Working with children from substance-affected families: the community-based group intervention TRAMPOLINE


  • Sonja Bröning Centro Médico Universitario Hamburg-Eppendorf
  • Diana Moesgen Universidad Católica De Ciencias Aplicadas, Nordrhein-Westfalen
  • Michael Klein Universidad Católica De Ciencias Aplicadas, Nordrhein-Westfalen
  • Rainer Thomasius Centro Médico Universitario Hamburg-Eppendorf



Children from substance-affected families, prevention program, resilience, parental substance abuse, group program


Introduction: Children from substance-affected families show an elevated risk for developing own substance-related or other mental disorders. Frequently, they experience violence, abuse and neglect in their families. Therefore, they are an important target group for preventive efforts. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated program for children from substance-affected families exists in Germany. Methods: A new group intervention for children from substance-affected families was developed and is currently being evaluated in a randomized-controlled multicenter study funded by the German Ministry of Health. The development process was simultaneously guided by theory, existing research knowledge and expert opinion. Promoting resilience in children affected by parental substance abuse is a key goal of the program. Results: The TRAMPOLINE manual describes a 9-session addiction-focused, modular group program for children aged 8 to 12 years with at least one substance-using parent. Weekly sessions last for 90 minutes and combine psychoeducational elements with exercises and role play. A two-session parent intervention component is also integrated in the program. Content, structure and theoretical background of the intervention are described. Discussion: TRAMPOLINE is a new interventive effort targeting children from substance-affected families. It is grounded in theory and practice. The results of the research in progress will provide fundamental information on the effectiveness of a structured group prevention program for German children from substance-abusing families. Thus, the study will contribute to creating a broader and more effective system of preventive help for this high-risk target group.


Antonovsky, A. (1997). Salutogenese. Zur Entmystifizierung der Gesundheit. Tübingen: dgvt-Verlag.

Arenz-Greiving, I., & Kober, M. (2007). Metastudie. Arbeit mit Kindern und deren suchtkranken Eltern. Berlin: Bundesministerium für Gesundheit.

Ashenberg Straussner, S. L. (2012). Children of substance-abusing parents: an overview. In S. L. Ashenberg Straussner & C. Huff Fewell (Eds.), Children of substance-abusing parents. Dynamics and treatment (pp. 1-27). New York: Springer Publishing Company.

Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.

Barnow, S., Lucht, M., Hamm, A., John, U., & Freyberger, H.-J. (2004). The relation of a family history of alcoholism, obstetric complications and family environment to behavioral problems among 154 adolescents in Germany: Results from the children of alcoholics study in Pomerania. European Addiction Research, 10(1), 8-14. doi: 10.1159/000073721

Bröning, S., Kumpfer, K., Kruse, K., Sack, P. M., Schaunig-Busch, I., Ruths, S., Moesgen, D., Pflug, E., Klein, M., & Thomasius, R. (2012). Selective prevention programs for children from substance-affected families: a comprehensive systematic review. Subst Abuse Treat Prev Policy, 7(1), 23.
PMid:22691221 PMCid:PMC3490747

Bröning, S., Wiedow, A., Wartberg, L., Ruths, S., Haevelmann, A., Kindermann, S.-S., Moesgen, D., Schaunig-Busch, I., Klein, M., & Thomasius, R. (2012). Targeting children of substance-using parents with the community-based group intervention TRAMPOLINE: A randomised controlled trial - design, evaluation, recruitment issues %U BMC Public Health, 12 %@ 1471-2458(1 %M doi:10.1186/1471-2458-12-223), 223.

Connors, G. J., Donovan, D. M., & DiClemente, C. C. (2001). Substance abuse treatment and the stages of change: Selecting and planning interventions. New York: Guilford.

Cork, M. R. (1969). The forgotten children: A study of children with alcoholic parents. Toronto: Addiction Research Foundation.

Dore, M. M., Nelson-Zlupko, L., & Kaufmann, E. (1999). "Friends in Need": designing and implementing a psycho-educational group for school children from drug-involved families. Social Work & Society, 44 (2), 179-190.

