There are a wide range of therapeutic options available to individuals struggling with substance abuse, and it is important for recovering addicts to align with the forms of therapy that are the most beneficial to their progress. One almost universally helpful addiction treatment intervention is family therapy.
What is family addiction treatment and what is it for?
Family therapy can be key to recovery success. Addiction doesn’t just affect the individual abusing drugs or alcohol, but everyone who regularly interacts with that individual. In fact, many people refer to addiction as “the family disease,” because of the destructive effect that the disease has on a family’s functioning and the emotional well-being of individual family members and the family unit.
Most addicts will attempt to keep their substance abuse secret from loved ones, but the addiction will inevitably start to interfere with a family’s routines and communications, introducing new stressors and interpersonal conflicts. As the addict exhibits negative changes due to substance abuse, other family members will ask questions and express concerns, which the addict will usually respond to with dishonesty and/or hostility. The resulting lies, confusion and conflicts create an unhealthy dynamic that prohibits the family from interacting in a peaceful, respectful, and open state of loving communication.
Another way that addiction affects families is by causing the addict and their loved ones to become codependent. In cases like these, family members will enable the addict’s substance abuse behaviors, either knowingly, out of a fear of being rejected by the addict, or unknowingly, in a state of deep denial. Codependent relationships are unhealthy for everyone involved. Not only do they encourage the addict’s substance abuse, they also hurt the enabler, who rapidly becomes drained of mental, emotional, physical and financial resources.
Seeking out family support for addiction treatment ensures that destructive interpersonal conflicts and/or codependent behaviors do not cause stumbling blocks that could lead the recovering addict to relapse.
How do you define Family?
Families come in all forms. While many families you’ll find in family addiction treatment are traditional ones, with a married mother and father and their biological children, many are less conventional. Some children have single parents, or same sex parents, or are being raised by grandparents, or other relatives, and there are stepfamilies and adoptive or foster families.
Many addicts have elected families—groups that self-identify as a family even though they aren’t connected by blood, marriage or other legal ties, such as emancipated young people who live with peers, or adults who turn to a close-knit friend group during times of tragedy or celebration rather than blood relatives. All that is necessary for a family to be a family is a level of interpersonal intimacy and commitment that would make any group member’s addiction a problem for everyone.
Family therapy can involve anyone who is emotionally close to the recovering addict, especially if these loved ones share a home environment.
Benefits of Family Therapy
Having family support for addiction recovery can make a dramatic difference to recovery progress. Recovery treatment is not just for the addicted individual, but for their loved ones as well. Addiction breaks down relationships, communication, and self-worth, and family addiction treatment repairs broken connections, decreases anxiety, and increases trust, self-worth, and honesty. Family therapy can help family members shift from playing roles such as the victim, the rescuer, the cop, and the protector to just being themselves within healthy, authentic relationships.
Drawbacks of Family Therapy
Family addiction treatment has very few drawbacks, but like any form of addiction treatment, there are negatives as well as positives. During family therapy, there is always the chance of a family member feeling attacked and reacting poorly. Recovering addicts may be triggered to relapse, or engage in other self-destructive behaviors. Unstable or reactive family members may respond to sensitive conversations with anger or even violence. Usually though, these sorts of extreme situations can be avoided by counselors or therapists who thoroughly assess or screen family members before the group gathers for family addiction treatment.
Some family members may need to be excluded from family therapy for the sessions to be beneficial. In some cases, this drawback is really a benefit, as the process of having a counsellor identifies a family member as a potentially destructive force in therapy will also identify them as a potentially destructive force in the recovering addict’s life. The primary patient may want to consider adjusting their home environment, if possible, to exclude such people.
Types of Family Therapy
Functional Family Therapy (FFT) takes a family systems view of family functioning, which holds that problem behaviors stem from unhealthy family interactions. Counselors work to teach families behavioral techniques that will improve communication, conflict resolution, problem solving and parenting skills.
In Behavioral Contracting, the therapist works with the family to create a written contract on maintaining a substance-free home environment. The therapist also helps the family identify substance abuse triggers, predict potential conflicts and challenges, and develop plans to avoid them.
Family Behavior Therapy (FBT) combines contingency management with behavioral contracting in ways that not only address addictive behaviors, but other behavioral problems as well. Goals are set for using behavioral strategies to improve the home environment, and rewards are provided at each session for goals achieved.
In Behavioral Marital Therapy the therapist helps a couple to create a substance-free home environment while working with them on communication skills, coping skills, reinforcements for abstinence, and relapse prevention.
Multidimensional Family Therapy (MDFT) is a community and family based treatment for adolescents and their families. Its focus is to improve family competency and the behavioral skills of individual family members while collaborating with community systems like schools or juvenile justice. It can be very effective in helping adolescents move past substance abuse and successfully reintegrate into their communities.
