Trampoline - a selective prevention programme to prevent substance use disorders in children from vulnerable families

TRAMPOLINE was developed for children aged 8-12 years that have at least one substance-abusing or -dependent caregiver. The intervention is specifically geared to the issues and needs of children of substance-abusers (COS). The name TRAMPOLINE was chosen because it creates positive associations in children, but also because it combines the ability to jump higher with the protection of a soft landing. The programme aims to empower the participation of children and at the same time to provide them with support and a safe place.

The TRAMPOLINE manual includes nine weekly 90-minute modules for children, as well as two optional sessions for their parents. The programme modules include: 1 – getting to know each other, 2 – self-worth: how I feel about myself, 3 – alcohol and/or drug problems in my family, 4 – knowledge: what I need to know about drugs and addiction, 5 – handling difficult emotions, 6 – self-efficacy: what I can do to solve problems, 7 – learning new patterns of behaviour in my family, 8 – what I can do to find help and support, and 9 – a positive good-bye.

All subjects are delivered in an interactive and age-appropriate way, with a large proportion of the sessions devoted to exercise and role-play. Special attention is paid to devise small rituals and a recurring structure to the sessions, both of which children in substance-affected homes often lack. Each session follows the same structure: it begins with an exchange on how children feel that day, followed by a discussion of the “homework” from the previous session; the new topic is then introduced, and developed through a variety of didactics. In between learning activities, there are “fun-and-play” activities such as songs or creative exercises. The sessions end with a relaxation exercise.

The parent sessions can be attended independently; providers should not assume that parents from volatile families will come to both, or even one, of the sessions. The first session, at the start of the programme, seeks to inform parents about the programme and about risk and protective factors children face when growing up in a substance-affected environment. Parents share the hopes they have with regards to living with their children, and are encouraged to consider parenting skills and their importance for their children. The second session, at the end of the programme, seeks to inform parents on how the programme went (from the trainer’s perspective), to answer questions about issues that may have come up at home in the course of the programme, and to sensitize parents to the needs of children in substance-affected families and how caregivers may be empowered in the future. Parents are encouraged to seek and accept further support in their parenting role. The manual for parents provides questions, group discussion and practical exercises.

The programme evaluation explores the role of psycho-education on children’s well-being by comparing the effects of TRAMPOLINE to an intervention for COS that is very similar with regard to setting, dose, and trainer qualification, but does not include addiction-related content or activities. We hypothesize that addiction-specific education, activities and role play will enhance the effectiveness of a prevention program compared with a prevention program without educational components.