Addiction is sometimes referred to as a “family disease,” and rightfully so. It affects the patient and his or her entire family’s physical health, finances, and psychological well-being. At the same time, the family also has the power to make or break their loved one’s recovery efforts as he or she goes through the journey to sobriety. That’s why the importance of family therapy can never be overstated.
Family therapy is designed to address specific issues that affect the psychological health of the family, like substance abuse. It helps families work through challenges, struggles, and tough times in a manner that doesn’t just address the problem but leaves the family stronger.
Addiction takes a toll on everyone. It forces family members to pick up the slack of the addict, make excuses for his/her behavior, and potentially endure physical, sexual, and emotional abuse. Extended family members and friends may also have to chip in financially (or in other ways) to cushion the ignored responsibilities. Unfortunately, this naturally leads to instability and conflict within any given family, irrespective of how close-knit it used to be. In the long run, family members end up feeling disappointed and even frustrated with the behavior.
Therapy is a means to help cope with alcohol or drug addiction – and that’s not the same as making the problem disappear. Accepting the situation and letting go of things that are beyond control is part of family therapy. When families let go of expectations, they can heal and embrace their present reality while working to a better future. The opposite is also true.
What is family therapy?
This therapy recognizes that the addiction problem affects the entire family as opposed to just one person. It aims to empower families with skills to help adults and adolescents communicate through conflict and understand any substance abuse or co-occurring disorders like mental health disorder, family conflict and communication, learning disorders, peer networks, work or school issues, and so on. Family involvement is especially critical when the addict is an adolescent because he or she is still under parental care and is subject to the parent’s rules, control, and support.
Family therapy is based on the belief that every family member plays a part in the family system, and when one person is affected, the entire family takes the hit. Treating an individual alone is the same as addressing an illness’s symptoms without treating the disease itself. And although this approach is often used to help solve a person’s problem that’s impacting the entire family, it also applies in family-wide issues like conflicts between spouses, siblings, children, or parents. Family therapists can help loved ones to identify ways to manage conflicts, struggles, and challenges.
Family-based interventions are often provided in conjunction with behavioral interventions and medications. The adult or adolescent substance abuser may attend individual or group therapy sessions with their peers and family therapy.
Models of family therapy
Family therapy is offered in outpatient, intensive outpatient, and residential rehab programs. According to the National Institute on Drug Abuse post, dubbed “Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide,” here are some types of family-based approaches.
Family Behavioral Therapy (FBT)
Family Behavioral Therapy is an evidence-based intervention that uses innovative, easy-to-learn, behavioral therapies to attain goal performance within a family context. It blends behavioral contracting and contingency management to address drug and alcohol abuse and other behavioral problems. FBT addresses vast areas, including family relationships, mental health, sobriety, and effective management of substances, sports performance, self-protection, employment, beautification, and home safety. Under this model, the patient and family member take part in treatment planning and select specific treatments from a list of evidence-based treatment options. FBT also rewards positive behavior during each session. And when behavioral goals are met, the therapist may use contingency management to reinforce the behavior.
Multidimensional Family Therapy (MDFT)
MDFT protocols guide counselors in analyzing and intervening simultaneously in adolescents and their family’s life. Cognitive processes, emotions, and behavior are linked and are all addressed under this family-based treatment model. Teen problems like substance abuse and delinquency are multidimensional, and therefore require multifaceted therapist behaviors and remedies. As a multisystem model, therapists work separately with the teen, the family and other systems (juvenile justice systems or school), and then together to forge new relationships.
Brief Strategic Family Therapy (BSFT)
BSFT diagnoses and corrects patterns of family interactions connected to distressing symptoms and experiences in children ages 6-10. It attempts to shift family interactions from habitual to proactive or conflictive to collaborative, to allow the trapped love to thrive. BSFT is a short-term, problem-focused model with an emphasis on adjusting maladaptive interaction patterns. It includes 12-16 sessions that run over three months.
Multisystemic Therapy (MST)
The overriding goal of MST is to keep adolescents who display serious clinical issues like violence, drug use, or severe criminal behavior in school, at home, or out of trouble. Through intense contact and involvement with family, this treatment model tries to get to the bottom of the adolescent’s behavioral issues. It works to change the patient’s ecology to enhance prosocial conduct while minimizing problems and delinquent behavior.
Functional Family Therapy (FFT)
FFT is an empirically grounded family therapy for dysfunctional and at-risk adolescents ages 11-18 and their families. It’s a short-term (about 30 hours) program that helps the youth overcome conduct disorders, behavior problems, delinquency, and substance abuse. The counselor works with families to uncover family behaviors that contribute or lead to delinquent behavior. He or she then modifies the communication in the dysfunctional family, and trains members to set clear rules about responsibilities and privileges, negotiate effectively and generalize changes to community relationships and contexts
Family therapy in addiction treatment leverages the family’s strength and resources to find ways for the addict to live without drugs or alcohol and to improve the effect of dependency on both the patient and their family. It can help families uncover their own needs and help to keep addiction from moving from generation to generation.