Family therapy is a form of psychotherapy that can reduce conflict or distress in the family unit by improving family member interactions. When patients with substance use disorders seek treatment, the family holds the key to understanding how substance abuse develops, is maintained, and what can positively or negatively impact treatment.
At United Recovery CA, we are dedicated to providing compassionate, effective family care in a welcoming, safe environment as part of our residential treatment or extended treatment program.
The Role of Family for Addiction Treatment
The family is the primary source of nurturing, socialization, and attachment in society. Healthy relationships are profoundly beneficial for all family members because they form the foundation of how individuals relate to other people and the world around them.
Substance use disorders may cause physical damage to your body, but they also do similar damage to family relationships and dynamics. Rebuilding healthy relationships is essential for recovery because it can positively impact mental health. By contrast, toxic relationships can turn into triggers for relapse.
There is a strong association between social interactions and our brain chemistry. During social interactions, there is a notable change in the brain’s chemical composition. Healthy relationships can build healthy neurotransmitters and provide neurochemical rewards that positively impact health and well-being. Healthy relationships provide support, stability, reliability, encouragement, and a strong emphasis on health and wellness. They are characterized by love and affection and help family members to feel safe and cared for.
Some of the benefits of healthy, positive relationships include:
- Developing trust and confidence
- Lowering stress
- Alleviating some mental disorder symptoms
- Increasing life expectancy
- Improving the quality of life
The Role of Addiction in the Family
The research shows that substance use occurs in one-third to two-thirds of child maltreatment cases, and a parent with a substance use disorder is three times more likely to physically or sexually abuse a child. Furthermore, these children are 50% more likely to be incarcerated as juveniles and 40% more likely to commit violent crimes. Within families where substance use is prevalent, children will internalize problems and experience anxiety, depression, substance use, aggression, impulsivity, and conduct problems such as lying and stealing. Sharon Wegscheider-Cruse has documented six roles that are commonly seen and taken on in an addicted family:
The addicted: The addicted person or people may be the primary care providers or an adolescent. With this role, the substance is the coping mechanism.
The enabler: This is often a spouse but may be the oldest child. The enabler makes excuses to smooth problems over in the family.
The hero tries to bring the family together and create a sense of normality. The oldest child often takes on this role. The hero is under tremendous pressure, which makes them highly anxious.
The scapegoat: The scapegoat is the person who is blamed for the family problems. The scapegoat will voice their anger but will shield the addicted.
The mascot: The mascot tries to defuse stress with humor. This role is usually taken on by the youngest member of the household, who is vulnerable and desperate for approval. Humor is used as a defense against pain and fear. The mascot will often grow up self-medicating.
The lost child: This role is usually adopted by the middle or youngest child, who doesn’t get much attention. They are ‘invisible.’ The lost child struggles with decision-making and relationships later in life. They use solitary activities as a coping mechanism.
Children of parents with substance use disorders are furthermore likely to
- Have unmet developmental needs
- Have impaired attachment
- Experience economic hardship
- Be in emotional distress
- Have legal problems
- Experience violence
- Be at elevated risk of developing a substance use disorder themselves.
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Teenage Addiction
It is reported that 10.37% of teens in California aged 12-17 have used drugs and 8.85% consume alcohol. Of concern, 24.46% of California teenagers are more likely to have used drugs in the last month than the average American teen. Californians in the 18 to 25 age group are 18.24% more likely to use drugs than the average American in the same age group.
Opioid use disorders among teens have been categorized as a national public health emergency, with overdose deaths due to opioid use in the 15 to 24 year age group increasing by 500% since 1999.
Adolescents are more likely to have a lifelong substance use disorder if they do not get help early on.
The Science behind Family Therapy
According to the work of social worker Laney Cline King, there are four types of approaches to family therapy.
Bowenian: This approach works on the premise of two core concepts: triangulation and differentiation. Triangulation occurs when someone tries to divert conflict by involving a third party. Differentiation is the process of learning to be less emotionally reactive in family relationships.
