In many cases, the therapist’s functional analysis of the client’s drinking behaviors identifies problems encountered in interactions with others. Consequently, clients have to learn to resist offers to drink or related forms of social pressure from coworkers, friends, or even family members. In addition, clients may be deficient in very basic social skills, leaving them isolated substance abuse counseling and without adequate social support, which are common antecedents to drinking. These clients benefit from training in starting conversations, nonverbal communication (body language), giving compliments, being assertive, refusing requests to do things for others that will overburden them, communicating emotions, and improving functioning in an intimate relationship.

Substance Use Disorder Treatment and Family Therapy: Updated 2020 [Internet].

It can be difficult for family members to divulge secrets or express differences outside the family. Family members can and will oppose certain family beliefs or report certain family incidents, but when they do so, they normally experience shame, fear, or feelings of disloyalty. Loyalty can be a strength or a limitation for counselors in addressing family problems. Even family members who have moved far away, disengaged emotionally, or become estranged from the family are still a part of it.

Functional Family Therapy

• Throughout the course of the discussion, the therapist provides frequent summaries of what the client has said to focus attention on the problems that are being uncovered and to highlight whatever motivational statements the client has made along the way.
• Motivational interviewing starts with the therapist recognizing and accepting client ambivalence.
• This is achieved by using an ecological approach (that is, focusing on engaging family and social resources) or a problem-solving family therapy approach (that is, focusing on the substance misuse problem itself rather than the inner workings and relationships within the family).
• Clients who live at home and receive outpatient treatment, for example, are likely to encounter high-risk situations daily that require complex skills.
• Interest in the role of families, family dynamics, and family theoretical approaches appeared to emerge simultaneously in the 1950s among practitioners and researchers in the United States and other countries.
• Older children and adolescents contribute verbally to mapping, and younger children offer information about family interactions via their behavior (Liepman et al., 2008).

Theories can also help with interventions, treatment, prevention, relapse and recovery. The family projection process discusses how parents transmit their emotional problems to their children, affecting their development.10 Acknowledging this process can be the first step towards healing for you and the family. You will encounter challenges, myths, and obstacles that hinder engagement and treatment of families dealing with SUDs. Some challenges are related to attitudes and myths about offering family counseling in SUD treatment settings. Still others are related to family issues such as low motivation to change and power dynamics within the family.

Cue Exposure Therapy

• In this vein, compared to MI clients who used weak commitment language (e.g., “I will try to stop using”), clients who used strong commitment language (e.g., “I am determined to stop using”) were more likely to achieve abstinence outcomes up to 12 months later.
• Potential rewards can be vouchers or prizes, clinic privileges such as rebates of treatment fees and take-home methadone, and housing and employment (Petry, 2000; Petry et al., 2000).
• In addition to these positive evaluations of MI, recent studies have shown MET to be as effective as other common treatments, such as TSF, CBT, and social behavior and network therapy (Babor and Del Boca, 2003; Stephens et al., 2000; UKATT Research Team, 2005).
• In doing so, the counselor can develop strategies the couple can use as a team to learn from the experience and prevent another return to use.
• In the case of a child or adolescent, a healthcare provider may focus on their parents.
• The goal of this assessment is to identify their current coping skills and abilities; family, social, and recovery supports; motivation and commitments to change; self-efficacy; and other sources of recovery capital.
• External resources include employment; safe housing; financial resources; access to health care; as well as social, family, spiritual, cultural, and community supports (White & Cloud, 2008).

Having the client participate in individual sessions with the counselor as well as group sessions with the counselor and the network of family and friends. Help families develop behavioral competencies for parenting, communication, and supervision. Fidelity in community-based settings tends to be low (Lebensohn-Chialvo, Rohrbaugh, & Hasler, 2019).

The therapist identifiesand corrects family interactions that provoke problematic behavior. The approach can be used in mental health facilities,rehab clinics, homes and a variety of other settings. The therapist is a teacher and coach, developing a positive relationship with the patient and promoting behavioral change.The therapist promotes dignity and self-worth in the patient who avoids confrontational communication. Today, therapy for substance use disorders is available in a variety of settings, includinginpatient residential rehab programs, outpatient rehab programs, sober living communities, private practices anda variety of support groups.

Other Family Therapy Treatments

Common Characteristics of All Families

• Providing information about the treatment process including schedules, treatment activities, staff involvement, and program expectations.
• Frequent reviews of previously taught skills will enhance the clients’ mastery and help to counter problems they may have in retaining the skills.
• Treatment begins by meeting first with the adolescent and the family members in individually so that they can be prepared to talk about the factors behind the runaway episode in a family session.
• When family counseling is viewed as an adjunct to individual or group counseling, it sends the message to clients and family members that family counseling is simply not that important.
• We also excluded interventions to improve coping and self-care among CSOs of persons with SUDs, such as Al-Anon.

Incorporating the Concept of Systems Into Family Models