Chapter 8 Brief Family Therapy Brief Interventions and Brief Therapies for Substance Abuse NCBI Bookshelf
It also explores the diversity of family cultures you will encounter in your work. Historically, the term “denial” has described clients or family members who do not see substance misuse as a problem. This label is judgmental, so avoid using it and let family members know that using labels to confront each other leads to conflict or an emotional cutoff. As with name calling, using labels like “denial” is often an attempt to establish power in a relationship, which is damaging to that relationship. Set boundaries in early family sessions by establishing some rules for interactions, including no “labels” or name calling.
What Is the CRAFT Approach to Substance Abuse Intervention?
You can also reframe “denial” as precontemplation, one of the stages of the SOC model and simply an indication that the family member is ambivalent and not quite ready to change. SUD treatment has historically been viewed through the lens of an individual approach. Integrated family-based interventions should be as much of a priority in your treatment program as any other treatment activity. When family counseling is viewed as an adjunct to individual or group counseling, it sends the message to clients and family members that family counseling is simply not that important. Evaluate your attitudes about family involvement in treatment and be a champion for integrating family-based interventions as an important and primary part of SUD treatment. Actively link family members to community-based family recovery supports (e.g., Al-Anon) and additional behavioral health or social services, when appropriate.
What medications and devices help treat drug addiction?
Recognizing the therapeutic value of working with family members, not just the individual with SUD, as they deal with SUDs. Ask the client whether he or she is willing to have family members help in this way. Use reflective listening to understand family members’ frustrations and concerns. Facilitating family member interactions (avoid being an arbiter of right and wrong).
Initial Integration of Families Into SUD Treatment
Parents are challenged to listen to their teens and let theparent-child relationship evolve into one of mutual respect, balancing theparental tasks of guidance with support. This involves charging both theadolescent and the parents with responsibility for change while conveying theclear expectation that the family can arrive at this point of reconciliation(Liddle et al., 1992). See TIP 32,Treatment of Adolescents With Substance Use Disorders(CSAT, 1999b), for more informationon family therapy for adolescent substance users.
What Every Family Should Know About Addiction and Recovery
Including family members at the start of SUD treatment gives you an opportunity to provide education about the biological and psychosocial aspects of SUDs. It also helps uncover client and family strengths and begins the process of preparing family members for changes to the family system that will happen as the client initiates recovery (van Wormer & Davis, 2018). Once you have addressed safety issues, you may still be able to engage parents in couples counseling that focuses on parenting issues. If you suspect a parental figure in the family is abusing a child, consult your supervisor immediately and follow agency policy and mandated reporting laws in your state to report the abuse. A family therapy approach that has been successful with substance-using Hispanicadolescents combines elements from structural, strategic, and Milan therapies(Szapocznik and Kurtines, 1989;Szapocznik et al., 1988, 1991).
Substance Use Disorder Treatment and Family Therapy: Updated 2020 [Internet].
It is important for families to learn how to talk about addiction openly, honestly, and without judgment in order to create a safe environment for healing. Because family therapy involves talking about emotional problems and conflicts, it can be difficult and upsetting. It is important to remember that a professional therapist is there to help members of the family work through these conflicts and handle the intense emotions that people may experience.
- Family-based SUD interventions focus on encouraging clients with SUDs to initiate and sustain recovery, improving their family communication and relationships to support and sustain their recovery, and helping family members engage in self-care and their own recovery.
- Conduct a strengths assessment with the client and all family members involved in treatment.
- In family counseling, the units of treatment are the family and the individual within the context of the family system.
- The approach rewards abstinence using a “Recovery Contract.” The addicted person expresses their intent not to use alcohol or drugs, and their partner supports this intention.
Sessions are held in the clinic; in the home; or with family members at the court, school, or other community location. The format of MDFT has been modified to suit the clinical needs of different clinical populations. A full course of MDFT ranges between 16 and 25 sessions over 4 to 6 months, depending on the target population and individual needs of the adolescent and family.
