In other cases, neither youth nor caregivers successfully engage with a provider during routine outreach procedures for SUD services. One evidence-based model for enhancing engagement in this scenario is Strategic Structural Systems Engagement (Szapocznik et al., 1988), which was developed on samples of high-risk youth. In some cases, youth with SUD exhibit narcissistic alcoholic mother minimal or no readiness to enter treatment, whereas family members are motivated to assist them in doing so. A research-supported approach to boost engagement in this scenario is Community Reinforcement and Family Training (CRAFT; Smith & Meyers, 2007).
Substance Use Disorder Treatment and Family Therapy: Updated 2020 Internet.
The panel included representatives from several disciplines involved in family counseling and SUD treatment, including alcohol and drug counselors, family therapists, mental health practitioners, researchers, and social workers. Other professionals also generously contributed their time and commitment to this project. In encouraging counselors, administrators, and others who work in the field to acknowledge substance misuse as a critical issue that can negatively affect families, the consensus panel hopes the guidance in this TIP will help families move toward recovery. To ensure use of family counseling and family services to their greatest potential within SUD treatment, it is essential to broaden the focus of SUD treatment from an individual to a family perspective. It is common to acknowledge the unique individual factors (e.g., environmental, genetic, biological) that may influence a person’s substance misuse and SUD treatment outcomes.
Current Models for Including Families in SUD Treatment
- According to the latest national data (Substance Abuse and Mental Health Services Administration SAMHSA, 2020a), about 6.4 million youth under the age of 26 meet diagnostic criteria for a SUD and over 300,000 youth meet criteria specifically for an opioid use disorder.
- Enter your phone number below to receive a free and confidential call from a treatment provider.
- This TIP, Substance Abuse Treatment and Family Therapy, addresses how substance abuse affects the entire family and how substance abuse treatment providers can use principles from family therapy to change the interactions among family members.
- The CRAFT approach uses a structured system to help families deal with substance abuse.
Ideally, such screening instruments are administered in parallel to youth screening tools. The goal of this conjoint approach to screening is to increase the likelihood of case detection and set the stage for family involvement in subsequent stages of the continuum. Evidence suggests that parental reports are fair-to-good proxy measures of youth substance use behavior (McGillicuddy et al., 2012), though they typically underestimate to some degree (Fisher et al., 2006).
It is no accident that the terms “co-alcoholic” and “codependent” were applied to spouses. Early SUD treatment programs began incorporating family psychoeducation, but there was an inherent attitude of “them” (family) versus “us” (those in recovery or treatment). Family counseling is a collection of family-based interventions that reflect family-level assessment, involvement, and approaches.
How Does Family Therapy Work in Addiction Treatment?
For example, a teenager in family counseling may look what does being roofied feel like to a parent before answering a question; a husband may roll his eyes when his wife speaks. Historically, the addiction field has used role and birth order theory to help families explore how they have adjusted or reacted to SUDs in the family. Roles help families maintain homeostasis, yet certain roles affect the individuals in that role negatively or distract from underlying issues. For example, a family may see a child as the root of their problems, although one or both parents have significant SUDs. But some subsystems are unhealthy, even if they serve a necessary function in the family—as with a parentified child assuming adult roles that are not age-appropriate (Exhibit 1.5).
How to Use the CRAFT Method
How he or she adjusts or changes certain behaviors in response to the individual’s progressing SUD. Reduce risk in children and adolescents of being exposed to violence and of developing SUDs/mental disorders. As a result of the above techniques, family members can reframe anger, pain, and other emotions and gain a deeper awareness of how to resume a healthy family function. Furthermore, family members can gain self-awareness and transform relationships with themselves and others. Enter your phone number below to receive a free and confidential call from a treatment provider. Sometimes, family members are too emotionally drained to participate in therapy.
Systemic therapy hones in on unconscious communication and underlying meanings behind certain actions. Additionally, the therapist may observe how the family interacts with each other but takes a neutral or distant approach. Structural therapy enhances the family dynamic by keeping parents in the position of authority.
In earlier attempts to involve families in SUD treatment, spouses were invited to sessions of groups that the family member with the SUD attended regularly rebuilding life after addiction with other individuals in residential treatment. This did not often foster a welcoming environment for spouses, who were generally ill-prepared and had no alliances to create a sense of safety in the group. The objective of including spouses and other family members in this way was to gain collateral information from them about patterns of substance misuse in the individual with the SUD—and to highlight spouse or family behaviors that contributed to past use or could trigger a relapse.