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Interview Questions: Child and

Family Services
Interviewee: Valerie Joco

 Topic 1: Strong Family and Community Relationships

 Q1: A study done in India underscores the role of family relationships and how they can affect addiction. “It has
been observed that children in drug-abuse afflicted families become the first causality in multiple ways. It is not
only that assistance for attaining their full potential is missing in such homes but delay in unfolding of their
normal psychological process, sometimes affecting them to the extent of their puny existence,” - Sharma, Rajni.
"Role of Family Relationship in Child Rearing of Drug Addiction Afflicted Vs Normal Families." Do you agree with this
information? Have there been any patients that exemplify/disprove this?
I strongly agree that drug-abuse afflicted families has a huge effect on each member. About 90 percent of
the youth that I am working with are unable to focus on the normal day to day task most teenagers in
normal home environments can manage. They struggle with attending school regularly, getting along
with other peers, and keeping up with their school assignments. They are also being stereotyped by their
own teachers and school officials. This leaves them feeling less than or below others. Because they come
from unhealthy homes, where there isn’t any structure such as parents who themselves are dealing with
drug abuse or most commonly absent parenting, it is difficult for these youth to feel a sense of belonging
and trust. They have very low self-esteem, self-concepts of who they are and no motivation. Because of
this, they stop trying and get involved with drug users and dealers because they feel a sense of
acceptance from these people that they don’t feel from others.

 Q2: How can family and friends make a difference in the life of someone needing treatment? family and
friends can make a huge impact of someone struggling with addiction or drug use.
They can help by being there as a support system. Someone to talk to, and help by finding resources,
such as programs, such as ours.
Q2:I think family and friends make all the difference in someone needing treatment. A few of the ASAM*
dimensions we assess highlight social and relapse potential which are highly influenced by friends and family. A
person needing treatment will not be successful without some type of social support to give encouragement and
be with them for motivation. In adult substance abuse that comes in the form of mentors and peers from
Alcoholic Anonymous and Narcotic Anonymous groups. For, kids it can easily just be the friend groups.
However, as much as social supports can be helpful they can also be detrimental, it`s important for their
supports to be healthy and living pro-social lifestyles that don`t drug or alcohol use. -AJ
*ASAM is the acronym for the American Society of Addiction Medicine. The ASAM Patient Placement Criteria is
used to help identify the extent of the severity of a person’s substance use. There is an adult ASAM criteria and
a separate one for adolescents. More information can be found at this website:
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 Q3: Do healthcare providers play a role in decreasing addiction rates?

Q3: Health care providers play a significant role in paying for treatment and making it affordable for clients. Not
all clients can afford treatment and having health care helps alleviate some of the expenses. -AJ
It’s important for primary care physicians, nurse practitioners, physician assistants, etc., to receive education
and training in how to screen their patients for substance use and to know how and where to refer their
patients to the right services, if appropriate.

 Topic 2: Rehabilitation Over Incarceration

 Q1: What do your Adolescent Substance Abuse Treatment Services involve?

TIFFE Youth Outreach program involves outpatient counseling for youth who uses drugs and alcohol.
We offer school-based programs and community based programs.
Q1: Our adolescent treatment involves individual and group sessions centered around relapse prevention. This
is to include the development of coping techniques, communication building, skill building, identifying distorted
thinking, triggers, and pro-social supports/activities. -AJ
The 12 Core Functions of Substance Abuse Treatment serve as the framework of our adolescent
substance abuse treatment services. The 12 Core Functions are: Screening, Intake, Orientation,
Assessment, Treatment Planning, Counseling (individual, group and/or family), Case Management,
Crisis Intervention, Client education, Referral, Report & Record Keeping, and Consultation. The web
resource below provides a good description of each function.
Our school-based services are in two high schools, two middle schools and one combined middle and
high school. In our community-based services, our substance abuse counselors go out and service youth
in the community that they live in outside of their school hours. During the school breaks, we provide
program youth opportunities to participate in fun, pro-social activities that also include community
service projects so they can give back to the community. We also provide substance abuse treatment
services to incarcerated youth that live in the Hawaii Youth Correctional Facility.
 Q2: Prohibition and incarceration has been observed to only create more issues such as high rates of
HIV and Hep C infection, inmates learning more effective crime strategies from each other, and
desensitization to the threat of future imprisonment. Do you agree with this?
Q2 :I don`t necessarily agree that it creates more issues. I think prohibition and incarceration are sometimes the only
way for people to learn how substances will affect quality of life. What you stated may happen but the same
could be said if there was nothing in place as a consequence. What I think needs to be done in order to prevent
high rates would be having a reform of what treatments work effectively in the correctional setting. Ideas that
may work and are currently being suggested/used are restorative justice circles, relapse prevention curriculum,
and HIV/AIDS education. There is going to be a point that may happen for repeat offenders where they realize
"I`m done". -AJ