Dube, S. R., Anda, R. F., Felitti, V. J., Croft, J. B., Edwards, V. J., & Giles, W. H. (2001). Growing up with parental alcohol abuse: Exposure to childhood abuse, neglect, and household dysfunction. . Child Abuse & Neglect 25, 1627-1640.

EMCDDA. (2008). Drugs and vulnerable groups of young people. Selected issue 2008. Lissabon: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

Fonagy, P., Gergely, G., Jurist, E., & Target, M. (2002). Affektregulierung, Mentalisierung und die Entwicklung des Selbst. Stuttgart: Klett-Cotta.

Grant, B. F. (2000). Estimates of U.S. children exposed to alcohol abuse and dependence in the family. American Journal of Public Health, 90, 112-115.
PMid:10630147 PMCid:PMC1446111

Grucza, R. A., Bucholz, K. K., Rice, J. P., & Bierut, L. J. (2008). Secular trends in the lifetime prevalence of alcohol dependence in the United States: A re-evaluation. Alcoholism: Clinical aned Experimental Research, 32(5), 1-8.

Haggerty, K. P., Skinner, M., Fleming, C. B., Gainey, R. R., & Catalano, R. F. (2008). Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction, 103(12), 2008-2016. doi: 10.1111/j.1360-0443.2008.02360.x

Hill, S. Y., Shen, S., Lowers, L., Locke-Wellman, J., Matthews, A. G., & McDermott, M. (2008). Psychopathology in offspring from multiplex alcohol dependence families with and with-out parental alcohol dependence: A prospective study during childhood and adolescence. Psychiatry Research, 160, 155-166.
PMid:18597856 PMCid:PMC2605725

Hill, S. Y., Tessner, K. D., & McDermott, M. D. (2011). Psychopathology in offspring from families of alcohol dependent female probands: A prospective study. Journal of Psychiatric Research, 45(3), 285-294. doi: 10.1016/j.jpsychires.2010.08.005

Horn, K., & Kolbo, J. R. (2000). Application of a cumulative strategies model for drug abuse prevention: Exploring choices for high risk children. Journal of Drug Education, 30(3), 291-312. doi: 10.2190/udc0-6ect-eqca-wvtt

Kelley, M. L., Pearson, M. R., Trinh, S., Klostermann, K., & Krakowski, K. (2011). Maternal and paternal alcoholism and depressive mood in college students: Parental relationships as mediators of ACOA-depressive mood link. Addictive Behaviors, 36(7), 700-706. doi: 10.1016/j.addbeh.2011.01.028

Klein, M. (2005). Kinder und Jugendliche aus alkoholbelasteten Familien. Stand der Forschung, Situations- und Merkmalanalyse, Konsequenzen. In M. Klein, T. Hoff & A. Pauly (Eds.), Schriftenreihe Angewandte Suchtforschung (Band 1). Regensburg: Roderer.

Klein, M., Ferrari, T., & Kürschner, K. (2003). Kinder (un)behandelter suchtkranker Eltern: Eine Situationsanalyse und mögliche Hilfen. Unveröffentlichter Forschungsbericht im Auftrag des Bundesministeriums für Gesundheit und Soziale Sicherung, Berlin. Retrieved from

Klein, M., Moesgen, D., Bröning, S., & Thomasius, R. (submitted). Trampolin. Kinder aus suchtbelasteten Familien entdecken ihre Stärken. Manual. Göttingen: Hogrefe.

Küfner, H. (2010). Epidemiologie des Substanzkonsums und der Suchterkrankungen in Deutschland. Bundesgesundheitsblatt, 53, 271-283.

Kumpfer, K. L. (1999). Factors and processes contributing to resilience: the resilience framework. In M. D. Glantz & J. L. Johnson (Eds.), Resilience and development: positive life adaptions (pp. 179-224). New York: Kluwer Academic Plenum Publisher.

