The guide "Substance Abuse Treatment and Family Therapy" also includes information to provide family therapists with basic information about treatment models and the role of 12 step self-help programs in substance abuse treatment.
"Substance Abuse Treatment and Family Therapy," SAMHSA's Treatment Improvement Protocol (TIP) #39, includes discussion of treatment models that integrate substance abuse treatment and family therapy. These models can serve as a guide for joint treatment of the addicted person and his or her family and others with close emotional connections.
"This TIP, like the others in the series, is a key element in SAMHSA's mission of building resilience and facilitating recovery for people with or at risk for mental or substance use disorders by providing best-practices guidance to clinicians, program administrators and payors," SAMHSA Administrator Charles Curie said. "This TIP will help bridge the gap between the promise of research and the needs of practicing clinicians to use the most scientifically sound and effective methods as they strive to serve people who abuse substances."
Family Therapy Can Help
The TIP explains that family therapy in substance abuse treatment can help by using the family's strengths and resources to find ways for the person who abuses alcohol or drugs to live without substances of abuse and to ameliorate the impact of chemical dependency on both the patient and the family. Family therapy, the TIP says, can help families become aware of their own needs and aid in the goal of keeping substance abuse from moving from one generation to another.But, TIP #39 warns substance abuse counselors that they must always be aware that family-counseling techniques should not be used where a batterer is endangering a client or a child. The first priority is safeguarding all parties.
The TIP warns that family therapy for women with substance use disorders is appropriate except for cases of ongoing partner abuse. Further, women who have lost custody of their children may be strongly motivated to overcome their substance abuse since often they are working to get their children back.
Substance Abuse Impacts Families
The TIP identifies various family structures and how substance abuse may impact these families.
- A client who lives alone or with a partner – In this situation both partners need help. If one is chemically dependent and the other is not, issues of codependence arise.
- Clients who live with a spouse or partner and minor children – Most available data indicate that a parent's drinking problem often has a detrimental effect on children. The spouse of the person abusing substances is likely to protect the children and assume the parenting duties of the parent abusing substances. The effect on children is worse if both parents abuse alcohol or drugs.
- A client who is part of a blended family – Stepfamilies present special challenges and substance abuse can become an impediment to a stepfamily's integration and stability.
- An older client with grown children – Additional family resources may be needed to treat the older adult's substance use disorder. There may be issues of elder maltreatment that must be reported to local authorities.
- An adolescent substance abuser living with his or her family of origin – Siblings in the family may find their needs and concerns ignored while their parents react to the continuous crises involving the adolescent who abuses alcohol or drugs. If there is a parent who also abuses substances, this can set in motion a combination of physical and emotional problems that can be very dangerous.
