Addiction, or substance use disorder, is a brain disease [1] which requires thorough treatment in order to combat.
While the disease of addiction is technically a chronic disease, meaning that it is not ‘curable’, it is certainly treatable, and addicted patients can overcome their addiction through a range of comprehensive treatment methods.
These treatment methods include behavioural and individual therapies such as Cognitive or Dialectical Behavioural Therapy, as well as Medicated Assisted Therapy in order to help them overcome the immediate symptoms of drug and alcohol addiction. Another important aspect of recovery is family therapy.
The entire family and close friends play an important role in assisting their loved one’s recovery.
Addiction is a debilitating disease, and the close friends or loved ones of an addicted person can maximise their quality and commitment of recovery by reinforcing positive habits and offering positive reinforcement.
Family involvement is integral, as each family member can play an important role regardless of the family structure and dynamics.
Whether the addicted person has a positive or a negative relationship with their family members, there are always methods by which they can improve their relationship and the efficacy of their unique support system.
It should be noted that family therapy will not solve any pre-existing issues between family members, however, it will provide them with the necessary tools in order to communicate more clearly and establish more transparency and honesty in their relationships.
The Benefits of Family Therapy During Addiction Treatment and Recovery
The benefits of family therapy throughout addiction treatment and recovery are invaluable for both short-term and long-term recovery. Studies [2] suggest that the involvement of family therapy can improve the rates of treatment participation and recovery outcomes.
Additionally, family therapy is not restricted to one form of treatment, it can offer a diverse range of benefits depending on its form. Not only does it offer a myriad of benefits for the entire family, but it also offers a wide range of benefits for the addicted person.
Family members and close friends of the addicted person are often considered to be the ‘first line of defence’ in the event of a relapse.
In order to prevent relapse and sustain the loved one’s recovery, the members of the addicted person’s support network must not only be in a state of optimal mental health, but they must also understand how they can support their loved one.
Some forms of therapy, such as Brief Strategic Family Therapy and Multidimensional Family Therapy (MDFT), aim to improve the level of support which family members can offer their addicted loved one.
It will help them improve their level of communication and also understand effective strategies for preventing relapses and sustaining their loved one’s recovery.
On the other hand, forms of therapy such as Family Behaviour Therapy offer emotional counselling and support for family members and friends who are struggling to process and cope with their loved one’s addiction.
Not only does the family member need to be able to know what to do during their loved one’s addiction recovery, but they also need to be in a state of mind which allows them to effectively employ these skills.
How are Family Members Affected by Addiction?
The effects of addiction are not only physical and psychological to the person who is addicted to substances, but they will suffer from a range of social effects.
These social effects include antisocial behaviour, damaged relationships and breakdown, isolation, and more, and these can inevitably affect those who are around the addicted person or those who deeply care for them.
Friends and family members will suffer significantly from the indirect effects of addiction, and these include emotional trauma, depression and anxiety over their loved one’s ill health, mental and physical fatigue from supporting the loved one, and so on.
Additionally, it can have a catalytic effect and even expose others to developing a pattern of drinking or consuming drugs which can inevitably lead to an addiction.
In addition to emotional stress and relationship breakdown, friends and family members may suffer from financial issues due to their loved one’s illness.
They may have been lending money to their loved ones in order to help them, only for them to spend the money on their addictive substance. Some people who are suffering from addiction may even resort to stealing from loved ones in order to satiate their cravings.
Furthermore, some friends or family members may even deny that their loved one is suffering from a substance use disorder.
Not only will this enable the addicted person, but it can also exacerbate their symptoms which means that the friends and family members will have a more profound task to deal with when they need to support their loved one in the future.
What Happens During a Typical Session of Family Therapy?
Family therapy sessions can take place with or without the addicted person, depending on the form of therapy.
Some will require that the addicted person is present in order to improve levels of communication between them and their family members. In contrast, other forms of therapy may emphasise emotional support instead.
Typically, family members and the addicted person will gather to participate in a therapy session which is led by a licensed counsellor.
The licensed counsellor or family therapist will create a safe environment where non-judgemental discussion can take place, and they will facilitate discussion between the active participants.
Listening in a non-judgemental fashion is hugely important throughout family therapy, and each family member will have the opportunity to share their thoughts and feelings about their loved one’s addiction and recovery.
Who Can Attend Family Therapy?
Family therapy does not limit itself to direct relatives of the addicted person, but it can include friends, colleagues, in-laws, sponsors, mentors, and other acquaintances.
These people can have a positive influence on the addicted person’s recovery, and they can be considered to be the addicted person’s support network.
