Has your loved one been struggling with drug or alcohol addiction?
The disease of addiction can often throw a family unit out of balance when a spouse, child, or other loved one find themselves the unintended victim of a family member’s addiction. In fact, substance abuse and addiction can damage family dynamics, erode trust, and weaken communication.
Family members who experience a loved one battling with a substance use disorder (SUD) often endure a host of painful emotions. Equally frustrating is the hopelessness loved ones feel in response to substance abuse. Family members may feel at a loss when seeing a loved one caught in the grips of substance abuse. For example, stumbling upon burnt spoons and used syringes can create paralyzing feelings of fear and shock.
On the other hand, families can also make a huge difference in their loved one’s recovery and can help their loved one achieve and maintain sobriety. Despite seeing a loved one struggle, family members can and ideally do play a major role in the treatment process. Cumberland Heights believes that the role of family in addiction recovery is vital and that is why we created a family program. But first, let’s dive into why involving family in the treatment of drug and alcohol addiction is so important.
DISEASE OF THE FAMILY
When one family member has an addiction, it affects all family members, and has a detrimental impact on every aspect of family life, including emotional, physical, and financial components.
Researchers have developed several theories for the impact of addiction on family members, including the stress-strain-copying-support (SSCS) framework, which explains that addiction is stressful for family members and can put them at risk for many different problems. Additionally, attachment theory and family systems theory can provide two possible explanations for the impact of addiction on families.
Attachment Theory
This theory is based on the idea that caregivers provide the primary sense of safety and security within families. Someone with an addiction cannot provide these fundamental needs to another because they are distracted by substance use, experience associated mood changes, and are dealing with a variety of impacts of substance misuse on their entire lives. A caregiver’s addiction deprives children of the opportunity to form a secure attachment to their parents, which serves as the basis for establishing healthy relationships for the rest of their lives.
Family Systems Theory
This theory presents the idea that the family is one single and interdependent unit; there is a dynamic and complex interplay where the needs of each family member can be impacted by the needs of others. Three key concepts in family systems theory include:
- The family’s need to maintain homeostasis, or balance.
- Feedback, or the way communication occurs and how each person’s behavior impacts others.
- Boundaries, or the limits and rules that each person sets for themselves.
Family systems theory can help explain maladaptive behaviors that family members engage in a way of trying to maintain balance and family functioning, even if it is unhealthy and inadvertently perpetuates the addiction.
DYSFUNCTIONAL FAMILY ROLES
A family impacted by substance abuse inevitably develops into a dysfunctional system. In this system, members unknowingly take on “roles” in order to cope. Perhaps you can relate to one or more of these.
The Savior Or Hero
Is there someone in your family who is labeled the “star child” or the “family favorite”? This person might present themselves well, have several accomplishments under their belt, or have a reputation for never letting the family down. They compensate for the shame the family feels around the addict by being the family superstar. They may cover for the individual who has an SUD, attempting to make the individual look pleasing to everyone. They may be in denial, overlooking major problems that require professional intervention, or they may be compensating for feeling empty and helpless themselves due to the dysfunctional family dynamic.
The Mascot
Who is the comedian, the light-hearted one who can always get the family laughing even in the most tense of situations? The Mascot is the role that provides comic relief for the hyper-stressed family. Sometimes their humor is tactlessly aimed at the individual suffering from the SUD, but essentially, the mascot uses humor to minimize the pain in situations and to deflect hurt. This often becomes a maladaptive coping skill – avoiding or putting off situations that make us comfortable.
The Lost Child
What about the avoider? The Lost Child role hides out, both physically and emotionally. They can be counted on to never “rock the boat.” They avoid conflict and suppress their emotions. They do not drain the limited emotional resources of the family, but still suffer deeply internally.
The Scapegoat
The “black sheep” or the person that always gets blamed for a problem is called the Scapegoat. They actually tend to create other problems and concerns in order to deflect attention away from the real issue. They are very successful at distracting the family and others from the individual with an SUD.
The Enabler/Rescuer/Caregiver
Finally, the Enabler insulates the addicted individual by excusing their behaviors. They are unwilling or unable to hold the addicted individual accountable for their actions. They smooth things over and run interference to keep the addict from experiencing the logical consequences of their poor choices. This behavior often stems from their desire to avoid shame and embarrassment. They will often stunt the addict’s ability to recover if they don’t change their patterns.
HEALTHY FAMILY ROLES
Despite the unhealthy, dysfunctional roles some family members can play, there are also healthy roles and behaviors that can encourage and support recovery. For example, a parent may play the role of the supportive, yet firm, caregiver who encourages their loved one to take thoughtful and positive action. Healthy family roles and behaviors include holding the loved one accountable for their behavior and creating rewards for positive choices.
Family members may attend support groups with their loved one or attend their own support groups for families of addicts. The creation of healthy boundaries is a building block of recovery for the family.
HOW FAMILY AIDS RECOVERY
In the same way addiction affects everyone in the family, healing is not only possible but critical for the whole family system. Addiction can and does affect families across generations. Although the pain is great, the strengths you and your family have developed are equally great. We will help you identify and learn how to use these for recovery for your entire family.
