core competencies related to the care of children and adolescents in families affected by alcohol- ism and drug dependence. Dr. Adger discussed the work of the Association for Medical Education and Research in Substance Abuse (AMERSA) both to adopt the core competencies and develop a training program for primary health care professionals specifically on addiction and its impact on children and families. He called upon meeting participants to embark upon a similar project to benefit those in faith communities.

Panelists’ Reflections on the Potential for Change

In response to the presentations that opened the meeting, participants immediately undertook the deliberative process of identifying the elements of core competencies for the training and education of clergy and other pastoral ministers focusing on alcohol and drug abuse and dependence and their impact of affected individuals and their family members. The first step was to identify and respond to misconceptions and negative attitudes that might need to be overcome before either core competencies or relevant curricula could be adopted routinely in training and education programs for members of the faith community.

Several participants reflected on the historical failures of faith communities to focus any attention on the issues of alcohol and drug dependence. They observed that by heaping shame or threats of God’s punishment on those struggling with alcohol or drug dependence or addiction, the religious community – and its congregation – actually may be driving individuals in need and their families away from a significant source of comfort, help, and hope. Moreover, when it is the member of the clergy who suffers from alcoholism or drug dependence, the un- healthy systemic impact is even more deeply experienced within the organization. One panelist urged the clergy to help substitute messages of hope based on the proven efficacy of treatment, the demonstrated reality of recovery, and the role of spiritual- ity in sustaining recovery for negative attitudes toward alcoholism and drug dependence. Another noted that, while the churches are imperfect institutions, members of the clergy can and should lead them to become loving communities.

Dr. Sheila B. Blume, M.D., reminded partici- pants of Dr. McLellan’s comment about the widespread, mistaken, belief that treatment is ineffective. She spoke of a mythical treatment facility – “Nonesuch Detox” – in which a small number of patients are grossly over-represented in the facility’s caseload at any one time. They represent individuals who repeatedly fail at treatment. To the casual observer, the incorrect impression is left that alcohol and drug dependence are difficult to treat, if not impossible, despite significant research findings and clinical experience to the contrary.

Identifying the Multiple Tasks of Pastoral Care

The next step for participants was to define and articulate the range of opportunities the clergy has to help. They agreed that a number of interrelated functions provide clergy and other pastoral ministers with a host of ways in which the issue of alcohol and drug dependence can be broached. Thus, a major clerical responsibility is to comfort and support individuals – a task accomplished in different ways, based on the nature, size and character of the individual congregations. In smaller and more cohesive institutions, pastors often develop long-term, personal relationships with individual members of their congregations. In larger religious congregations, they or their assistants usually are available for individual counseling. Members of the clergy also typically visit the sick in hospitals and at home, and perform weddings, funerals, and other observances of life’s milestones.

However, the clergy’s role is not limited to serving individuals. They also work to create a community of mutual caring, making individual congregants aware of the impor- tance of serving others both within the congregation and beyond in the outside community, alerting them to the needs of others as they arise, and developing mutual aid programs. The clergy also serve as educators. This “prophetic” function involves messages to the congregation and the larger community about issues of importance to spiritual well-being. The messages conveyed generally are guided by the text and liturgy of the particular faith tradition.

Participants agreed that each role offers the clergy and other pastoral ministers unique, unparalleled opportunities to address problems of alcohol and drug dependence and their impact on the individual, affected family members and friends, and the community at large.

Caring for and Supporting Individuals and Families

A key message conveyed by meeting participants was that a member of the clergy should establish an atmosphere in which individuals – whether experiencing drug or alcohol dependence or a family member of such a person – are encouraged to acknowledge the problem and seek help. When they do come forward, they should find compassion, acceptance, and helpful resources to lead them to the help they need and, ultimately, to recovery. Clergy and other pastoral ministers should listen sympathetically and encourage both the individual and family to embark on the journey of recovery. A knowledgeable, supportive individual or group within the congregation should be available to the affected individuals and family members seeking recovery, every step of the way.

At the same time, members of the clergy should know that the supportive environ- ment they create does not preclude the potential for initial backlash or denial by the affected individuals and family. Clergy members should not be surprised if either happens and should be prepared to continue a supportive and encouraging role that promotes movement toward recovery.

Participants emphasized that the role of the clergy in addressing alcohol and drug dependence is not and cannot be simply a matter of “referring out” to treatment. While referrals may be appropriate, alone they are insufficient. The clergy or other pastoral minister should ensure that appropriate support continues to be available to the individual and family members, and should take an active role in reintegrating the individual and family members into the faith community during the process of recovery.

Participants also pointed out that the ability to make referrals to the most appropriate treatment or to peer support groups is not a simple task. Clergy must find ways to help the individual and family find treatment resource that meet their individual needs and means. To do so, he or she must have contact with individuals knowledgeable about available programs and must be sufficiently aware of the circumstances of the affected individual and family to help assure a good match.

A consistent message by participants was that children in families experiencing alco- hol or drug abuse or dependence need attention. They may be growing up in homes in which the problems are either denied or covered up; these children need to have their experiences validated. They also need safe, reliable adults in whom to confide and age-appropriate support services to meet their special needs. Research evidence continues to suggest that chronically high- stress family environments are a risk factor for potential substance abuse, and both mental and physical health problems in children. They need early interventions from nurturing, supportive individuals and insti- tutions to help change the risk equation. There is documentation that just being associated with the activities of a faith community serves as a protective factor for children living in high-risk environments. One participant further noted that families with no history of alcoholism or drug depen- dence, but who have children dependent on or addicted to alcohol or drugs, also need the support and education that could be provided by faith community leaders.