SocialChangePortfolio_HillB (Final)

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COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy Social Change Portfolio Brittany M. Hill

Contents Below are the titles for each section of the Social Change Portfolio. To navigate directly to a particular section, hold down <ctrl> and click on the desired section below. Please do not modify the content section, nor remove the hyperlinks. Overview Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy References ScholarWorks Contributor Agreement

OVERVIEW Keywords: Substance Abuse Prevention, Children, Lynchburg, Virginia, advocacy Substance Abuse Prevention in Children Goal Statement: The goal of this portfolio is to prevent an increase in substance abuse among children. Significant Findings: In Lynchburg, Virginia, substance use impacts many families. If a child grows up in a household where there is substance use, they are more likely to use substances themselves (Hussong, et al., 2012). In the state of Virginia, the opioid overdose rate continues to rise, which may lead to more children engaging in substance use (Virginia Department of Health, n.d.). This portfolio outlines the scope and consequences, application of the social-ecological model, theories of prevention, diversity and ethical considerations, advocacy recommendations to prevent an increase in substance abuse among children. The final recommendation of the portfolio is an advocacy action that would provide a single prevention program across all providers. Objectives/Strategies/Interventions/Next Steps: The objective of this portfolio is to prevent an increase in substance abuse among children. A community program in the Lynchburg, Virginia area that addresses the problem of substance abuse among children is The 96.8 Campaign, which holds events and education programs for children to prevent substance use (Harfmann, 2021). Other than The 96.8 Campaign, other interventions for substance use among children would be for the children to be enrolled in extracurricular activities or to be around care givers that do not use substances. A final action item for advocacy that is recommended by this

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portfolio is to implement a single prevention program that will be available at every provider/office to decrease the problem of competition and inclusivity (Lindholm, et al., 2004). INTRODUCTION Substance Abuse Prevention in Children Lynchburg is a small town in central Virginia that is heavily influenced by a Christian college, Liberty University. On the outskirts of Lynchburg, most families live below the poverty line and substance abuse and addiction are a prevalent problem. The substance abuse and addiction impacts children in these families considerably. Because of the influence of the Christian college on the area, programs and prevention methods of substance abuse and addiction are minimal. Due to the prevalence of substance abuse and the impact on children, the topic that this social change portfolio will address is the prevention of substance abuse in children and adolescents. PART 1: SCOPE AND CONSEQUENCES Substance Abuse Prevention in Children Substance abuse and addiction are a problem that impacts not only the user, but others that are close to them. Studies show that a child with a parent who has a substance use disorder is at higher risk of alcohol, marijuana, and other illicit drug use (Hussong, et al., 2012). From 2017 to 2021, the opioid overdose related death rate in Virginia has increased from 17.4 to 30.5 (Virginia Department of Health, n.d.). According to the National Center for Drug Abuse Statistics [NCDAS] (2022), teenagers in Virginia are 16.46% less likely to have used drugs in the last month than the average teenager in America. However, 6.96% of teens (ages 12-17 years

old) in Virginia have reported using drugs in the last month (NCDAS, 2022). If substance use/abuse was a topic of education for children, it is possible to prevent substance use into adulthood, even if the child lives in a household where substance use is prevalent. Consequences of not incorporating more prevention strategies with children include the child being at an increased risk for depression, anxiety, opposition or conduct disorders, impulsivity, emotional outbursts, and aggression (Lander, et al., 2013). The goal of this portfolio is to implement prevention programs to reduce substance abuse and addiction from childhood into adulthood. PART 2: SOCIAL-ECOLOGICAL MODEL Substance Abuse Prevention in Children The social-ecological model for prevention explains the protective and risk factors that people may experience at different levels of their life (CDC, n.d.). The different levels that the social-ecological model focuses on are individual, relationship, community, and societal (CDC, n.d.). This section of the portfolio will list different risk and protective factors for each level of the social-ecological model. Risk factors of substance abuse for the individual and their family system include “unmet developmental needs, impaired attachment, economic hardship, legal problems, emotional distress, and sometimes violence being perpetrated against [the user]” (Lander, et al., 2013). If an individual experiences any of the risk factors, they are more likely to develop a substance use disorder (Lander, et al., 2013). If a child is in a household where one or more parent suffers from a substance use disorder (SUD), the child is at a higher risk of developing a SUD themselves (Lander, et al., 2013). When a child has a parent that suffers from a SUD, that child is more likely to have increased difficulties in social and academic settings (Lipari & Van Horn, 2017).