The following are research-back benefits of family therapy:
- Improved treatment retention
- Improved understanding of addiction and how it affects families
- Increased family support for the person in recovery
- A better understanding of what to expect in treatment and recovery
- Increased awareness of the warning signs of relapse
- Helping the family make positive changes related to the substance use disorder (SUD), such as their patterns of communication and behavior
- Promoting family strengths
- A reduced risk of relapse
- Helping families understand the importance of taking responsibility for their own emotional, physical, and spiritual well-being
HOW DOES FAMILY THERAPY WORK?
Family therapy can take different forms in the addiction treatment process. It typically involves the whole family meeting together with a therapist, but sometimes only part of the family meets, or in atypical cases, each person might meet individually with a therapist.
Each session lasts about an hour and may look different, depending on the family’s unique needs. For instance, an entire session might be devoted to talking about each person’s feelings and concerns, while another meeting may involve education on effective communication and improved listening to reduce misunderstanding. Based on the specific issues, the therapist may use different types of family therapies, including:
Behavioral Couples Therapy (BCT)
Intended for married or cohabitating couples where one person suffers from a SUD, BCT promotes and rewards abstinence through a daily “Recovery Contract.” This involves the person with the SUD expressing their intent not to drink or use drugs and the partner supporting their efforts to stay abstinent. This therapy can help improve communication, reduce stress, and maintain abstinence.
Family Behavior Therapy (FBT)
This model has been successful with adults and adolescents with SUDs. It’s sort of a pick-and-choose your own therapy based on a menu of evidence-based treatment options that aim to teach everyone skills to help them all improve their home environment. FBT focuses on how the behaviors of the person with the SUD affect the family as a whole and works to change those behaviors with the involvement of the entire family.
Brief Strategic Family Therapy (BSFT)
Geared toward families dealing with adolescents who have SUDs, this therapy is based on interventions that focus on family interactions. Research suggests that adolescent substance abuse stems from unhealthy family dynamics.
Functional Family Therapy (FFT)
A therapy used to help families with adolescents with SUDs, FFT focuses on improving family interactions since the underlying belief is that unhealthy family dynamics lead to problem behaviors. Thus, strategies include effective communication techniques, problem-solving, conflict resolution, parenting skills, behavioral contracts, and more.
Solution-Focused Brief Therapy
This can help families struggling with co-occurring disorders, meaning your loved one suffers from addiction and another mental health disorder, too. It doesn’t involve pinpointing the exact reasons for family dysfunction. Instead, this therapy focuses on finding solutions for specific problems.
Community Reinforcement and Family Training (CRAFT)
CRAFT takes a structured approach to teaching families dealing with SUDs positive reinforcement strategies to encourage the loved one with the SUD to change their substance use behaviors.
Multi-Systemic Therapy (MST)
A model used to help adolescents with SUDs, violent behaviors, and/or criminal records, MST utilizes goal-oriented techniques and family-strengthening strategies to encourage the adolescent to change.
Multi-Dimensional Family Therapy (MDFT)
A treatment approach suitable for diverse populations and adolescents with severe SUDS and their families, MDFT is designed to improve the adolescent’s and family’s functioning through a comprehensive treatment program that also involves the school, legal system, and other relevant parties.
Family Recovery & Peer Recovery Support Groups
These provide support to the members of families who have a loved one in recovery from SUDs. Family members—with a loved one in recovery—get education, support, and resources from someone who has also had a family member in recovery from SUDs.
THE FAMILY PROGRAM AT CUMBERLAND HEIGHTS
By the late 1970s, professionals had begun to recognize chemical dependency as a family disease. At the time however, few treatment centers had established a formal program for families with a patient in treatment. Ginny Alston, cofounder of the family program at Cumberland Heights was a director of pre-school education for 17 years before entering the rehabilitation field. Alston had extensive experience working with parents and was well-seasoned in the importance of family relationships.
Prior to the creation of the Cumberland Heights family program, Alston attended a training program in family counseling at the University of Missouri and became involved in helping families suffering and understanding the disease process. As Alston noted, “Understanding the disease is where the bonding comes in. Unless family members can understand the disease and their part in it, very little healing can occur.”
In 1978, Alston, along with Bee Robinson, founded the family program at Cumberland Heights, which has become one of the most important programs in the history of Cumberland Heights.
At Cumberland Heights, we believe that addiction is a family disease that affects each family member. Recovery, too, is a family process. Each member of a family deserves to have their own healing from the pain that addiction causes. Since 1978, Cumberland Heights has offered services in support of the entire family. Our family program includes several options of support designs to increase each family members’ opportunity to join in the recovery process.
Our offerings at Cumberland Heights include:
- Family Education Program
- Relapse Family Education Group
- Family Aftercare (Peer Led)
- Individual Family Therapy Sessions
- IOP Family Groups
For over 40 years now, the Cumberland Heights family program has been part of the renewal of life that occurs along River Road. It is impossible to encapsulate the profound knowledge and healing this one program has engendered. Alston claimed, “There is no way for a family to heal and reestablish healthy relationships if a patient begins recovery but a family member does not.”
It is our honor to support individuals and their families in the journey of reclaiming their lives. We have a family treatment team dedicated to supporting your family and support system. To learn more about our family program, click here or call (615) 432-3191.
