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Family involvement during treatment

Distinguishing between family therapy and family-involved therapy

The emotional and psychological pain inflicted by addiction doesn’t just affect the addicts, but their families as well, contributing to a variety of complexities. Family involvement, however, plays a vital role in the treatment of addiction.

Family integration has become a strong and consistent theme for many treatment approaches (Kaufmann and Kaufman 1992), but family therapy is often not used to its capacity in substance abuse treatment. Broadening the substance abuse treatment focus from the identified patient (IP) to the family remains a challenge.

It is important to distinguish between family therapy and family‐involved therapy.

Family-involved therapy

Family‐involved therapy focuses on educating families about the elements that contribute to the development and continuation of substance abuse. It is limited to psycho-education that encompasses the principles of substance abuse and the behavioral, medical and psychological consequences.

Psycho-educational workshops (FPW) have been incorporated in all types of psychiatric and addictive disorder treatment. Such workshops render a positive impact on participants by reducing the family’s burden, encouraging helpful behaviors and decreasing discouraging behaviors. These are semi-structured sessions in which a group of clients and their families are provided with specific information about addiction and recovery. Support is also provided, and families are encouraged to share their questions, concerns and feelings. However, involving families too much can be counterproductive, so education and support remain the main areas of focus.

It differs from family therapy in that the family is not the primary therapeutic grouping, nor is there intervention in the system of family relationships. Most substance abuse treatment centers offer such a family educational approach.

Family therapy

Family therapy emphasizes the interdependent nature of family relationships and how these relationships influence the IP and other family members. The focus of family therapy treatment is to intervene in these complex relational patterns and alter them in ways that bring a productive change for the entire family. Family therapy is developed on the system’s perspective, so that, changes in one part of the system produce variations in other parts of the system. These changes can either result in problems or solutions.

It is important to understand the complex role that families can play in substance abuse treatment. They can be a source of help to the treatment process and must maintain responsibility to manage the consequences of the IP’s addictive behavior. Individual family members are concerned about the IP’s substance abuse, but they also have their own goals and issues. Providing services to the whole family can improve treatment effectiveness.

Meeting the challenge of working together is based on balancing mutual understanding, flexibility and adjustments among the substance abuse treatment provider, family therapist and the family. This requires a stronger focus on the systemic interactions of families. Family therapy calls for the reconciliation of many divergent practices to be used in substance abuse treatment.

Focus often relies on individual needs of people with substance use disorders, urging them to take care of themselves, neglecting the impact these changes will have on other family members. Hence the IP often is not prepared for the reactions of other family members and to cope with these reactions. Involving the family or significant other of the addicted client in individual or multiple family group sessions can reduce the risk of relapse.

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