The Use of Family Therapy in Treatment
Family therapy isn’t “one size fits all.” After all, families come in all shapes and sizes. Not every family has the same set of problems, and each individual member is unique. Even if all family members share the mutual issue of addiction, it doesn’t mean it has affected them in the same ways across the board.
In some cases, unmarried partners or even roommates may need family therapy, and that’s a perfectly acceptable application. The same treatment approach can be applied. This scenario is actually quite common today since couples are waiting longer to get married and start families. In fact, substance abuse may be a contributing factor to that trend. The journal Alcoholism: Clinical and Experimental Research reports that young people reaching into the early 30s who drink heavily are marrying less during these years than their peers who don’t drink, noting 40 percent lower rates of marriage for females and 34-37 percent lower rates for males.
Who Needs Family Therapy?
There are certain situations that warrant family therapy. Likewise, there are situations in which family therapy should be avoided. Family therapy is crucial if:
- There is maltreatment of family members.
- There are children in the home.
- A marriage or intimate relationship is on the line.
- There are other forms of abuse in the family home.
- The family can be an ongoing source of support for the individual in treatment.
Family therapy may not be advisable if family members are actively abusing drugs or alcohol, and have no interest in getting help. In addition, family therapy might not be the best choice if the client does not have active relationships with family members. It should only be used if it will be beneficial to the person in recovery, and this decision is generally made in conjunction with the client’s treatment team.
What Family Therapy Can Address
Family therapy can greatly improve communication between family members. It can cut down on resentment and misunderstandings, and also allow loved ones to retrain themselves on how to talk to and treat one another. Often, when addiction tears a family apart, people who love each other can become hostile or defensive and begin to attack each other’s character and intentions. This is especially common coming from the client, who may resort to petty arguments, inflammatory remarks, and hurtful acts to get what they want, manipulate situations, or defend their behavior.
The most commonly used therapy module for family treatment purposes is Cognitive Behavioral Therapy (CBT). This form of treatment focuses on finding solutions to problems within the family unit. Resolving substance abuse behaviors alone won’t solve the underlying problems that perpetuate the cycle of substance abuse in the family home. CBT is highly successful in helping people to change old behavior patterns and break free of limitations, such as the fear of being hurt or betrayed that encourages them to withhold support from their loved one. CBT is also highly effective in helping clients remain sober. An Archives of General Psychiatry study noted 60 percent of people suffering from cocaine dependency and treated with CBT remained clean a year after treatment.
Family therapy can assist clients in mending fences with loved ones whom they have hurt or betrayed. Family members often come to understand their loved ones better when they are introduced to the world of addiction treatment through group therapy. When loved ones are able to see that the poor choices and hurtful words and actions of their family member were caused by an addiction rather than their loved one’s intentions, they are more easily able to forgive and move on. Part of this also comes in tow with seeing their family member in treatment, sober, and taking responsibility for their health and life.
In other cases, a person’s addiction may be crippling a marriage or harming the development of children in the home. In many cases, marital counseling is also necessary, so a couple can learn how to start fresh, even with years of marriage under their belt. Behavioral couples therapy (BCT) is a great addition to any addiction treatment program and known to be highly effective in preventing relapse too. A Science and Practice Perspectives study noted half of the men who participated in BCT remained clean while only 30 percent of those who opted for individual-based treatment (IBT) did; likewise, just 8 percent of those who received BCT were arrested on drug-related charges in the following year, compared to 28 percent of the IBT group.
While children may be too young to participate in therapy sessions, parents can use family therapy as a way of forming a solid plan to co-parent for the betterment of their little ones. Children do not have to miss out on knowing one of their parents because of an addiction when the parent is willing to leave their addiction in the past and embrace recovery. Therapists can also lend parents some direction on how to talk to young children about why Mom or Dad is absent and what changes are being made.
Last but not least, other forms of abuse that often occur alongside drug and alcohol abuse may be impacting the family unit. Learning to trust a parent or partner again after they’ve been physically, verbally, or emotionally abusive can be tough. Therapy is almost always a necessity to help these individuals repair their broken relationships. Part of that is knowing how to make things better moving forward, and a trained therapist can help in that department.
Still, much of the way things pan out and the pace at which they do are determined by the person who has been abused. The National Clearinghouse on Child Abuse and Neglect reports roughly 6 million children live with a parent who engages in substance abuse, and between one-third and two-thirds of child maltreatment situations involve drug or alcohol abuse too. Family therapy focuses on communication in these cases and teaching the family unit how to cope with stress and problems that arise in healthy ways.
When Family Therapy Isn’t Enough
That being said, family therapy isn’t right for everyone. Some people should focus their time on themselves and how to readjust to life after treatment without their family’s involvement. This is mostly the case for individuals who come into treatment from homes where substance abuse is occurring. If a client has a spouse, sibling, parent, or roommate who abuses drugs or alcohol, their chances of recovery are often tainted by the fact that they have to return to an environment where substance abuse will be prevalent. The only effective way to insure this doesn’t happen is to remove that environment from the equation. Most of the time, this can be accomplished by arranging for the client to stay at a sober living facility post treatment.
Making changes to lifestyle habits is an important part of treatment, and the client will have to alert their family to their impending absence. Sometimes it’s easier for clients to explain this to their families with the support of a therapist at their side, so they don’t become overwhelmed or feel threatened.
SAMHSA notes some family members may opt of participating in therapy for a number of reasons, such as:
- Being tired of dealing with the family member’s issues
- Fear of what lies ahead
- Having little faith in therapy practices
- Being uncomfortable with discussing personal issues with a therapist
- Feeling powerless and preferring to ignore the issue rather than confront it and possibly make it worse
When seeking the appropriate form of treatment, individuals should pay close attention to the credentials and experience of treatment center staff. Therapists should have training and experience in family therapy. Also, family therapy should not be the only type of therapy the client engages in; it can complement a robust treatment program but the person should also participate in individual therapy and peer-support programs.