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The Seven Cs


The annual Children of Addiction Week was celebrated internationally in February. Hundreds of organizations and thousands of individuals across the globe acknowledged the Week with educational programs and celebrations honoring recovery not only for addicted individuals, but also for impacted children and families. The Week coincides with the anniversary of the founding of the National Association for Children of Addiction (NACoA) in 1983, the national “voice for children” of addiction for the past thirty-five years. In addition, April is Alcohol Awareness Month and also Child Abuse Awareness Month.

An effective tool that NACoA utilizes in its work to bring awareness to those in a position to help children of parents suffering from alcohol or drug misuse is the Seven Cs. It also helps caring adults in positions to support affected children understand how parental addiction devastates children, and how to communicate the simple concepts embodied in the Seven Cs that can assist caring adults grasp what will help children survive and thrive.

Understanding the Seven Cs helps children learn what they cannot change in their families, and that they can still be okay. More importantly, it also provides a road map for helping these children develop a variety of healthy coping skills. This resource is used in children’s groups in drug and alcohol treatment programs, in school groups as an integral part of student assistance programs, in family service agencies, in faith communities, and in drug court programs.

NACoA looks at the plethora of compelling and concerning reports that have grown from the Centers for Disease Control and Prevention’s (CDC’s) Adverse Childhood Experiences (ACE) study with Kaiser Permanente, and thinks about the millions of children and teens suffering in silence during yet another addiction epidemic. Those who are allocating the billions of dollars to attack the problem are focusing on funding treatment, overdose prevention, and other proposed strategies to bring recovery to addicted individuals, while impacted children and families—where real prevention begins if parents and children alike can receive healing support—appear to be judged as not as worth saving.

The First C: I Didn’t Cause It

Youngsters face many challenges growing up in families hurt by addiction. They often keep pent up feelings inside including confusion, shame, and guilt. Many end up blaming themselves for family problems. Sometimes children are told it is their fault by other family members stuck in their own pain, shame, and denial. When children experience trauma in their lives, and no one explains it to them in an age-appropriate way, they sometimes make up a story for it all to make sense. They are often not only dealing with addiction, but also other problems that can rear their ugly heads when this chronic disease is present, like family conflict, domestic violence, divorce, child maltreatment, co-occurring disorders, and parental incarceration, to name a few. Many children come to the conclusion that it must be their fault.

During a children’s program at a treatment center, Phil was taking it all in. This ten-year-old was fully engaged at the end of the second day of a four-day session. When asked what the kids had learned so far, he quickly chimed in, “I thought it was my fault and that I was bad.” He shared, “Now I’m learning it’s not my fault.” As tears rolled down his face, he concluded, “I’m starting to feel better about myself.”

The Second C: I Can’t Control It

Children may take steps to stop a parent’s drinking and/or using. They vigorously attempt to improve things in their families. Some pour out alcohol and throw away drugs they find hidden in the household. Others take on parental responsibilities, which can include caring for younger siblings. Still others try to play the peacemaker during times of family conflict. Some try to be perfect in all they do. Children hope these behaviors will help the problems go away. When this does not work, some simply try harder.

It is important to teach kids that addiction is a disease. Once people start drinking or using, they cannot stop. There are three words that especially work in helping children understand addiction: “stuck,” “hooked,” and “trapped.”

It is also essential to explain that people suffering from addiction are not bad people. Yet when they get stuck, hooked, and trapped, they sometimes do bad things like breaking promises, not playing with their kids, or maybe even not coming home.

Another important strategy is to help children separate the people they love from the disease that envelopes and consumes them. It is the people with the addiction that need to get help, and that is not the children’s job—it is vital for children to simply be children.

The Third C: I Can’t Cure It

A child cannot stop addiction. Addicted people must get help for that very serious medical problem. When they get help, we call it “treatment and recovery” or T&R. T&R can include going to a treatment program, working with a counselor, attending Twelve Step meetings, and/or returning to faith. While there is no cure for addiction, people can find joy, peace, and serenity by sticking with T&R. It is their responsibility to continue to work on their health and wellness, not the kids’.

