Why is family therapy important? How can this help for a member with Substance Abuse Problems?

Is family therapy really necessary in case it is found that one or more of the family members is or are suffering from substance abuse problems? How best can it be done, and is there any harm if the whole family does not receive this kind of therapy?

Thank you all for your opinions in this matter.


Regular User Asked on September 24, 2018 in Family Support Systems.
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I don’t think family therapy in this case is a necessity. It can only help for family support at home and for the family to understand what the suffering family member is going through (it is a disease, it is not the suffering patient’s fault, etc). The way it is done is when the family is invited by the counselor to one or more therapy session with or without the suffering patient and discuss the main elements of drug addiction, what is treatment about and the patient’ status if authorized (only if the patient signed a consent to authorize his/her counselor to give information to the family, due to confidentiality reasons). I don’t think there is any arm at all if the family doesn’t receive family therapy.

Super User Answered on September 25, 2018.
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Thank you Olivier for your thoughts. I beg to diverge a little by stressing that its really helpful and important for a family to undergo therapy.

The modern family unit may include single-parent families, unmarried cohabiting couples and children, increased divorce rates, gay and lesbian marriages, in addition to shared childcare, household and employment duties.

Regardless of the various ways the family unit changes, family therapy is still a beneficial component of substance abuse treatment. In fact, research has found that behavioral health treatment that includes family therapy works better than treatment that does not, and when combined with individual treatment, can reduce rates of relapse, improve medication adherence, reduce psychiatric symptoms, and relieve stress.

Addiction is a Family Disease

The National Council on Alcoholism and Drug Dependence calls addiction a family disease. That’s because addiction affects the entire family system and the individuals who comprise it. Addiction puts family members under a great deal of stress, disrupting routines and causing unsettling or even frightening experiences.

As a result, family members develop unhealthy coping strategies as they strive to maintain equilibrium in the household. The family unit becomes a fragile and dysfunctional system, and this often unwittingly contributes to the addiction as the family adopts destructive behaviors as a result of it.

Children in the household are particularly affected by addiction. Substance abuse in the home interrupts a child’s normal development and leads to a higher risk for physical, mental and emotional health problems. Children of an addicted parent often have difficulties in school and are more likely than their peers to have a learning disability, skip school or be expelled. They’re also four times more likely than their counterparts to become addicted to alcohol or drugs themselves.

Impact of Substance Abuse on Families

children suffering from parents' substance abuse

Although the effects of substance abuse vary based on family structure, drug and alcohol-abusing behaviors impact family dynamics in several ways that are very unhealthy.

  • Negative emotions – As a result of the substance abuse, family members typically experience negative emotions such as anger, resentment, anxiety, concern, guilt, and embarrassment.
  • Safety – In some cases, the safety of other family members may be put at risk by a person’s substance abuse. Children or spouses may also feel the need to obtain legal protection due to fear of their loved one’s actions.
  • Responsibilities – Certain family members inherit too many responsibilities or responsibilities that are not age-appropriate. This can cause children or spouses to become overwhelmed, anxious and resentful.
  • Communication – When a family member is abusing drugs, communication within the family unit is often negative and positive interaction is very limited. In addition, the needs, concerns, and wants of the family members other than the substance abuser may be overlooked.
  • Structure and boundaries – Homes in which substance abuse exists often have a lack of structure with minimal parental involvement and loosely existing or non-existent boundaries. This results in confusion for children and negative/inappropriate behaviors. Parents and siblings may also adopt enabling behaviors that contribute to their loved one’s substance abuse.
  • Denial – In many cases, when a child has a substance abuse problem, parents will deny that there is an issue. This may be because they don’t want to face the problem or they simply cannot see it clearly.
  • Relationships – Substance abuse produces damaged relationships that can continue on through generations through negative behavioral modeling. Additionally, drug or alcohol abusers will often isolate themselves from other family members and spend the majority of their social time with other substance abusers.

Coping with Addiction in the Family: Unhealthy Behaviors

Families often cope with addiction in unhealthy ways, such as by living in denial about the addiction or by following behind their loved one, picking up pieces. Their lives may revolve around the addiction, whether it’s at the root of endless arguments or it’s an elephant in the room.

Codependent and enabling behaviors are common among families living with addiction. These types of behaviors can foster the addiction as well as make recovery very difficult for both the addicted loved one and the family members.


Codependency often results when someone has to adapt to dysfunction in the family system. Codependent behaviors are learned thoughts, attitudes and behaviors that lead to neglecting your own needs and desires in favor of being obsessively concerned with a loved one’s problems.

Codependent behaviors include:

  • Worrying constantly about your loved one’s drug abuse and the consequences of the addiction
  • Living in denial about the addiction, such as by lying to others about a loved one’s substance abuse or avoiding contact with others because you don’t want to have to make excuses
  • Reacting violently or irrationally to events related to the addiction
  • Having very low self-esteem as a result of neglecting your own physical, spiritual and emotional needs as you focus solely on your loved one
  • Aiming misplaced anger at others, such as the kids or pets
  • Engaging in your own unhealthy behaviors that help you cope with reality, such as over-eating, excessive shopping or obsessive Internet use
  • Basing your mood on that of your loved one

Now let’s understand what family therapy is:

What Is Family Therapy?

couple holding hands during family therapy

There are many benefits of family therapy, especially when it’s used in an addiction treatment setting. Family therapy helps the members of a family unit heal and recover as a group. The therapeutic setting provides a safe space for everyone to learn how to adjust to a loved one’s recovery from addiction and mental illness. Family therapy sessions are also designed to help family members make specific, positive changes to improve the home environment as well as heal relationships within the family unit.