Solution Focused Therapy focuses on problem solving and not on how the family problems developed. In this therapy, the recovering addict, their family, and a counselor work together to come up with ways to avoid substance abuse and to envision a home without alcohol or drugs.
Multifamily Groups are support groups that provide families with insight into their behaviors and show them that other families are struggling with the same challenges. In this way, family support for addiction treatment is shared between different family groups.
How does family therapy compare to other forms of therapy?
Individual therapy provides a safe space for recovering addicts to process past trauma, present challenges, and to strategize for the future. Therapists help patients discover and address mental health issues and to change negative patterns of thought and behavior.
Group therapy helps recovering addicts recognize that they are not alone. The process of openly sharing experiences with the group can help members shed burdensome feelings of shame that can derail progress. Giving and receiving support can be equally useful to the recovery process.
Family therapy accomplishes many of the same things that are achieved in both individual and group therapy, but with a more intensive focus on the family unit and the patient’s home environment. By engaging each family member and working to identify each individual’s participation within the cycle of addiction, family addiction treatment enables the entire family to evolve into a better functioning, healthier unit that can sustain a positive environment that supports the mental health of everyone in the family.
How can I know if family therapy is right for me?
Here are 11 reasons why family therapy might be a good choice for you.
1. Addiction is not an independent disease, but a family one.
The family disease model asserts that in most cases, addiction is not an independently developed disease, but reflects a family issue or issues. To overcome addiction, the addict’s family must come to terms with the factors that led to the substance abuse. Often families will try to blame the recovering addict as being solely responsible for family problems, when in fact, the substance abuse may be a symptom of previously existing issues that require full family participation to heal.
2. Treatment for adolescent substance abuse should always involve family addiction treatment.
If the recovering addict in your family is an adolescent, family therapy is essential to recovery. Adolescents live with at least one parent or legal guardian and are subject to that caregiver’s rules, controls, and support. Adolescents rely on family support for addiction treatment, and need considerable help to establish a positive home environment because they live in a dependent situation.
3. Family involvement removes the fear of being judged.
A common stumbling block to addiction recovery is the shame that addicts feel about their disease. They don’t want to be open about their problems out of a fear of being judged. Family addiction treatment puts the substance abuse right out in the open within a safe, therapist-led environment. This helps the recovering addict and their family come to the mutual acceptance required for true addiction recovery.
4. Family therapy allows all family members to process the addict’s actions.
Because addiction is a disease than alters the structure and functioning of the brain, addicts are not able to behave in predictable, reasonable, logical ways. This can seriously throw off a family’s functioning. Family members need to emotionally and mentally come to terms with the addict’s past actions, while also learning practical ways to respond in the future, such as how to stop enabling their loved one’s addictive behaviors.
5. Family members learn about self-care.
Family addiction treatment often shows siblings, parents, children or spouses of the recovering addict that they are also in need of help. This might mean they simply need to be kinder to themselves and find ways to release stress and find enjoyment, or perhaps they need to seek out a support group such as Nar-Anon or Al-Anon, or individual therapy from their own counselor.
6. Families are taught about substance abuse triggers.
Families may contribute to a family member’s addiction without realizing it. Family therapy counselors can lead individuals to recognize and avoid creating trigger situations that might endanger the recovery success of their addicted loved one.
7. Family therapy educates families about what to expect from treatment.
Family members without much knowledge of addiction treatment may have unrealistic expectations that put undue pressure on the recovering addict. For example, the recovering addict may not be able to accomplish their fair share of household duties, and may not be able to give as much emotional and physical support as they need to receive. Families should be compassionate about this, and also understand when and how this imbalance will start to shift, as the addict begins to gradually take on a wider range of home obligations.
8. Family members are guided to rebuild their own lives.
Family addiction treatment means that not only does the recovering addict improve their life, but family members do as well. Many forms of family therapy will help individual family members to work towards their own personal, professional, educational, and health goals.
9. Counselors will identify any negative relationship structures.
Often addiction causes role reversals in families. Parents may begin to act like children and children like parents. Family counselors can identify these kinds of negative patterns or inappropriate roles among family members and suggest alternatives that will restore a more beneficial family structure.
10. Family therapy provides a safe, neutral forum for discussion.
Talking about addiction issues at home can often lead to chaos and negativity. Counselors are trained to mediate family discussions so that the conversation remains useful and productive for everyone involved.
11. Family addiction treatment brings families closer.
Addiction can wreak havoc on a family, driving them apart, and in some families, addictions have developed due to problems that were already present. Family addiction treatment allows family members to work together to correct negative personal behaviors, increase mutual understanding and support, and better communicate their love and compassion for one another. This naturally strengthens family bonds and brings individuals closer together as a functional unit.