Author: James Anderson

The Role of the Family in Alcohol Use Disorder Recovery for Adults Alcohol Research: Current Reviews

A review of controlled outcome studies found that it provided significant positive benefits to adults with mental disorders and showed promise for improving family functioning, particularly for families under stress of having a family member with a mental disorder (Gingerich & Peterson, 2013). A study of parents with SUD and trauma-related symptoms who were involved in the child welfare system found that solution-focused brief therapy was effective in reducing substance use and trauma-related symptoms (Kim, Brook, & Akin, 2018). Family peer recovery support specialists understand the perspective of family members living with the effects of substance use behaviors and the challenges and successes of recovery. They provide education and emotional support to family members and actively link them to family-based resources in the addiction treatment, mental health, criminal justice, and child welfare service systems.

1. Family therapy can be emotionally uncomfortable, but that’s where the work gets done.
2. However, these mechanisms have not been well tested in the context of couple or family treatment for AUD.
3. Systemic-motivational therapy is a model of SUD family counseling that combines elements of systemic family therapy and MI.
4. 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.
5. We need more multilateral efforts and collaborations like this one, and family therapy as an established field needs to hear much more and much more often about the ways practice must be adapted to meet country contexts across the globe.

Most practitioners work within the context of a profoundly individual approach, granting supremacy to the notion of individualism, self-reliance, and the generally autonomous self (Rasheed, 2010). A paradigm shift toward relational interventions would invite movement toward systemic conceptualizations of SUD problems and solutions. It would also provide more fluid and flexible roles for target clients and CSOs while recasting “alone” to “together” in SUD treatment. A large-scale shift of SUD services would require re-alignment of billing/reimbursement, documentation, and services offered.

Sexual and Gender Minority Populations

These systems-level changes lead to positive outcomes for the family member who is misusing substances and improved health and well-being for the entire family. You can help clients and their family members initiate and sustain recovery from substance use disorders (SUDs) by actively involving family members in treatment. At IINE, we’ve been doing this a long time—we try to assess each family’s needs and we give as much individualized support as we can.

A mental health counselor can mediate and help your family stay on track to getting the addicted person and your family unit the help to move forward. That package that was begun in 2018 in Vienna is now called Treatnet Family (see below for an example of some of the concepts addressed in the package). Treatnet Family has been a part of feasibility studies, has been implemented in many countries and regions, and involved hundreds of practitioners across the globe. The package is openly accessible at no cost, and as of this writing, has been translated into four languages, with more on the way.

Family Therapy for Substance Abuse

Knowledge of the impact of AUD on families has led to the development of family-engaged treatments. Considerable research has focused on the development and testing of these family-engaged treatments to foster recovery from AUD. These treatments have focused on the role of the family in the initiation of help seeking, initiation of change, and maintenance of long-term change.

It introduced the value of engaging family systems in treatment and has been an auxiliary part of SUD treatment programming for decades. Psychoeducation is more than just giving families information about the course of addiction and the recovery process. Goals include engaging family members in treatment, providing information, enhancing social support networks, developing problem-solving and communication skills, and providing ongoing support and referrals to other community-based services (McFarlane, Dixon, Lukens, & Lucksted, 2003). Psychoeducation can take place in individual or group sessions with family members, single family group sessions, and multiple family group sessions.

Exploring Partner and Family Integration in Recovery-Oriented Systems of Care

The current update focused on the past decade of research involving couple and family treatments for SUDs. The therapies that were reviewed included interventions that aimed to improve couple and/or family relationships. These interventions focus on changing aspects of the couple or family relationship such as attachment, cohesion and conflict, communication, and shared values. We also excluded interventions to improve coping and self-care among CSOs of persons with SUDs, such as Al-Anon. We excluded CRAFT because it focuses on CSO self-care and strategies to encourage those with SUDs to enter treatment (Archer, Harwood, Stevelink, Rafferty, & Greenberg 2020; Kirby et al., 2017). Included studies also had to meet criteria stipulated by Southam-Gerow and Prinstein (2014) for adequate methodological rigor.

The counselor coaches family members to engage in new behaviors that increase positive interactions and improve communication and problem-solving skills (Lam et al., 2012). BFT is not manual based, but it applies evidence-based practices in SUD treatment (e.g., contingency management, communication skills training, CBT) to family counseling. The existing literature suggests that families play a key role in motivating persons with AUD to recognize the need to change, providing support for change, and supporting long-term recovery and that AUD recovery is good for families. Most of our current knowledge, however, has come from studies of relatively small clinical samples or from treatment studies. Similarly, the lack of research on the role of the family in AUD recovery in diverse populations is a major gap in the current literature.

You are unable to access recovery.org

Family counseling approaches in SUD treatment refect the principles of systems theory. Such approaches view the client as an integral part of the larger family system. In SUD treatment, family counseling focuses on how the family influences one member’s substance use behaviors and how the family can learn to respond differently to substance misuse. When family members change their behavioral responses to substance misuse, the entire family system changes, leading to improved health and well-being for everyone. Chapter 4 advances the systems theory approach and provides counseling strategies to apply during intakes, initial sessions, and other stages of treatment. To counteract these influences, treatment emphasizes contingency management strategies that reward abstinence, reduce reinforcement of alcohol and drug use, and increase positive behaviors and social interactions incompatible with substance use (Lam et al., 2012).

Literature identifying barriers to provider uptake and patient utilization is also limited. CRAFT is a structured, family-focused, positive reinforcement approach, usually four to six sessions in length, that teaches family members and CSOs strategies for encouraging the family member who is misusing substances to change his or her substance use behaviors and enter SUD treatment. For example, a positive reinforcer may tell the family member how much the CSO enjoys spending time with him when he is not smoking marijuana or going to a movie with him after a day without drinking. The underlying assumption of CRAFT is that environmental contingencies are important in promoting treatment entry (Bischof, Iwen, Freyer-Adam, & Rumpf, 2016). The counselor’s role in CRAFT is to work with family members to change the way they interact with the person who has an SUD and that, in turn, will have an impact on his or her substance use behaviors. Functional family therapy has been widely disseminated in the United States and other countries.