One protective factor of substance abuse in the individual and family level of the social- ecological model would be for the individual to not have close proximity to others who use substances (Lander, et al., 2013). If a child lives with family members that frequently use substances, they will be more likely to use substances (Lander, et al., 2013). For the school or peer group level, a protective factor would be to be involved in extracurricular activities. If an individual is involved in extracurricular activities, they will likely stay away from negative peer pressure from others that use substances. PART 3: THEORIES OF PREVENTION Substance Abuse Prevention in Children A theory can be described as a set of concepts, definitions, and propositions to understand specific events or situations and the variables of the relationships involved (National Cancer Institute, 2005). It is important for preventative programs to be based on research and have been proven to be effective for the population and problem. This section will explain a theory that can be applied to substance abuse prevention in children. Theory of Planned Behavior The Theory of Planned Behavior (TPB) explains that behavioral intention and subjective norm are important for a person to approve or disapprove of a behavior (National Cancer Institute, 2005). Behavioral intention can be defined as “perceived likelihood of performing behavior” (National Cancer Institute, 2005, p. 14). Subjective norm is best explained as an individual looking towards another individual that is important to them for approval or disapproval of a behavior (National Cancer Institute, 2005). This theory relates to the population of this portfolio, which is children, because if a child has parents or loved ones that use

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substances, they will think that it is normal or acceptable to use substances also. If a child has a positive role model that does not use substances, the child will be less likely to think that using substances is an acceptable behavior in their life. The 96.8 Campaign An evidence-based program that is available to children to prevent substance use in the Lynchburg, Virginia area is the 96.8 campaign. The 96.8 campaign holds events and provides education to the youth in the area on the importance of abstaining from substance use (Harfmann, 2021). Harfmann (2021) explains in their article that substance use has dropped in the area and 96.8% of high school students report that they have not used drugs in the past thirty days at the time of the survey . PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS Substance Abuse Prevention in Children Diversity Considerations Children are more likely to be affected by substance abuse if they have lower socioeconomic status and/or parents that suffer from substance abuse (Lipari & Van Horn, 2017). A child who has someone in their family that struggles with substance use or abuse will be more likely to develop a substance use disorder themselves (Lipari & Van Horn, 2017). According to a study conducted with data from National Surveys on Drug Use and Health, one in eight children aged seventeen or younger lived in households with at least one parent who suffered from a substance use disorder in the past year (Lipari & Van Horn, 2017).

Since substance use disorders impact an entire family system, treatment and prevention should be accessible to the entire family system, as well (Lander, et al., 2013). One mechanism that can be utilized to encourage prevention of substance use in children is to put collaborative providers in place to provide multiple services to the child or family system. In the Lynchburg, VA area, one organization that provides a collaborative service is Horizon Behavioral Health ( https://www.horizonbh.org/ ). Horizon Behavioral Health is able to connect families with continuous care in many areas, including mental health, and can be useful in the prevention of substance use disorders in children. Another mechanism that can be utilized to prevent substance use in children is quality training of professionals that provide support to the child and family. Lander, et al. (2013) explains that it is important for the training that a professional receives to emphasize the surroundings that may impact an individual. For example, if a child grows up in a household where substance use is normal, they may not know it is not an ideal situation to be in. If a professional is trained to recognize cultural norms for each individual, they will be able to assist more efficiently with helping to prevent substance use in children (Lander, et al., 2013). Ethical Considerations As it pertains to informed consent during the prevention process, it will be important for any professionals involved to understand that the clients (children and/or their family) have the freedom to stop any counseling relationship (American Counseling Association, 2014). If a child or their family decides they are not interested in participating in any prevention programs for substance use, it is their right to stop participating at any time, per ACA Code of Ethics A.2.a (ACA, 2014).

According to the ACA Code of Ethics A.3, if a counselor learns that a client has relationships with other mental health professionals, it is the counselor's ethical responsibility to establish a collaborative relationship with the other providers (ACA, 2014). Collaborating on the services provided ensures that the client receives the most appropriate care that will best meet their needs. For this reason, it is important for any mental health professional to collaborate with all providers the client sees to ensure quality care. The ACA Code of Ethics explains in section B the importance of confidentiality in the counseling relationship (ACA, 2014). It is important for a counselor to continuously explain the parameters of confidentiality, including what can and cannot be shared and when it is mandated for the counselor to report certain information (ACA, 2014). When advocating for clients, it is important for the counselor to explain to the clients what they are advocating for and what information will be shared during this process to ensure confidentiality is kept (ACA, 2014). PART 5: ADVOCACY Substance Abuse Prevention in Children According to the Multicultural and Social Justice Counseling Competencies (MSJCC) (2015), it is important for counselors to be able to intervene with, and for, clients in different levels. These levels include “intrapersonal, interpersonal, institutional, community, public policy, and international/global” (MSJCC, 2015, p. 11). In each of these levels, there will be different interventions that will be effective as well as barriers. Barriers

