Psychotherapy plays a role in just about every rehab program. This should be commonsensical, seeing as addiction is a multilayered condition that needs to be treated from various angles. It’s not just about detoxing and encouraging the individual to practice substance abstinence, it’s about understanding the root issue(s) that led to initial use, identifying co-occurring disorders, and developing tools and stratagems to remain sober well after the treatment is finished. One beneficial type of therapy involves the individual’s family. This should also be commonsensical, seeing as anyone suffering is greatly aided by a strong support system. The success of treatment can often depend upon family involvement. In which case, this article will speak on the benefits of strategic rehab family therapy within addiction treatment, and how family counseling techniques can assist the loved one suffering from addiction.
What Role Does the Family Play?
Family dynamics shape identity. This has been a facet of the human condition since the dawn of civilization. A healthy, wholesome, and loving family typically nurtures the same qualities in their offspring. A broken, absent, or violent family will do the inverse. Through the interactions with our mothers, fathers, siblings, and extended family, we begin to create ourselves, fostering our identity through the eyes of our kin. This is why a parent that constantly encourages and validates their child will—typically—raise a confident, affirmative person. Whereas a bad parent that constantly puts their child down, or treats them poorly might raise an individual tarnished with low self-esteem, communication issues, and behavioral problems. Within the context of addiction, the root of the problem can manifest from these very dynamics. The story of the family member—unhappy with their upbringing and environment—turning to drugs to cope is not one you haven’t heard. Additionally, even if the problem has nothing to do with how the individual fits within the family unit, there is no one closer or more capable of reaching them than their own kin. Family therapy in rehab works to:
- Identify root problems
- Create solutions for these problems
- Remedy internal relationships
- Strengthen relationships
- Teach the family unit how to best support the loved one suffering from addiction
- Teach the individual how to communicate with their family unit
What is Family Systems Therapy?
The thesis of family systems therapy is that each family is its own universe, one with its own set of rules, structures, and patterns of communication. The personalities, individual beliefs, and values of each independent member all make up the greater dynamics of the family unit. Each person feeds their energy to this greater thing we know as the family. You can deduce, then, that family systems therapy views the family unit as its own living, breathing entity. If one member of the family experiences a change, this will then impact the other members of the family. The bigger the change, the greater the force of the impact. In which case, family systems therapy works to address how all members of the family can solve a problem. In the case of a loved one struggling with addiction, it works to migrate from “treating” this specific person and rather “treating” the entire family. In this way, being that family systems therapy is often action-driven, each member will have their own set of responsibilities to uphold. Everyone must carry out their necessary tasks to improve the “greater good” of the family. This, by default, unites the family to work towards a common cause. No longer is it about the addict beating their condition so they can heal, it’s about how the entire unit can help them along the road to recovery, so the entire family can heal. It’s about the system, not the individual.
What Does This Mean for Interventions?
Addicts are notoriously difficult to communicate with. The disease they suffer from forces them to prioritize substance use over all other aspects of their lives. Unfortunately, this can mean they push their family away, which causes great strain on the family unit. In which case, an intervention is a common tactic used to try and motivate a loved one towards recovery. Yet, interventions can be tricky, seeing as they run the risk of frightening or pushing the individual away even further. Family systems therapy—or family therapy in any form—is often utilized by families trying to stage an intervention for their family member. A therapist will work to understand the problem, create an intervention strategy, and ultimately highlight the ways in which each member of the family unit can work to remedy it. Hopefully, if the intervention goes well, the member suffering with addiction can eventually join the family therapy sessions.
While the strategy of the intervention is going to be specific to the sufferer and the family unit, typically there are some rules that are ubiquitous. A family therapist will explain the ins and outs of each aspect, further ironing out the strategy. To put in perspective: often family members will have written scripts for the intervention, and each will have a specific order in which they’re going to speak. Some general facets of intervention strategy include but are not limited to:
- Exclusivity: it’s encouraged that the family unit only stages an intervention with people they know the addict will trust. This means only bringing in those closest to the addict, and those currently in good standing with them. The group needs to promote openness and honesty rather than sparking conflict. That means that if the addict is at odds with a certain family member, it’s best they’re left out of the intervention process. The focus is not to mend family relationships; it’s to motivate the addict to face their condition.
- A Neutral Space: therapists or intervention specialists will often recommend utilizing a neutral space, one that’s comfortable yet formal. At home, the addict may be too comfortable in the space, running to their room if they want out of the talk. A neutral but formal space also validates the planning that went into the intervention, further expressing the seriousness of the problem.
- Speaking Order: as stated above, there is typically a speaking order during an intervention. A family therapist will work to create this order by understanding the individual relationships between the addict and the family members, as well as the relationship between the addict and the family unit.
