Family relationships affect substance abuse treatment because, in addiction, biology, psychology, and a patient’s social network all play a part. Usually, a person’s family is their most significant social network, with the longest-lasting and most intense relationships. Family members often feel helpless in the face of addiction, but, in reality, there’s a lot that they can do to encourage and support their loved one’s recovery.
Benefits of Family Therapy
If you have a loved one in an addiction treatment program that offers family therapy, your participation can be very beneficial, not only for your family member but for you. Ideally, everyone’s needs will be acknowledged and addressed because the family is a system where people react and interact, and changing one part of the system can affect it all.
Because secrecy and denial are generally part of addiction, communicating openly in a safe and supportive environment is a meaningful family-based treatment component. The therapist can help you create the opportunities to say what’s been difficult to say in the past. Family-focused therapy can help everyone set common goals and determine the best way to work together for the good of all.
In a metaphorical sense, addiction can be a contagious disease, moving from person to person in a family. A publication on substance abuse treatment and family therapy notes that “Study after study shows that if one person in a family abuses alcohol or drugs, the remaining family members are at increased risk of developing substance abuse problems.” One benefit of therapy, then, is that it may not only help the substance-abusing patient resolve addiction issues but also keep others from following in their footsteps.
Common Family Patterns
Every family is unique, but there are common patterns and needs based on which family member is diagnosed with substance abuse disorder.
- The Needs of Parents with Substance-Abusing Children
Substance use disorders often begin in adolescence when people frequently begin to experiment with drugs and alcohol. It’s typically a time when children test their boundaries, which leads to strained relationships with their parents. When substance abuse is part of the picture, the strains are magnified and multiplied.
Even when there’s no substance abuse involved, there’s generally conflict between your child trying to assert independence and you want to maintain control so you can protect and direct them. Parents not only have a feeling of responsibility for their children but a legal mandate, which can add an extra degree of stress.
It’s easy to start believing that your children are a reflection of you and your parenting skill, so it’s unfortunately common to feel a degree of embarrassment or shame about substance use. Parents may fear being judged by others and feel they need to maintain secrecy, keeping them from getting the emotional support they need.
The conflict between parents and substance-using teens is magnified because drug and alcohol use is associated with conduct and oppositional disorders, problems with authority, and poor school performance. It’s also associated with high-risk activities like driving under the influence and having unprotected sex.
If you’re the parent of a child with an addiction, you may feel like you’re in a constant state of crisis, and the stress can have profound effects on your own physical and emotional health. Managing a person’s needs with substance use disorder takes a lot of time and energy, and other relationships may suffer.
Other children in the family may feel that their needs aren’t being seen or met. They can react by taking on more responsibility than they’re ready for or by being disruptive in an attempt to gain the attention and focus of their parents. The relationship between parents may also feel strained, especially if there’s disagreement on the best way to manage the situation. If the parents are divorced but share custody, presenting a united front is often very challenging.
If your child is an adult, you may feel many of the same frustrations and worries and have a sense of helplessness, since your options for intervening are more limited. You’re likely to struggle with how much assistance to offer. If there are grandchildren involved, you may be concerned about their welfare and feel a need to take responsibility for their care.
- The Needs of Children with Substance-Abusing Parents
Parents feel responsible for their children, but children can also feel responsible for their parents. The children of parents with substance abuse issues may even begin to feel responsible for the drug or alcohol abuse. They may spend a lot of energy trying to manage life in a way they think will minimize the risk of upsetting the substance-abusing parent or keep them from using drugs or alcohol.
Children of parents with addiction issues, especially those who live in the same home, often experience a great deal of fear. They may fear the personality changes that can occur when the parent is under the influence, and they may also fear legal authorities. They may worry that a parent will be arrested or lose their parental rights, which will disrupt the children’s lives.
When a parent is dealing with addiction, especially in a single-parent family, there’s often a role reversal, with the children taking on parental roles. Older children may be expected to care for the parent when necessary and care for younger siblings, minimizing their own needs.
Sometimes children experience direct negative effects. The Substance Abuse and Mental Health Services Administration states, “Although many children living in households with a substance-using parent will not experience abuse or neglect, they are at increased risk for child maltreatment and child welfare involvement compared with other children.” Guarding against that is a fundamental reason parents choose to head to a substance abuse treatment center.
If you’re an adult, and your substance-abusing parent is older, you may be frustrated by trying to get a clear picture of the situation. You may have a hard time distinguishing the effects of substance abuse from the typical effects of aging on the brain and body. Adult children of substance-abusing parents experience many of the same issues that parents of adult substance-abusing children do. It’s often challenging to define roles and know when and how to intervene and help.
- The Needs of Spouses and Partners of Substance-Abusing Loved Ones
The spouse or romantic partner of someone dealing with addiction often has to balance competing needs and desires. If your loved one deals with addiction, you may realize that protecting them from the consequences of their behavior is ultimately counterproductive, making it harder for them to recognize their need for help.
On the other hand, since your lives are so intertwined, you know you’ll feel the consequences, too. This fallout can be especially true in the financial realm, where a job loss, for example, can significantly affect others who depend on the income.
Spouses frequently take on the role of protector. They can spend a lot of time and energy protecting their mates from harm and from situations that may be triggering. If there are children in the family, the non-addicted parent may also feel a need to protect them from circumstances that might be emotionally damaging.
The Effectiveness of Family Therapy for Substance Abuse
A large amount of research has proven the effectiveness of family-based approaches to substance abuse treatment. Benefits include the following:
- Brief family treatment has proven superior to individual and group treatment for reducing drug use among children and adolescents.
- Adolescents who participate in family-based therapy complete their treatment at a high rate.
- Family-focused treatment shows reduced parental drug use and prevents the children of drug-using parents from beginning to use them.
- Drug-using parents showed improvements in parenting skills and family management.
- Couples therapy showed to be superior to individual therapy in increasing abstinence and reducing the rates of separation, divorce, and domestic violence.
As an article in the Journal of Marital and Family Therapy puts it, “The overarching conclusion is that family‐based models are not only a viable treatment alternative for the treatment of drug abuse, but are now consistently recognized among the most effective approaches for treating both adults and adolescents with drug problems.”
Preparing a Safe Space
In addition to participating in family therapy, you can also help your loved one by doing what you can to prepare a safe space for them by focusing on both the physical and emotional environment.
In the physical realm, you can help prepare an environment that’s free from triggers. Sights, sounds, smells and other sensory input that reminds people of substance use can trigger cravings. With your family member’s input, you might be able to help them avoid that by rearranging or switching out furniture or painting a wall a different color. Of course, you’ll also want to make sure there are no drugs or alcohol around.
Providing an emotionally safe space can involve offering to continue with family therapy and making it easy for your loved one to attend support group meetings, by helping with things like transportation or childcare. Providing emotional safety means communicating honestly but compassionately and being patient with the recovery process’s ups and downs. Another practical way to help is to support the development of new, healthy habits. Maybe you can exercise with your family member or keep each other accountable to meditate or write in a journal.
Despite the proven effectiveness of family-focused treatment for substance abuse, many treatment programs don’t offer it. It takes more effort and coordination on the part of the facility because it’s more logistically complicated to manage a larger group of people’s schedules and needs. It also requires specialized training on the part of the practitioners.
Here at The Right Step, we know that substance use disorder is a family disease, so we offer family therapy along with a wide range of other proven, evidence-based treatments. Let us help your loved one find the way back home. Our admissions professionals are ready to help. Call us at 844.675.1628