Substance Use Disorder Treatment and Family Therapy NCBI Bookshelf

Many specialized family SUD programs began to close in the 1990s as a result of managed care, pressure to shorten treatment length, and limited funding sources (White, 2014). A persistent view of family services as ancillary meant little or no reimbursement from insurance and other funding sources. Programs self-funded family services or offered them on a cash basis, which was usually unsustainable. Marked by transitions, aging, births, and deaths, extended families undergo developmental stages that predicate the normative stresses, tasks, and conflicts they may face. Understanding these normative stages will help counselors better perceive a family’s presenting problems, including SUDs.

  1. Peer recovery support services for people with SUDs have demonstrated efficacy in helping people initiate and sustain recovery (Bassuk, Hanson, Greene, Richard, & Laudet, 2016).
  2. The intensity and format of the family-based intervention should align with the stage and duration of an individual’s SUD treatment, and should also address the presenting needs of that individual’s family.
  3. For example, in a couples session in which the couple discusses the husband’s return to drinking after a period of abstinence, the counselor would note the interactions between the husband and wife but zero in on the return to use.
  4. Older children and adolescents contribute verbally to mapping, and younger children offer information about family interactions via their behavior (Liepman et al., 2008).

Support staff in exploring the role of SUDs in family counseling and in developing collaborative relationships to meet the diverse needs of families. In recent years, transition-age youth have experienced unprecedented levels of substance-related consequences in general and opioid-related consequences in particular. 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. Nearly 1,800 youth initiate heroin or pain reliever misuse each day (SAMHSA, 2020a), and 8–12% of those who engage in opioid misuse develop opioid use disorder (Vowles et al., 2015).

Promoting Personal and Family Wellness

Offer SUD treatment via culturally responsive approaches that involve the family as a whole. Research indicates that people with SUD who have family support recover more successfully. Plan for follow-up meetings to address ongoing recovery and relapse prevention concerns. Engaging family members and CSOs in helping the individual with an SUD get into treatment. Reframe continuing challenges as normal, not as failures of the family or the counseling process.

Recent surveys conducted in outpatient (Ryan-Pettes et al., 2019) and justice settings (Folk et al., 2020) found that most caregivers desired ongoing DTC support on parenting during aftercare. Couple and family-based therapies are shown to be superior to bona fide individual- and group-based therapies. Therefore, SUD treatment programs and practitioners should routinely offer couple and family therapies as a standard-of-care option. Couple and family therapists should develop familiarity with these treatment approaches to treat SUD.

How Is Family Therapy Helpful In Addiction Recovery?

Family therapy incorporates a person’s relatives and support system into their addiction treatment. Family therapy aims to support repairing relationships and bringing family members closer together. These groups provide access to support services, including education and resources. The CRAFT approach uses a structured system to help families deal with substance abuse. It uses positive reinforcement to help the person with SUD change their behavior. Solution-focused Brief Therapy is used when someone has co-occurring disorders.

Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction

This TIP also offers guidance for addiction treatment program administrators, supervisors, and clinical/program directors (called “administrators” for brevity) working in behavioral health programs and agencies that provide SUD treatment and recovery support services. The integration of family counseling into SUD treatment has posed an ongoing challenge since the inception of family therapy in the 1950s. Family counseling has been woven into treatment across the continuum of care, from prevention approaches, to treatment interventions, to continuing care services. Even so, it can be difficult for providers and programs to fit family services into existing schedules filled with the demands of SUD treatment and related services. SUD treatment programs may also face challenges related to funding, training, and other administrative aspects of integration.

Family Counseling: What Is It, and Why Is It Useful?

Family members learn to focus on their own mental, physical, emotional, social, and spiritual needs while still supporting their relative’s recovery. Involve supportive family members and other recovery supports in developing and implementing the continuing care plan; ask for their help to address barriers to continued treatment engagement. In the 1980s and 1990s, Berg and Miller (1992) and de Shazer (1988) 2c-b-fly developed a family counseling approach to help family members find solutions to their problems instead of using the problemsolving approach of structural and strategic counseling. The main assumptions of solution-focused therapy are that pinpointing the cause of problematic family functioning is unnecessary and that counseling focused on solutions to specific problems is enough to help families change.

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