Psychologist offers solutions for parents, children who use drugs

Parents are the key to keeping kids off drugs. That’s according to MUSC clinical psychologist Phillippe Cunningham, Ph.D. Many studies indicate that open communication and appropriate discipline, as well as positive parent-child relationships that balance warmth and structure, greatly reduce the risk of drug abuse among children and adolescents. But what happens when parents have issues to work through themselves? Cunningham’s latest work with juvenile drug offenders suggests that parents are still the key, though they may need some help to see it.

“Many drug courts and treatment programs have difficulty getting parents and caregivers involved,” Cunningham said. “These families have had a long row to hoe. They’ve suffered 10,000 defeats and they’re demoralized. But, if we can get them through the door and involved in their kids’ treatment, we have an opportunity to teach them skills and competencies that they can then use to help their child and themselves.”

When it comes to getting parents through the door, Cunningham thinks carrots work better than sticks. A new $3.6 million R01 research grant from the National Institute on Minority Health and Health Disparities, part of the National Institutes of Health, will allow him to put that theory to the test. 

In return for engaging in verifiable activities – taking part in parenting classes, meeting with teachers and attending school functions, creating a monitoring plan or parent-child contract, even planning a “date night” to bond with their child – parents who take part in the program will have the opportunity to earn rewards worth between $1 and $100. A parent who fully participates in these activities for the 16 weeks would earn, on average, a little more than $700.

Cunningham will begin recruiting parents with children in the San Antonio, Texas juvenile drug court system this spring. A co-investigator, Stacy Ryan, Ph.D., at the University of Texas at San Antonio had an existing relationship with the drug courts there, and San Antonio's crowded court system provided a large enough sample size for Cunningham's research. Once he has enough data to prove his program works, he hopes to procure additional funding to expand it to Charleston and other cities around the country. Ultimately, he'd like to empower parents nationwide.  

“Parents are centrally located, emotionally, psychologically and physically, to manage many of the factors that influence whether or not a kid uses drugs,” he said. “Setting limits, getting to know a child’s peers, enriching his or her life beyond drug use – those are things really only parents or caregivers can do.”

But most parents have issues to deal with themselves, especially in many of the low-income communities Cunningham works with. Some work multiple jobs and have difficulty juggling their commitments. Others mismanage issues through poor discipline.

“Many poor, disenfranchised families are nickel-and-dimed; they’re working all sorts of jobs to make ends meet, and they don’t have the opportunity to watch their kids or be connected with others in their communities. They have to keep a roof over their heads and food on the table,” Cunningham said. “And some parents just don’t know what to do. They’ve never experienced good parenting themselves, so they naturally turn to coercive or inconsistent discipline practices.”

Cunningham believes that most parents wake up every day wondering what they can do to help their kids be successful, but they just don’t have the tools or support to pull it off. “We live in a time where we have so much information, but so few relationships,” he said. “Without tight community relationships, kids can fall through the cracks.”

He hopes his project can change that.

“If you want to help a kid, you need to help a parent,” he explained. “And by helping a parent, you help a whole community.”

The communities Cunningham wants to help look very much like the one he grew up in. “I’m the son of an African–American father and a French woman,” he explained. “My father met my mother when he was in the Air Force stationed in France. They came back to the United States at the height of the tumultuous Civil Rights movement, and my father ended up leaving, so my mom raised five kids alone in a poor, black community in our nation’s capital. I went to a ‘separate–but–equal’ school; I had so many opportunities to go the wrong way.”

As a young man, Cunningham said it was the suffering he saw around him, both in the violence of the Civil Rights movement and in struggles closer to home, that kept him on the straight and narrow. His mother, who didn’t speak English well, worked as a waitress to get by and wasn’t around as much as she would have liked to be.

“I was fascinated by my mother’s experience,” Cunningham said.

From early on, he knew he wanted to get involved with kids and families, helping to build stronger communities in which to one day raise his own children.

After high school, Cunningham went to Virginia Union University, a historically black college, on an athletic scholarship. He later tried out as a free agent for the Detroit Lions football team, but when he wasn’t offered a contract, he decided to pursue psychology as a career.

“I went to Mankato State University in Minnesota for my master’s in clinical psychology. That was where 'Little House on the Prairie' was set," he laughed. “I went from the blackest environment in the world to the whitest. This was really my first experience with European-American culture. Outside of my mom and cutting grass at Chevy Chase Country Club in Washington, D.C., I seldom saw white folks.”

Though the change was jarring at first, he soon grew to love his new environment. “These were good, salt-of-the-earth people,” he said. “And many of them had never had experience with a black person before either.”

That experience guided him even after he left Mankato for Virginia Tech, where he earned his Ph.D. in clinical child psychology, and would continue to guide him at MUSC.

“An area that’s near and dear to my heart is building cultural competency,” he explained. “How do we train people to work with others who are different from them? In the past, many of the approaches we’ve taken have actually caused harm. For example, if we know that the best predictor of kids engaging in anti–social behavior is who they hang with, what’s the last thing you’d want to do? Group them together. And yet that’s exactly what we do. We either lock them up or put them in special classes together. We have a responsibility to use evidence–based interventions and prove that what we’re doing won’t cause harm. When I look at what’s happening to kids in this country, kids of color, kids from poor and disenfranchised communities, it just breaks my heart. I know we can do better.”

He hopes his new project is a step in that direction.