 Topic 3: Increasing Drug Education and Awareness

 Q1: What do you think is the biggest misconception about addiction?
I think one of the biggest misconceptions about addiction is that people can quit anytime. I learned
that those who quit cold turkey, usually relapse. This is why drug addiction treatment should be
treated like any other disease. Drugs changes the structure of the human brain, and physiologically
impacts the body, therefore proper diagnosis, assessment and treatment is necessary.
Q1: What I think the biggest misconception is people thinking addiction is a matter of will power instead of a
disease. I`ve been told its a brain diseased expressed in the form of compulsive behavior. It changes brain
structure and function that is uncontrollable even in the face of negative health or social consequences. .- AJ.
I think one of the common perceptions of a person that is dealing with substance addiction is that they are a
bad person or they have bad character. Anyone can become addicted and in the process of learning how to
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overcome it, everyone needs to take responsibility for themselves and learn to make healthy choices for
themselves. However, as our substance abuse counselors have shared, substance use affects and creates
changes in the brain such that addiction is recognized as a chronic brain disease. The approach substance
abuse treatment needs to incorporate this knowledge. The blog below provides a good explanation of this.

 Q2: Do you think increasing drug education and awareness will decrease addiction rates?
 If so, how?
 If no, why?
Yes, I do. Based on my assessments with my youth’s, I do believe that drug addiction and awareness
must start early. Many of youth started using drugs at the age of 9. The more education, and
awareness children have about the dangerous and negative effects of drug use, the less chances they
will start.
I think drug education and awareness will work but only when a certain level of intelligence has been met.
There`s a statistic going around in which DARE, an agency that provided education and prevention actually
peeked interest for elementary school to actually try drugs instead of deter. I think the issue is the continuity
of prevention. From what I know, the drug awareness and education stopped at the elementary school level
instead of being reiterated throughout health classes at middle and high school. -AJ.
It is important to educate children and youth in a way that is age-appropriate as well as educating
parents, teachers, and the larger community in which they live. However, I think AJ makes a good
point in that the risk of whether a child or adolescent will become involved in drug use is
determined by a number of risk and protective factors that are part of the individual, their family,
their peers, their school, and their community. One of our clinical supervisors put together the
attached list of risk and protective factors based on what we have observed in the youth and families
that we have served.
 Q3: How does Child and Family Services work to increase drug education and awareness in the
I can`t speak for CFS as an organization, but as the best team in ADAD-funded adolescent treatment
services, we take initiative in providing services to not only students but teachers/staff to identify how to
increase drug awareness and provide informational sources that are empirically supported.
As our TIFFE Youth Outreach program is funded by the Department of Health’s Alcohol and Drug
Abuse Division (ADAD), Child and Family Service has another program called “Together We C.A.N.
(Care, Aspire, Nurture)” that is also funded by ADAD. The Together We Can (TWC) program staff
provide substance abuse prevention curriculum to middle and high school students in specific
geographic areas on Oahu and participate on substance abuse prevention coalitions such as HPPUD,
the Hawaii Partnership to Prevent Underage Drinking.

 Topic 4:
 Q1: For our Senior Project, our focus is drug usage but also how it goes hand in hand with a state of
depression. Do you believe there is a correlation between drug addiction and depression?
Yes. I do notice that there is a correlation between drug addiction and depression because many if
not all of the youth I assess reported that they feel lonely, and unmotivated, and drugs make them
feel normal, and takes away their feelings of being sad.
There`s numerous research supporting that drug addiction and depression go hand in hand. The issue is on
what came first and what symptoms take precedence in treatment. -AJ
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 Q1: Do you have someone in your life that has been addicted to drugs?
 If you have, did you see firsthand how their drug use affected their everyday life?

Yes. Drugs became the most important thing that day and everyday. He didn’t care if he hurt his
family, and friends because as long as he got high that day nothing else mattered. He couldn’t keep a
job, and his relationships was tarnished.