Family therapy typically involves the substance abuser and at least one other member of the family. This could be a spouse, parent, significant other, sibling or any other individual who has a close relationship with the person in treatment.

Benefits of Family Therapy

A large body of research demonstrates the positive impact the family can have on a loved one’s recovery from addiction. The National Institute on Drug Abuse highlights the many benefits of family involvement in recovery, including:

  • Keeping your loved one engaged and motivated during treatment
  • Learning about addiction and its effects on the family as well as understanding how treatment works and what to expect when it’s complete
  • Enabling family members to voice feelings and concerns and ask questions about a loved one’s addiction
  • Offering a loved one a high level of appropriate support after treatment
  • Easing feelings of fear, anger, stress and confusion related to the addiction
  • The chance for family members to develop skills and strategies to help a loved one stay on the path to recovery
  • Improvements in family communication skills
  • The opportunity to address any mental health issues within the family system, such as depression or anxiety, which can hamper family communication and contribute to relapse

Getting involved in a loved one’s recovery improves the chances of long-term success while improving household function and family members’ own mental health.

Objectives of Family Therapy for Addiction

According to the Substance Abuse and Mental Health Services Administration, there are two main goals of family therapy for addiction.

  • Provide helpful support for the individual in drug treatment. Family therapy decreases an individual’s chances of relapse, aids in the development and maintenance of positive behavioral and attitude changes, and promotes long-term recovery of the individual in substance abuse treatment.
  • Improve the emotional health of the family as a whole. Therapy helps family members establish trust and encourage forgiveness for past behaviors. It also can provide peace and resolve conflict or feelings of anger, frustration, and sadness. Additionally, family therapy extinguishes the sense of ongoing crisis and encourages participants to let go of negative emotions.

What to Expect

According to the National Institute on Drug Abuse, family therapy has shown positive results for substance use problems and coexisting disorders such as depression, child abuse/neglect, depression, unemployment and other types of family conflict. If you and your family are enrolled in family therapy while a spouse, parent or other loved one is in substance abuse rehab, here’s what you can expect.

  • Family involvement. Family therapy for addiction typically starts after the user has entered substance abuse treatment and has made progress. This may be a few weeks or a few months into the treatment. It usually involves the client in substance abuse treatment and at least one other family member. This may be a member of the immediate, extended, blended family, or another individual that is significantly close to the client.
  • Life skills. During therapy, the counselor will assist family members as they acquire new skills and learn how to apply them. This helps create healthier interaction at home that improves the overall environment. Counselors also teach members of the family how to communicate more effectively and behave in ways that support the client’s recovery instead of hindering it.
  • Behavioral changes. Contingency management is also used within family therapy to assist the client as he or she develops behavioral goals that encourage abstinence from all substance use. This enhances progress and helps to resolve underlying issues and mend damaged relationships.
  • Goal-setting. Family members are also asked to set goals related the roles they play within the family unit. For example, parents set goals that are related to their parental roles, siblings set goals that are related to being a brother or a sister, and so on. These goals are reviewed during each session and family members provide rewards when they are achieved.

What to Do If a Family Member Does Not Want to Participate

In some instances, a family member may not be willing to participate in family therapy. This is often due to fear, skepticism that the counseling won’t make a difference, or sheer exhaustion from ongoing efforts. Some may also worry about the following things:

  • That they’ll be ganged up on in therapy.
  • That they’ll have to confront difficult issues that they’d rather not face.
  • That they’ll have to reveal family secrets like abuse or illegal activities.

If this happens, it is beneficial to have the individual meet with the counselor on an individual basis to address his or her concerns, review the purpose and benefits of family counseling, as well as encourage participation. Ultimately, the decision to participate must be made willingly, but additional education and encouragement from an addiction treatment professional can help persuade unwilling family members.

While it can be very difficult to get reluctant family members involved in treatment, psychoeducational workshops and motivational interviewing are two interventions that can help weaken resistance. Psychoeducational workshops impart the importance and far-reaching benefits of family involvement in recovery. Motivational interviewing can help a family member work through ambivalence toward recovery and help them identify their own motivation for change.

I therefore think family therapy in any addiction case can be very beneficial. Feel free to give your opinions Here, or share some places where some one can receive family therapy in an addiction setting below in your comments. Thanks again,


Regular User Answered on September 25, 2018.
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I agree, family therapy can be very important. Its hard to tell how anyone in the family will react or the decisions they’ll make about their lives or about their loved ones who may be suffering from an addiction. So I think its better to be safe than sorry, they all need therapy for starters to understand that:

  • Their loved one is suffering from a disease and not just a wilful habit
  • Their addicted member needs their love more than ever even if he/she may act otherwise.
  • Their addicted family member will most likely not heal through his tragedy as fast as they want or expect so a high degree of patience is required.
  • The new experience involving the addiction issues may change their visions, goals and how they relate to other people so a constant counselling should be sought so that they can remain humane and true to their own personal goals in life regardless of the effects of addiction faced in the family.
  • There’s need to understand extreme behavioural patterns portrayed by the addicted member or family towards the addicted member to ensure that if need be, a physical separation is done to allow the sick member receive specialized help in a specialized environment.

I’ve seen some families that go crazy because of addiction cases in their families. I can’t therefore overstate the value of family therapy. Its simply required.

I hope this helps someone. Feel free to ask for specific help through this website in case you are facing any such challenges in your family. We’ll give you guidance and point you to the right therapeutic resources to help you through the healing process. Thank you!


Regular User Answered on September 25, 2018.
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Thank you guys for the time you took and answering this question! I’ve been reading through your replies, learnt a lot, and I fully concur, family therapy though may not be as extensive should be considered for affected families. Some times collateral damage could be even worse than the real problem. Thanks everyone!!!

Regular User Answered on September 28, 2018.
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