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Some barriers to targeting the problem of substance abuse in children are noticeable at the institutional, community, and public policy levels. One of the main barriers that impacts multiple levels focuses primarily on collaboration between providers to provide prevention and treatment for substance use disorders (Lindholm, et al., 2004). Due to many programs being in competition with each other, the ability to collaborate with all necessary providers becomes difficult (Lindholm, et al., 2004). Another barrier that impacts multiple levels falls under inclusivity (Lindholm, et al., 2004). Inclusivity could be impacted based on a person’s insurance, gender, economic standing, or cultural identity. When programs do not have a broad definition of inclusivity, many people may not qualify for their services and not be able to participate in them (Lindholm, et al., 2004). If programs updated their inclusivity to allow a more diverse population to participate in their services, this barrier would no longer be an issue as everyone could have access to all treatment and prevention programs that are offered in their area (Lindholm, et al., 2004). Advocacy Action One action that could be taken to address the problem of substance use in children is having a single system for prevention and treatment of substance use (Lindholm, et al., 2004). This action would be important to implement because if the barriers of competition and inclusivity were not solved, every person would still have access to the same services due to a singular system for prevention and treatment. If every facility offered the same services to all of their clients/patients, there would be no competition on where someone should go based on any kind of bias (Lindholm, et al., 2004). REFERENCES

American Counseling Association. (2014). 2014 ACA Code of Ethics. Retrieved from https://www .counseling.org/resources/aca-code-of-ethics.pdf CDC. (n.d.). The social-ecological model: A framework for violence prevention. Retrieved from https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html Harfmann, T. (2021). Lynchburg sees a drop in substance abuse among high school students. WSLS; WSLS 10. https://www.wsls.com/news/local/2021/lynchburg-sees-a-drop-in- substance-abuse-among-high-school-students/ Hussong, A. M., Huang, W., Serrano, D., Curran, P. J., & Chassin, L. (2012). Testing whether and when parent alcoholism uniquely affects various forms of adolescent substance use. Journal of Abnormal Child Psychology, 40 (8), 1265-76. https://doi.org/10.1007/s10802- 012-9662-3 Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social work in public health, 28 (3-4), 194-205. https://doi.org/10.1080/19371918.2013.759005 Lindholm, M., Ryan, D., Kadushin, C., Saxe, L., & Brodsky, A. (2004). “Fighting Back” against substance abuse: The structure and function of community coalitions. Human Organization 63 (3), 265-276. https://www.proquest.com/scholarly-journals/fighting- back-against-substance-abuse-structure/docview/201162773/se-2 Lipari, R., & Van Horn, S. (2017). Children living with parents who have a substance use disorder. Samshsa.gov. https://www.samhsa.gov/data/sites/default/files/report_3223/shortreport-3223.html Multicultural and Social Justice Counseling Competencies (MSJCC). (2015). Retrieved October 27, 2015, from

http://www.counseling.org/docs/default-source/competencies/multicultural-and-social- justice-counseling-competencies-pdf?sfvrsn=20 National Cancer Institute. (2005). Theory at a glance: A guide for health promotion practice. Washington, DC: US Department of Health and Human Services: National Institutes of Health. https://cancercontrol.cancer.gov/sites/default/files/2020-06/theory.pdf National Center for Drug Abuse Statistics [NCDAS]. (2022). Drug use among youth: Facts & statistics. https://drugabusestatistics.org/teen-drug-use/ Virginia Department of Health (VDH). (n.d.). Overdose deaths. https://vdh.virginia.gov/opioid-data/overdose-deaths/ SCHOLARWORKS CONTRIBUTOR AGREEMENT ScholarWorks Publication Consideration ScholarWorks makes the intellectual output of the Walden University community publicly available to the wider world. By highlighting the scholarly and professional activities of our students and faculty, ScholarWorks' rich repository encourages new ideas, preserves past knowledge, and fosters new connections to improve human and social conditions. If you would like your portfolio from your Counseling 6785 course to be considered for submission to ScholarWorks, please review the ScholarWorks Contributor Agreement below and agree to the terms and conditions. Acceptance of the policies and terms of the ScholarWorks Contributor agreement  will not impact your grade  will not guarantee publication ScholarWorks Contributor Agreement To administer this repository and preserve the contents for future use, ScholarWorks requires certain permissions from you, the contributor. By making a submission to ScholarWorks , you are accepting the terms of this license. However, you do not give up the copyright to your work. You do not give up the right to submit the work to publishers or other repositories.

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SocialChangePortfolio_HillB (Final)

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