Substance abuse doesn’t just affect the person using drugs or alcohol. A person’s family and loved ones are also impacted. From the spouse who has to work extra hard to compensate for a person’s lack of parenting due to substance abuse to the co-worker who covers for a person who is consistently under-performing due to their substance abuse history, there are many people who are impacted by substance abuse. When a person does pursue sobriety, they may wish to begin rebuilding these relationships whenever possible. Family therapy can help.
Family therapy involves having a person struggling with substance abuse participate in counseling sessions with family members or loved ones or having family members participate in their own counseling sessions. Often, when a family member struggles with substance abuse, the family falls into familiar and often detrimental patterns that can keep the relationship from being a positive one. By participating in family therapy and working with a counselor, a family can learn about and start to correct the dysfunctional roles that the family may have taken on.
Therapists have used family therapy since the 1950s to help families strengthen their roles with each other. Since that time, several treatment approaches and theories as to how to conduct family therapy have emerged.
How Does Addiction Impact a Family?
Addiction can affect families in a number of ways, from causing conflict to depression. Potential impacts and conflict sources include:
- Conflict: A person can experience conflict with several family members due to their substance abuse. Examples can include conflict with a partner. A couple may argue with each other and start to grow apart as a person gets deeper and deeper into their addiction. A couple may especially argue about money, as a person struggling with substance abuse may have difficulty keeping a job or may spend most of their money on drugs or alcohol. A person may also experience conflict with their children. Their children may lose respect for a parent’s authority, which can lead to further conflicts as well.
- Jealousy: A person abusing substances may experience jealousy of people who have their lives more together or do not struggle with drugs or alcohol. A partner may also be jealous of a person who is abusing a particular substance because that person may seem to be having fun or partying and living a carefree lifestyle.
- Emotional/Physical Trauma: Substance abuse can wreak havoc on a person’s family. A person who abuses drugs or alcohol may engage in verbal and physical abuse. A person may yell, scream, or insult other family members. Sometimes, they may even become violent by throwing objects, hitting others, or smashing objects. Each of these behaviors can leave lasting emotional and physical scars.
- Isolation: Substance abuse can be isolating to families. The person abusing drugs or alcohol may start to withdraw from friends and family members for fear the family will learn about their substance abuse. Or, they may become so wrapped up in using drugs or alcohol that they miss important life events and functions. Also, family members may isolate themselves from a loved one who abuses drugs for fear that person will be a bad influence on children or other family members.
The effects of substance abuse on a family can create strained or complicated relationships. Children can become the caregivers of their parents. People can also suffer from co-dependence, which is where a person maintains a relationship with a person who is emotionally destructive or abusive. Sometimes a co-dependent person may enable the person who struggles with addiction by ignoring their problems, covering up their mistakes, and making excuses for their bad behaviors. These strained relationships can be very harmful to both parties because one is the victim and the other is addicted. Both parties need help in order to heal.
Who Is Included in the Term "Family"?
“Family” therapy can include participants who are not blood relatives. Sometimes a family member can be a partner or spouse. Children and family members like a mother, father, brother, or sister may also participate in family therapy.
For the purposes of the therapeutic environment, the term “family therapy” is more related to people who are close to a person and who have a stake in seeing the person get better and recover from their history of drug or alcohol abuse.
From neighbors to friends to co-workers, there are many people who are affected by a person’s drug abuse beyond close family members. While not all people necessarily need to participate in family therapy, those who a person considers closest to them should be considered as potential participants in family therapy.
These people can become a person’s “elected” family. People who could participate in family therapy sessions include those who play one or more of the following roles in a person’s life:
- Providing financial support
- Maintaining a person’s household
- A person who has an enduring emotional bond with an individual
Any of the people who fall into this category may be considered people who could benefit from participation in family therapy.
How Does Family Therapy & Support Work?
Family therapy can come in many forms when treating a person struggling with substance abuse. For example, a person struggling with abuse may participate in counseling sessions with their family. Other times, the family will go to counseling without the family member who has a substance abuse history.
A variety of mental health professionals provide family therapy. Examples include a psychologist, clinical social worker, or a licensed therapist. Some of these therapists may have pursued additional certifications in family therapy from the American Association for Marriage and Family Therapy (AAMFT), one of the major accrediting bodies for family therapy. The therapist will lead a session that usually lasts anywhere from 50 minutes to one hour. During the session, a therapist may help family members address several key areas of substance abuse recovery. These include:
- Identifying problems in the family’s relationships and discussing ways to solve them in a constructive manner
- Discussing current family roles and how adjusting these family roles could help build stronger relationships
- Identifying a family’s current strengths as a whole as well as discussing potential weaknesses that could be improved through family therapy
Therapists may practice one of four family therapy models to base their treatment approaches. These include:
- Cognitive-behavioral approaches: The theory behind the cognitive-behavioral approach is that a family’s tendency toward certain behaviors can reinforce negative interactions. This therapeutic approach involves suggesting treatments that change a person’s behaviors to promote a stronger family unit.
- Family disease model: This therapy approach follows the concept that substance abuse is like a disease that affects the whole family and must be treated. Co-dependence is particularly a factor in this treatment model, and therapists work to help family members recognize co-dependent behaviors and correct them whenever possible.
- Family systems model: A family systems model operates on the concept that families adjust their traditional roles when one person abuses a particular substance. A therapist will help a family adjust their dynamics to a more positive one.
- Multidimensional family therapy: This approach can act as a blend of the above-listed approaches while emphasizing the important relationship between thinking and behavior on the part of all family members.
While there are variations on each of these treatment approaches, these are four of the most major available treatments.
Why Choose Family Therapy & Support?
Family therapy is very important in breaking the cycle of addiction, not only for the person who abuses a substance but also to reduce the risk that future generations will abuse drugs as well. Examples of potential benefits from participation in family therapy include:
- A person will be able to rely on their family’s strengths to help them overcome their drug and alcohol addiction.
- A person’s family will be able to understand the detoxification process and what a person is going through when they are withdrawing from a certain substance.
- Family members will better understand how to express their thoughts and feelings to each other through participation in therapy.
- A person may be able to re-connect with their family in the hopes of rebuilding trust and an improved relationship.
Family therapy is not for every family. Those with a history of physical abuse may not benefit from family therapy if the abuser is a close family member. Also, those who have severe mental illnesses, such as schizophrenia, may be unable to participate in family therapy sessions.
What Are Typical Outcomes for Participants of Family Therapy?
Family therapy is typically a short-term approach to substance abuse recovery. Families may attend several sessions with a therapist to start to regain trust and achieve a better understanding of each family member’s role in a person’s recovery. According to the Mayo Clinic, participating in family therapy can help resolve problems such as stress, anger, conflict, or grief due to a history of substance abuse.
For many people who struggle with substance abuse, family relationships can take minutes to years to destroy. These cannot always be rebuilt with a few sessions of family therapy. However, family therapy can give people a new “language” to constructively speak to each other and to gain a better understanding of each other.
Ideally, family members will enhance their communication skills through participation in family therapy. They may also boost conflict management skills, better understand how to manage addiction, and learn how to better resolve conflict.