- Diction & Temperament: a family therapist will work to perfect the language and emotionality used during the intervention. This could be the difference between using an accusatory or persuasive tone, to expressing shame for not having spoken up sooner. If an addict feels accused, or if they feel that they’re being cornered, this is often motivation to run or sink further into denial. And, of course, if they sense anger or a rise in temperament, they will be less likely to participate in the dialogue, or hear anyone out
- Body Language: a family therapist will work to explain how body language can affect the situation, teaching the unit the right type to focus on. If an addict walks into a room and senses tension, they might immediately draw their shield and become defensive.
- Backup Plan | Rehearsal: a thorough family therapist will rehearse the intervention multiple times, constantly addressing the “what ifs.” They will address the greatest possible outcome, the worst, and everything in between. Additionally, they’ll then create strategies that should be used depending on the given outcome. This usually comes with a backup plan, which allows the family unit to remain flexible in the case of a disaster.
How This Plays into Family Systems Therapy
Staging an intervention is in itself an act that’s congruent with family systems therapy. Each family member has an assigned role, an understanding of that role within the larger context of the entity (the intervention, in this case), and each is working to better themselves, in turn solving problems for the entire family. Using the intervention as a basis opens the possibility for further improvement, especially if the addict beats their addiction and joins the family counseling throughout strategic therapy. By design, interventions help families communicate, understand the perspective of their loved one struggling with addiction, work together, identify solutions, and ultimately remedy the problems threatening their unit; which is the goal of family therapy.
How Family Therapy Plays into Addiction Treatment Through a Wider Lens
While family therapy has a longstanding history with mental health—namely its ability to treat the family and sufferer—within the context of addiction its only been utilized for the last 50~ years or so. The Treatment Improvement Protocol (TIP) released by SAMHAS (Substance Abuse and Mental Health Services Administration), states that: “Family therapy has a long and solid history within the broad mental health field. Substance abuse treatment, on the other hand, developed in considerable isolation. Indeed, until the 1970s, alcoholism counselors typically outright rejected the predominant view of mental health practitioners that alcohol abuse was a symptom of some underlying disorder rather than a primary disorder on its own account.” The truth is that the definition of a family is not static. Societal differences, cultures, and individual experiences all contribute to the subjective definition of what family is to a certain group of people. Yet, the family itself, bound by blood or definition, is an organism that can be studied, understood, and identified within different contexts. The major benefit of family systems theory—which was developed in the 1960s—is its ability to reshape narrative and responsibility. Rather than looking at the loved one suffering from addiction and saying “how do I make this person get help, in so that things can get better,” the family is encouraged to say “how do I change my perspective, my resolve, and my tactics to better myself for my loved one who is struggling?”
Strengthening the Family
Inadvertently, this line of thinking and the exercises employed by family system therapy works to strengthen the core of the family as a whole. Rather than alienating or isolating the individual struggling with addiction, therapists will work to question whether the family members would have contributed to the problem, and how they can bond together to assist their loved one. By all means, this form of thought and behavioral therapy will work to help problems beyond the loved one suffering from addiction, creating a more structured unit afterwards. The key takeaway here is that the impetus for change is universal with systems therapy.
Is It Effective?
Family therapy—of any form—is considered to be extremely influential on the success of rehab. Addiction within the family unit is difficult. Often, families do not know how to respond to the change of their loved one. They feel sorrow, anger, shame, and a host of negative emotions that come spilling forth when they try to tackle the issue. But families, like individuals, are multilayered, complex, and in constant need of upkeep. By treating the bigger picture, the addiction becomes easier to handle and overcome. Remember, the change of an individual can break the system, which means the system needs to be healed. Lastly, family therapy provides an outlet for families to speak on things they otherwise don’t know how to. Simply sitting before a therapist can provide a safe place to deal with the emotions that come about in these turbulent times. An addict desperately requires the support of their loved ones, especially if they’re trudging down the road to recovery. This safe space can allow these loved ones to deal with their own issues, effectively becoming the best versions of themselves; which is exactly what the addict needs, and exactly what’ll aid the healing process.
If you’re currently dealing with a loved one who is suffering from addiction, then it’s possible you’re researching different types of family counseling. Perhaps you want to utilize family counseling to stage an intervention. Whatever the case, a rehab center like Apex Recovery can provide valuable insight into the problems you’re facing, explain the different facets of family therapy, and provide you with experienced therapists that will be able to aid you throughout this troubling time. A change in a member of a system is a change in the system itself. Family therapy says “we can all work together to ensure that this change, despite the current troubles, will result in a positive outcome.” Sources:
- SAMHSA. Substance Abuse and Mental Health Services Administration. A Treatment Improvement Protocol. No. 39
- SAMHSA. Brief Interventions and Brief Therapies for Substance Abuse. No. 34. 1999
- Liana Lowenstein and Trudy Post Sprunk. Creative Family Therapy Techniques: Play and Art-Based Activities to Assess and Treat Families.