During a recent school group, a very wise eleven-year-old explained it much better than I do: “T&R is like base in the game of tag. Once you’re there [at base or in T&R], no one else can mess with you,” she shared. “My job is to get myself to base,” she noted, “I can’t make others do so.”

Al-Anon and the Three Cs

The origin of “I didn’t cause it / I can’t control it / I can’t cure it” comes from Al-Anon family groups.

Al-Anon is a worldwide fellowship that offers a program for the families and friends of alcoholics. I had used the Three Cs for many years in my work with children and families. While it very effectively helped youth to realize and understand what they could not do, it finally dawned on me that it did not help them see what they could do for their own healing. This began the evolution of Three Cs to Seven Cs.

The Fourth C: I Can Help Take Care of Myself

We often close children’s program groups with the Serenity Prayer. It is a useful tool to help youth differentiate what they can and cannot change.

  • “Serenity to accept the things I cannot change” (the first three Cs)
  • “Courage to change the things I can” (the last four Cs)

This is simply another way to look at this.

Self-care is often a foreign concept in many families hurt by addiction. Jeopardy, the Self-Care Game, a spin-off of the popular television show, is an exercise to do with families. The five Jeopardy categories are body, mind, feelings, spirit, and kid. The group brainstorms ways to care for themselves in each category and the answers are recorded on the board. Once complete, each family member takes a lunch bag and decorates it as their “self-care bag” and fills it with ideas from the game board written on index cards. The goal is to pull out an index card and practice a self-care idea, such as “read a book,” “make a gratitude list,” or “play a game,” each day.

A dad, six months sober, brought his family to the children’s program. When he completed his self-care bag, he told the group, “This is part of my relapse prevention.” A wry smile came to his face as he made this important connection.

The Fifth C: Communicating Feelings

The Fifth C is about helping children develop the skills of identifying and expressing their feelings in healthy ways. Give kids a “feelings vocabulary” to assist them with this process. A set of eight feeling faces up on the wall in the group room works wonders in this regard.

Children share their feelings through artwork, writing, role-play exercises, and simply by talking. Providing opportunities to participate in all of these activities helps youngsters see which ways are the most comfortable for them. In group, kids are often amazed that others have similar feelings of anger, hurt, fear, and happiness—a powerful way for them to realize they are not alone.

The Sixth C: Making Healthy Choices

When Leo could not wake up his mom, he remembered what he had learned in group. This twelve-year-old quickly, yet calmly, called his grandfather for help, who arrived in ten minutes.

Teach kids to make self-care choices, whether having fun with friends, playing outside, reading a book, keeping a journal, or singing and dancing in very silly ways. It is also important to teach them that it is okay to ask for help. Introduce them to the concept of safe people in their lives that they can turn to when times get tough. Safe people could be family members, teachers, coaches, ministers, neighbors, a friend’s parents, or other trusted adults.

The Seventh C: Celebrating Me

Everyone is born with beauty and goodness inside. Unfortunately, the family disease of addiction often has an insidious way of obscuring and diminishing this. In children’s programs, counselors often hold up “mirrors” to point out the special gifts children possess. They create opportunities in group for youngsters to build upon these strengths and deepen their resilience. Take time to celebrate these kids when they complete very challenging tasks, do well in school, are good friends, or excel in sports or creative arts. Acknowledge and honor these accomplishments. This helps children to deepen their sense of connection and belonging, two critical components in the healing process.


Please use the Seven Cs as another resource to put in your toolbox. It works well with any major challenges and stressors your clients might be facing. It is also proven effective with “kids” of all ages. By helping individuals see what they can and cannot change, the Seven Cs provide a clear road map to help, hope, and healing.

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Jerry Moe, MA, is the national director of children’s programs at the Hazelden Betty Ford Foundation.

Jerry Moe, MA

Jerry Moe, MA, is the national director of children’s programs at the Hazelden Betty Ford Foundation.

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