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Family Therapy for Addiction

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The impact of addiction is vast. Not only does it affect the person struggling with the substance use disorder (SUD), but it can impact the entire family. This makes sense considering we are all shaped by, and help shape, our environments. Moreover, the decisions you make can impact the people around you positively or negatively. There is no denying that addiction harms the family and can lead to negative consequences, including emotional distress, legal and financial challenges, and violence.1

Fortunately, family therapy can be an integral part of a substance abuse treatment plan and can be highly beneficial to how the family unit functions. Some of the benefits of family therapy include improving communication skills, strengthening one’s understanding of addiction, and supporting loved ones by learning and adopting healthy coping skills and behaviors.2

Family therapy is a process that involves many techniques to help you and your family improve overall functioning and reduce the negative impacts of addiction. In this article, you will gain an in-depth understanding of what family therapy entails, how it can help you and your family recover from the negative impacts of addiction, and how to locate treatment programs near you.

What Is Family-based Therapy for Substance Use Disorder?

Family therapy is a broad term used to describe a group of treatment approaches designed to treat the entire family, rather than just treating the person struggling with the substance use disorder (SUD). Family-based therapy focuses on the inclusion of parents, siblings, and even peers in the treatment of SUDs and targets family communication, conflict reduction, mental health challenges, and other social and occupational challenges.3 Family-based approaches can be used with teenagers and adults.

Substance abuse treatment is a process that can occur in many different treatment settings that range in intensity. Family-based therapies can be incorporated in various settings, including more intensive settings like residential treatment.3 Family therapy programs utilize the benefits of several evidence-based therapeutic approaches, including contingency management, behavioral therapy, and community-based treatment interventions.3

Family therapy is fluid and flexible, and the interventions utilized are based on each family’s unique needs. There are no rules regarding who can attend family therapy, and studies consistently demonstrate that family support can positively impact a loved one’s recovery from SUDs and mental health disorders.4

What Are the Benefits of Family Therapy?

The benefits of family therapy are far-reaching and can improve the overall functioning of the family unit.

Goals of family therapy include:2

  • Increasing your loved one’s motivation to enter a treatment program.
  • Educating family members on SUDs, risks of relapse, resources and supports available to family members, and the impact of SUDs on the family system.
  • Changing the way family members interact within the family system and with the loved one.
  • Improving communication among family members.
  • Addressing family members’ experiences and emotional burdens.
  • Acquiring new skills to resolve emotional burdens caused by addiction to improve the mental and physical health of family members.
  • Learning how to support the loved one in recovery through boundary-setting.
  • Learning how to stop engaging in enabling behaviors.
  • Encouraging family members to obtain support through mutual support groups such as Al-Anon or Nar-Anon.

One of the key elements of family therapy is to strengthen overall family functioning and to prevent the negative impacts of substance use from spreading across the entire family. Through the identification and correction of unhealthy family interactions and dynamics, family therapy can help prevent substance misuse among other members of the family.5

Substance abuse treatment is effective in treating addiction and helps people improve their functioning and overall quality of life.2

Individual and group therapy helps the person with the substance use disorder:2

  • Prevent relapse.
  • Strengthen relationships.
  • Develop communication and assertiveness skills.
  • Learn how to live life without the use of substances by changing thoughts and actions.
  • Develop a social support system.
  • Improve functioning at work and school.
  • Engage in enjoyable activities without the use of substances.

What Are the Techniques Used in Family Therapy?

One of the biggest challenges that family members may face is motivating their loved ones to enter a substance abuse treatment program. Community Reinforcement and Family Training (CRAFT) and A Relational Intervention Sequence for Engagement (ARISE) are 2 different treatment approaches that aim to increase your loved one’s motivation to enter treatment.

CRAFT:5

  • Is a highly structured family approach that centers around the idea that the family environment is essential in motivating a loved one to enter treatment.
  • Teaches behavior change strategies, such as positive reinforcement to motivate the family member to stop abusing substances and enter treatment.
  • Is the least intensive option for motivating a family member to enter treatment and should be used first.
  • Is approximately 4–6 sessions in length.
  • Uses positive rewards to motivate the loved one to stop substance misuse, engage in activities that don’t involve substance use, and get the help they need.

ARISE:6

  • Encourages participation from the loved one from the very beginning of the intervention process.
  • Involves family members discussing their concerns from a place of love.
  • Does not involve coercion, judgment, or secrets from the family members.
  • Involves 3 levels: The First Call, Strength in Numbers, and The Formal ARISE Intervention.
    • Level 1: The First Call—A loved one reaches out to a licensed ARISE interventionist and obtains coaching on how to engage others in helping to motivate the loved one in entering treatment.
    • Level 2: Strength in Numbers—If the loved one has not agreed to enter treatment in Level 1, the group of family members meet with the loved one as a team, 2–5 times in intervention meetings.
    • Level 3: The Formal ARISE Intervention—Occurs if the commitment to treatment hasn’t occurred in Level 1 or Level 2. Severe consequences are established with the loved one, which usually results in treatment agreement.