Kumpfer, K. L., Alvarado, R., & Whiteside, H. O. (2003). Family-based interventions for substance abuse prevention. Substance Use & Misuse, 38(11-13), 1759-1789.

Lam, W. K. K., Cance, J. D., Eke, A. N., Fishbein, D. H., Hawkins, S. R., & Wiliams, J. C. (2007). Children of African-American mothers who use crack cocaine: Parenting influences on youth substance use. Journal of Pediatric Psychology, 32, 877-887.

Lam, W. K. K., & O'Farrell, T. J. (2012). Dynamics of Substance-Abusing Families and Implications for Treatment. In S. L. Ashenberg Straussner & C. Huff Fewell (Eds.), Children of substance-abusing parents. Dynamics and treatment (pp. 49-75). New York: Springer Publishing Company.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.

Lazarus, R. S., & Launier, R. (1981). Stressbezogene Transaktionen zwischen Personen und Umwelt. In J. R. Nitsch (Ed.), Stress, Theorien, Untersuchungen, Maßnahmen (pp. 213-259). Bern: Huber.

Marmorstein, N. R., Iacono, W. G., & McGue, M. (2009). Alcohol and illicit drug dependence among parents: associations with offspring externalizing disorders. Psychological Medicine, 39(1), 149-155. doi: 10.1017/s0033291708003085

McKenna, T., & Pickens, R. (1981). Alcoholic children of alcoholics. Journal of Studies on Alcohol, 42, 1021-1029.

Meyer, C., & John, U. (2008). Alkohol-Zahlen und Fakten zum Konsum. Jahrbuch Sucht 2008. Geesthacht: Neuland Verlagsgesellschaft.

Molina, B. S. G., Donovan, J. E., & Belendiuk, K. A. (2010). Familial Loading for Alcoholism and Offspring Behavior: Mediating and Moderating Influences. Alcoholism: Clinical and Experimental Research, 34(11), 1972-1984. doi: 10.1111/j.1530-0277.2010.01287.x

NACOA Deutschland. (2006). Kinder aus suchtbelasteten Familien. Hilfen zur Unterstützung in Kindertagesstätte und Grundschule. Berlin: NACOA Deutschland – Interessensvertretung für Kinder aus Suchtfamilien e.V. .

Petermann, U. (2009). Die Kapitän-Nemo-Geschichten: Geschichten gegen Angst und Stress. Freiburg im Breisgau: Herder.

Pfeiffer-Gerschel, T., Kipke, I., Flöter, S., & Jakob, L. (2011). Bericht 2011 des nationalen REITOX-Knotenpunktes an die EBDD Deutschland: Drogensituation 2010/2011. München: DBDD.

Rothman, E. F., Edwards, E. M., Heeren, T., & Hingson, R. W. (2008). Adverse Childhood Ex-periences Predict Earlier Age of Drinking Onset: Results From a Representative US Sample of Current or Former Drinkers. Pediatrics, 122 (2), 298-304.

Rotter, J. B. (1966). Generalized Expectancies for Internal Versus External Control of Reinforcement. [Article]. Psychological Monographs, 80(1), 609.

Ruths, S., Moesgen, D., Bröning, S., Schaunig-Busch, S., Klein, M., & Thomasius, R. (in press). Präventive Gruppenangebote für Kinder aus suchtbelasteten Familien – eine bundesweite Bestandsaufnahme. Suchttherapie 2012.

Schuckit, M. A. (1991). A Longitudinal Study of Children of Alcoholics. Recent Developments in Alcoholism. 9, 5-19.

Schuckit, M. A., & Smith, T. L. (2001). The clinical course of alcohol dependence associated with a low level of response to alcohol. Addiction, 96(6), 903-910. doi: 10.1046/j.1360-0443.2001.96690311.x

Short, J. L., Roosa, M. W., Sandler, I. N., Ayers, T. S., Gensheimer, L. K., Braver, S. L., & Tein, J.-Y. (1995). Evaluation of a preventive intervention for a self-selected subpopulation of children. American Journal of Community Psychology, 23 (2), 223-247.