Structural: This approach addresses the notion of hierarchy by ensuring that the parents (or adults) are in control and set boundaries for the children. The structural approach incorporates ‘joining,’ where the therapist joins the family discussion to ensure that no one or two people have too much power.
Systemic: This approach focuses on the meaning behind the behavior and suggests that communication occurs unconsciously. This means that power doesn’t belong to a single person but actually to the ‘unconscious’ game that family members are complicit in, to keep a problem alive.
Strategic: The strategic approach can deliver results in a short time frame. The therapist will set homework so that family members can change how they relate to the person with the perceived problem or ‘symptom.’
Re-Establishing Connections
Family members may absorb the impact of a loved one’s substance use; they may cover up, rationalize or make excuses. Some may find it difficult to talk about how substance use affects them, while others may withdraw from the person with the problem to avoid conflict, leaving many issues unresolved. Some members may blame themselves for the problem, or blame the addicted person for their behaviors, harboring resentment and mistrust.
Substance use disorders exacerbate pre-existing communication and emotional issues between family members, such as relationship dynamics, mental health issues, and domestic violence. Sometimes family dynamics like grief, cheating, or LGBTQ+ challenges can lead to substance use. The abuse of substances in the family leads to trauma for the other family members, leading to further substance problems.
When abused by a parent, it causes marital strain between parents affects relationship dynamics, mainly if infidelity and financial problems are prevalent. When an adolescent family member develops a substance problem, this will amplify the family’s values about substance use and addiction stigmas. Parents may feel anxious about their teenage child skipping school, getting low grades, and mixing with other users. Denial, anger, and communication breakdowns are common responses within a family and can compound an issue unless professional treatment is sought.
Group Therapy for Families
Within a group therapy environment that is non-judgmental and safe, family members can learn about addictions and develop the coping skills to help them:
- Improve their quality of life
- Experience less conflict with the addicted person
- Lower stress levels
- Experience better mental health
Group therapy also ensures that every family member is given the time and space to voice their challenges and emotions. Working with a professional can help to keep these discussions productive and constructive.
Group therapy for families may draw on some of these techniques to bring family members closer together:
- Letter writing
- Roleplaying
- Journaling
- Step by step assistance to improve relationships
- Cognitive-behavioral therapy
The Role of Intervention in the Family
Family members can cover up and enable someone’s addiction, or they can take an active role in intervention, to help a fellow family member reach out for help. An intervention is a delicate process that should be planned and not spontaneous or reactive.
Some helpful questions to ask yourself before delving into an intervention could be:
- Will it be possible to state my case without angering the other person?
- Are other people in my loved one’s inner circle available to help me?
- Can I follow through with this conversation, even if the outcome is negative?
If your loved one is prone to violent outbursts, suffers from a mental health condition, or has known suicidal tendencies, seeking the help of a professional interventionist might be a more sensitive way to handle the matter.
Family Therapy – The United Recovery California Approach
At United Recovery California, we prioritize the entire family unit and recognize how a thriving functioning family system offers unparalleled support for members in their recovery journey. Addicted behavior is a symptom, and at United Recovery California, we work closely with our patients and their families to delve into the contributing factors that enable it.
We understand that many socio-emotional issues between family members are intergenerational and that many dynamics take place unconsciously. By working closely with the entire family, we can address past traumas to prevent them from causing future problems. We value healthy relationships and the decisive role they play in recovery.
We believe that we can help you repair family relationships no matter the damage that has been done.
Meet Your Recovery Team
Our Recovery Teams have been structured to provide maximum support, Family Medicine, and medical care for patients who want to recover from substance use.
By starting your recovery journey with us, you can expect:
- Evidence-based treatments
- Customized treatment plans
- Dual diagnosis and treatment for co-existing mental health conditions
- A supportive, safe, and non-judgmental environment