Treatment Techniques and Therapeutic Approaches

Once your loved one has agreed to treatment, several techniques and therapeutic approaches can be used. All family therapy techniques stem from family systems theory, which postulates that to be fully understood and treated, you need to comprehend how the person interacts as part of the larger family system.1

Behavioral dysfunctions such as SUDs are viewed as a result of trying to maintain normalcy or homeostasis in the family.1 Individual and family therapy techniques may be part of a comprehensive treatment plan.

Additional therapeutic approaches include:

  • Brief Strategic Family Therapy (BSFT): Originates from a family systems perspective that postulates that unhealthy behaviors are a result of problematic family interactions. Duration is 12–16 sessions and the therapist helps each family member change their problematic interactions to improve family functioning.3
  • Family Behavior Therapy (FBT): FBT teaches family members behavioral skills to strengthen the family home environment. It utilizes contingency management and behavioral contracting to stop substance use.7
  • Multidimensional Family Therapy (MFT): Usually used with teenagers, this approach elicits the help and support of the family system and the community (juvenile justice, school) to improve behavioral cooperation and reduce delinquency and substance abuse.3
  • Cognitive Behavioral Therapy (CBT): CBT teaches different cognitive (thinking) and behavioral (action) skills to help end addiction and prevent future relapse and can be used in individual and family counseling.8
  • Contingency Management (CM): CM provides physical reinforcers or rewards for engaging in positive behaviors, such as remaining sober from drugs and alcohol.9
  • Community Reinforcement Approach (CRA): CRA is an intensive outpatient program that utilizes family, occupational, social, material, familial, and recreational rewards to make sobriety more appealing than substance use. Throughout the process, a person develops a social support system and develops skills learned in therapy.10

Couples therapy involves both the person struggling with the SUD and their partner. During couples counseling, therapy aims to improve relationship dynamics and utilize partner support to strengthen abstinence efforts and improve family dynamics.5

Marriage and family therapy share similar goals as couples therapy and works to improve communication skills, utilize the power of positive reinforcement, and advance the quality of family relationships to support and promote recovery of the loved one.5

Family Therapy and the Addiction Treatment Process

There is no one-size-fits-all approach to family therapy. Session frequency and duration of treatment can last as little as several weeks or as long as a year or more. Because everyone’s situation is different, your therapeutic process will be unique to you, and your treatment plan will include interventions specific to you and your family’s needs.

Your treatment plan can include individual, group, and family therapy and involve multiple therapeutic methods, such as contingency management, community-based interventions, and behavioral therapies.3

Comprehensive substance abuse treatment involves an initial assessment and evaluation, followed by the identification of appropriate services and interventions that can include:2

Family therapy services can be obtained through a formal substance abuse treatment program or local community-based program available in your area.2 Resources for family therapy and other supportive services may be obtained from your physician or from an inpatient treatment facility.

Family members, peers, and friends play a vital role in motivating a loved one to agree to substance abuse treatment and keeping them engaged in the treatment process.11 Therefore, loved ones who can be included in family therapy aren’t limited to family members; they can include significant others, close colleagues, and peers.

Family therapy can occur at various stages throughout the treatment process. Usually, family therapy occurs during outpatient treatment. However, it can occur during more intensive stages of treatment, including residential and intensive outpatient settings.3 Family therapy can start during residential treatment and extend into your outpatient aftercare plan after you complete residential treatment. Family therapy may also begin during outpatient treatment and be an essential component of your continuous care plan.

Family Therapy for Addiction Near Me

American Addiction Centers (AAC) can help if you are seeking addiction treatment. AAC offers family-based therapy programs to help you and your entire family recover from the effects of addiction. By choosing to go to treatment, you and your family can capitalize on all of the benefits treatment has to offer such as improving relationships, strengthening your support system, and preventing future relapse.2

Once you call AAC at , you can speak with an admissions navigator who can answer questions about rehab and help you verify your insurance. Additionally, you can locate a rehab center using the online directory and instantly check your insurance coverage online.

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Kristen Fuller, MD, enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine and contributes to medicine board education. Her passion lies in educating the public on the stigma associated with mental health. Dr. Fuller is also an outdoor activist, an avid photographer, and is the founder of an outdoor women's blog titled, GoldenStateofMinds. In her free time, she enjoys hiking, backpacking, skiing, camping, and paddle boarding with her dogs in Mammoth Lakes, California, where she calls home.
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