Individuals who have a positive influence on the addicted person’s life are likely to be encouraged to participate during the intervention process.
Types of Family Therapy in Addiction Treatment
There are a wide range of family therapy methods. Each method has its own purpose and objectives, with no form being deemed more important than the other.
Some families or patients may benefit more from one form than another.
For example, a patient who has a negative relationship with their family will benefit from Functional Family Therapy more because it places more emphasis on improving relationships than other forms of therapy do.
1. Family Behaviour Therapy
Family Behaviour Therapy is employed in order to help family members cope with their loved one’s addiction. Witnessing and experiencing some of the indirect effects of your loved one’s addiction can be heart-wrenching, draining, and soul-destroying.
It is important that people understand some of the strategies they can employ in order to cope with their loved one’s addiction, and how to minimise its effects.
During a session of Family Behaviour Therapy [3], a licensed counsellor or family therapist will allow participants to express their concerns and anxieties regarding their loved one’s addiction.
The licensed counsellor will help these family members develop strategies such as cognitive and behavioural coping mechanisms in order to overcome their negative feelings.
2. Functional Family Therapy
Functional Family Therapy can facilitate a more positive relationship between the addicted person and their friends and family members. This is done by improving the way in which they communicate.
By improving the level of honesty and acceptance during communication, the relationships will become more positive between the patient and their family members.
Participants of Functional Family Therapy will learn how to approach things with more rationality, which in turn will create a more constructive and healthier environment.
In the future, this will lead to a great level of support because family members will feel more comfortable expressing their concerns or asking for help in a safe family environment.
3. Multidimensional Family Therapy (MDFT)
Multidimensional Family Therapy, or MDFT [4], is another form of therapy which seeks to improve the relationship between family members.
This is a collaborative approach to addiction recovery, and it typically focuses more on younger addicted people where their parents have more influence on their behaviour.
The purpose is to improve day to day behaviours of family members and to educate them about how they can foster a positive recovery environment for their loved one.
Multidimensional Family Therapy is also very effective in helping combat adolescent substance use issues.
Adolescent substance use can lead to long-term excessive alcohol and drug use, which will inevitably lead to social problems such as antisocial behaviour, financial struggles, as well as physical and psychological problems.
Multidimensional Family Therapy is one example of many family-based treatments which helps families maintain behavioural changes.
4. Brief Strategic Family Therapy
Brief Strategic Family Therapy [5], or BSFT, is more applicable towards treating family members and patients of addiction who have a negative relationship within the household.
A patient may have developed their addiction due to habits that their family members display, or their home environment may be one which affects the subject’s mental health in a way in which they turn towards drugs and alcoholic substances to cope.
The purpose, therefore, is to improve the daily habits of family members and the addicted person in order to not only improve their overall health but also those around them.
Being placed in an environment where its people constantly display negative forms of behaviour can have a destructive effect on surrounding people.
So, the sole objective is to improve habits and therefore foster an environment which is healthier and more sustainable.
5. Systemic-Motivational Therapy
Throughout addiction recovery, many patients will undergo a form of therapy which is known as motivational interviewing. The purpose of motivational interviewing is to reinforce the patient’s willingness to engage in recovery methods and to sustain their motivation towards reaching sobriety.
Within the context of family therapy, systemic motivational therapy can play a huge role in a patient’s recovery.
Rather than focusing on the individual to improve their willingness to recover as motivational interviewing does, Systematic Motivational Therapy (or Systematic Motivational Counselling [6]) aims to improve how the family works as a unit.
As a unit, the family can overcome maladaptive behavioural patterns which not only affect the addicted person but also other family members.
6. Behavioural Couples Therapy (BCT)
Behavioural Couples Therapy [7], or BCT, is a form of therapy which aims to help couples where one (or both) are suffering from an addiction or substance dependence.
Research shows that Behavioural Couple Therapy can provide tremendous benefits in helping patients abstain from their addictive drug or alcoholic substance.
The purpose of Behavioural Couples Therapy is to improve the functions of the relationship so that one can support and even facilitate the other one’s recovery.
Not only does it provide tremendous results in helping patients sustain their abstinence, it also greatly affects the relationship between the couple.
Behavioural Couples Therapy improves family functioning by reducing the levels of domestic violence among partners and emotional problems with the couple or their children.
Positive reinforcement is also a huge component, and when combined with other forms of therapy such as Cognitive Behavioural Therapy or engagement strategies such as 12-Step Facilitation Therapy [8], Behavioural Couples Therapy can drastically improve someone’s recovery.