Simon, R., Palazzetti, M., Helas, I., Holz, A., & Walter-Hamann, R. (1999). Jahresstatistik 1998 der ambulanten Beratungs- und Behandlungsstellen für Suchtkranke in der Bundesrepublik Deutschland. EBIS-Bericht für den Zeitraum 1.1.-31.12.1998. Sucht 5-52.

Sorensen, H. J., Manzardo, A. M., Knop, J., Penick, E. C., Madarasz, W., Nickel, E. J., Becker, U., & Mortensen, E. L. (2011). The Contribution of Parental Alcohol Use Disorders and Other Psychiatric Illness to the Risk of Alcohol Use Disorders in the Offspring. Alcoholism: Clinical and Experimental Research, 35(7), 1315-1320. doi: 10.1111/j.1530-0277.2011.01467.x

Ulrich, I., Stopsack, M., & Barnow, S. (2010). Risiko- und Resilienzfaktoren von adoleszenten Kindern alkoholkranker Eltern. Ergebnisse der Greifswalder Familienstudie. . Diskurs Kindheits- und Jugendforschung, 5 (1), 47-61.

Velleman, R., & Templeton, L. (2003). Alcohol, Drugs and the Family: Results from a long-running research programme within the UK. European Addiction Research, 9(3), 103-112. doi: 10.1159/000070978

Velleman, R., & Templeton, L. (2006). Reaching Out – Promoting Resilience in the Children of Substance Misusers. In F. Harbin & M. Murphy (Eds.), Secret Lives: Growing with Substance. Working with children and young people affected by familial substance misuse (pp. 12-28). Lyme Regis: Russel House.

Velleman, R., Templeton, L., Reuber, D., Klein, M., & Moesgen, D. (2008). Domestic Abuse Experienced by Young People living in Families with Alcohol Problems: Results from a Cross-European Study. Child Abuse Review, 17(6), 387-409. doi: 10.1002/car.1047

Vernarde, D. F., & Payton, G. J. (2011). Interventions with college students with substance-abusing parents. In S. L. Ashenberg Straussner & C. Huff Fewell (Eds.), Children of substance-abusing parents. Dynamics and treatment (pp. 223-242). New York: Springer Publishing Company.

Waldron, M., Martin, N. G., & Heath, A. C. (2009). Parental Alcoholism and Offspring Behavior Problems: Findings in Australian Children of Twins. Twin Research and Human Genetics, 12(5), 433-440.
PMid:19803771 PMCid:PMC2891521

Weitzman, E. R., & Wechsler, H. (2000). Alcohol use, abuse, and related problems among children of problem drinkers - Findings from a national survey of college alcohol use. Journal of Nervous and Mental Disease, 188(3), 148-154. doi: 10.1097/00005053-200003000-00004

Werner, E. E. (1986). Resilient Offspring of Alcoholics - a Longitudinal-Study from Birth to Age-18. Journal of Studies on Alcohol, 47(1), 34-40.

Wolin, S., & Wolin, S. (1995). Resilience among Youth Growing-up in Substance-Abusing Families. Pediatric Clinics of North America, 42(2), 415-429.

Wolin, S., & Wolin, S. J. (1996). The challenge model - Working with strengths in children of substance-abusing parents. Child and Adolescent Psychiatric Clinics of North America, 5(1), 243-257.

Wolin, S. J., Bennett, L. A., Noonan, D. L., & Teitelbaum, M. A. (1980). Disrupted Family Rituals - a Factor in the Intergenerational Transmission of Alcoholism. Journal of Studies on Alcohol, 41(3), 199-214.

Wustmann, C. (2004). Resilienz: Widerstandsfähigkeit von Kindern in Tageseinrichtungen fördern. Weinheim: Beltz.
PMid:15020529 PMCid:PMC1768172

Zobel, M. (2000). Kinder aus alkoholbelasteten Familien. Entwicklungsrisiken und –chancen. Göttingen: Hogrefe.