When clients stop taking medications, symptoms of mental disorders or old substance use behaviors reemerge, and families return to previous patterns of dysfunction. The issue of medication adherence is a common theme in the families you serve. In person-centered SUD treatment, the clients’ desire, ability, reasons, and need to change drive counseling goals. Yet each family member may have different ideas about what he or she can gain from participating in family counseling. The son may participate in family sessions to get his parents to stop fighting. The goal of each family member may differ, but the overarching goal is to engage the family in changing communication patterns that support the son’s substance use.
The BMT component was developed as part of theProgram for Alcoholic Couples Treatment, a research study that received goodempirical support after controlled trials (McCrady, 1989). Forty-five people with alcohol abuse disorders andtheir spouses were randomly assigned to one of three types of spouse involvementduring outpatient treatment (approximately 15 sessions) and then followed over a2-year period. Long-term family therapy is not usually necessary within the context of treatmentfor substance abuse disorders. An exception is long-term residential treatment,during which the involvement of the client’s family is highly recommended andoften is an integral part of the therapeutic process. Family members drop out and reenter the therapeuticprocess, and it becomes increasingly difficult for the therapist to avoid makingdecisions. The family may try to incorporate the therapist into the familysystem, routinely seeking direction in a crisis.
Only in rare situations are family-based interventions and counseling inadvisable, inappropriate, or counterproductive. Integrated family counseling is often an excellent way to approach the treatment of SUDs, but you may sometimes need to rule it out because of safety, health, or legal constraints. Several factors, including the presence of violence in the family, can influence your decisions about alcohol and anxiety involving family members in treatment. An obvious prerequisite for family therapy would seem to be the existence of afamily. However, some therapists, including Haley, believe it is possible to”create” a family by drawing on the client’s network of significant contacts. These people are significant and helpful in the client’s life and canbe important elements of a client’s recovery program.
Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues. For people with addictions to drugs like stimulants or cannabis, no medications are currently available to assist in treatment, so treatment consists of behavioral therapies. Treatment should be tailored to address each patient’s drug use patterns and drug-related medical, mental, and social problems. Family therapy is one of the most effective tools for dealing with substance misuse and abuse by a family member.
Prominent gaps and barriers to involving families in youth SUD services exist at multiple levels. Agencies frequently do not prioritize family-centered outreach or treatment planning (SAMHSA, 2020b). And families themselves experience can i stop taking wellbutrin suddenly or should i taper off lack of resources, low confidence, and stigma-related reticence to engage with SUD systems of care (England-Kennedy & Horton, 2011). Although the focus is on substance abuse, getting back to how it all started is crucial.
To prevent treatment goals from conflicting, both providers should have competency in family processes and SUDs. Case conferencing is an efficient way for family counselors and SUD treatment providers to address conflicting service objectives and other concerns constructively in a forum that fosters identification of mutually agreeable priorities and coordination of treatment. Family counseling approaches in SUD treatment refect the principles of systems theory.
We usually experience failures along the way, learn from them, and then keep going. Some are surprised to learn that there are medications on the market approved to treat alcohol dependence. The newer types of these medications work by offsetting changes in the brain caused 14 ways to cure a headache without medication by AUD. Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following questions.
Behavioral health services for youth with SUD can be conceptualized as a continuum (sometimes called a “services cascade”; see Belenko et al., 2017) consisting of the routine sequence of SUD-focused activities experienced by any given youth as they progress through the care system. For heuristic purposes we have previously described this continuum as a client flow chart anchored by four overlapping phases (Hogue et al., 2021). In the Problem Identification phase, youth are identified as having serious SU and/or SU-related problems that warrant consideration for treatment. Identification can be triggered via SUD screening by youth-involved professionals (e.g., physicians, school counselors, justice system personnel) or via voluntary referral by the client. In the Treatment Engagement phase, SUD treatment providers endeavor to contact identified clients and enroll them in services. In the Active Treatment phase, providers complete clinical needs assessments with enrolled clients and proceed as indicated with treatment planning and intervention delivery.