Hosting an Intervention for an Addicted Family Member
It is often the case that it is difficult to convince a family member or loved one to seek professional treatment.
This may be because they are refusing to believe that they are suffering from a drug or alcohol addiction, or that they are so sceptical about the treatment process that they are unwilling to commit to it.
In the event that an addicted family member is unwilling to seek professional help through the form of a drug and alcohol rehab, addiction specialists and treatment providers can help family members by staging an intervention [9].
During an intervention, participants (such as close friends or family members) will gather in the same space as their addicted loved one.
Here, they will be guided by a licensed interventionist who will help them articulate their feelings and concerns about their loved ones.
The objective of an intervention is to guide them to seek treatment, rather than forcing them to seek treatment.
It is not possible to volunteer someone else into undergoing addiction treatment at rehab. Instead, we must take measures in order to help them think for themselves and seek treatment.
Treatment providers and referral services can help family members and friends by assigning them an interventionist.
This interventionist will organise a vast range of the steps necessary to organising an intervention, including:
- Creating an intervention team: With many friends and family members to choose from, it can be difficult selecting or even leaving people out of the intervention process. However, sometimes it is necessary to decide who shall not be present as a participant. This is because some people may evoke very negative feelings and may even cause hostility or a confrontation during the session. The session should be non-confrontational and a safe space to communicate.
- Formulating a comprehensive intervention plan: The interventionist will coordinate with each family member and friend who will participate in the session. They will ensure that a suitable location, date, and time is set in order to create the most optimal intervention session.
- Understanding the addicted person’s personal profile: The interventionist cannot just jump into the intervention not knowing anything about the person who is struggling. Although they will not know them on a personal or friendship level, they will need to acquire information about the addicted person in order to optimise their intervention plan.
- Guiding participants throughout the process: The licensed interventionist will also need to ensure that the friends and family members understand what the rehab recovery process entails. It is important that they understand what their loved one will undergo in order to be able to fully support them.
- Facilitate rehearsals and encourage writing: Being prepared to articulate your thoughts and feelings with your addicted loved one is important, and it is not an easy task. The interventionist will help participants prepare by rehearsing and writing down what they will say during the intervention. It is important that friends and family members can clearly articulate their concerns about their loved one’s addiction and how it affects their life.
- Plan for rejection: While interventions have a success rate of around 80 to 90%, interventionists must also plan in the event of rejection. Not all addicted people who undergo an intervention immediately turn towards the support of a drug and alcohol rehab centre, so it is important that we consider the steps following an unsuccessful intervention.
- Help establish boundaries with the addicted person: The interventionist will also help friends and family members understand when and how they can help their loved one, and also when to establish firm boundaries. Sometimes, offering too much support can enable the addicted person’s addiction, therefore it is important that the friends and family members know when to create firm boundaries in order for them to understand their behaviour.
CRAFT Intervention [10] is a highly popular method of intervention. This is not only because the success rates of CRAFT are high when it comes to intervention methods, but it also places an enormous emphasis on the well-being of the family. In fact, it stands for Community Reinforcement and Family Training.
Because of its huge emphasis on the well-being of family members, it is also a form of family therapy.
CRAFT intervention can offer family counselling and support sessions, as well as training to help family members understand their loved one’s addiction and how they can help them overcome their illness.
It is especially useful for family members if their addicted relative is unwilling to recover from their addiction.
References
[1] The Brain Disease Model of Addiction https://www.hazeldenbettyford.org/education/bcr/addiction-research/brain-disease-model-ru-316
[2] Effects of Family Therapy for Substance Abuse: A Systematic Review of Recent Research https://pubmed.ncbi.nlm.nih.gov/36564902/
[3] What is Family Behaviour Therapy ? – FBT https://familybehaviortherapy.faculty.unlv.edu/what-is-family-behavior-therapy/
[4] Multidimensional Family Therapy https://www.mdft.org/
[5] Brief Strategic Family Therapy: An Intervention to Reduce Adolescent Risk Behaviour https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737065/
[6] Systematic Motivational Counselling: From Motivational Assessment to Motivational Change https://psycnet.apa.org/record/2011-23073-011
[7] Behavioural Couples Therapy for Alcoholism and Drug Abuse https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215582/
[8] 12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753023/
[9] Intervention for Addiction – OK Rehab https://www.okrehab.org/treatment/professional-intervention/
[10] The CRAFT Approach: Encouraging Healthy, Constructive, Positive Changes for your Family https://drugfree.org/article/craft-approach-encouraging-healthy-constructive-positive-changes-family/
