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Family Therapy for Substance Abuse

Clinically Reviewed

This page has been clinically reviewed by David Szarka, MA, LCADC.

When a loved one is abusing drugs and alcohol, it affects the entire family. It’s harrowing to watch a family member constantly put their health and life at risk, and the regular arguing and emotional challenges are frustrating and draining. Family therapy is critical to repair the emotional wounds of addiction and develop more productive, respectful ways of communicating with each other.

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Why Is Family Therapy Important?

You can help your loved one recover from substance abuse by participating in family therapy. It’s a critical component of a comprehensive addiction treatment program for two major reasons:

  1. Family involvement in addiction treatment and recovery shows your loved one that you care for them and can help prevent relapse.
  2. Family therapy helps you rebuild trust and open the lines of communication. Addiction is a chronic brain disease, but it’s also been called a “family disease.” Without intervention, the effects of substance abuse are progressive and spread to every aspect of the family system.

Addiction breaks down the family system and reveals vulnerabilities. It’s important to let a mental health professional help you navigate the minefield created by substance abuse and repair your relationships. A family therapist will create a safe space for families and people struggling with addiction to have difficult conversations.

Benefits and Goals of Family Therapy for Substance Abuse

Keeping family relationships healthy takes work, especially when dealing with addiction.

Family addiction counseling helps people:

  • Overcome resistance to change.
  • Break down barriers of communication.
  • Interact positively.
  • Understand family strengths and use them to help everyone recover together.
  • Address frustrations and strong feelings in a safe space in a way that doesn’t blame or shame.

A mental health counselor can mediate and help your family stay on track to getting the addicted person and your family unit the help to move forward.

Family therapy for substance abuse has multiple benefits, such as:

Setting Clear Treatment Goals

Families dealing with addiction are stressed. Emotions run high, and they probably have for a long time. It’s easy to lose sight of the main issue. Although the focus is on substance abuse, getting back to how it all started is crucial. Substance abuse is a symptom of a deeper problem. In family therapy, you’ll explore the root causes of substance use. You’ll identify collective and personal goals. Your family therapist will keep you on track to reaching those goals.

Improving Communication

Your family therapist will teach and model how to talk respectfully to each other. Just changing the language you use can go a long way toward getting your message across to your loved one.

Promoting Personal and Family Wellness

Addiction can cause you to sacrifice self-care and easily leaves emotional wounds. Family therapy is structured to address the needs of each family member. Some emotional needs may come about, such as the desire to accept, forgive, or to move on. As each family member builds their emotional wellness, the overall health of the family can improve.

What Is Family Addiction Counseling Like?

If you’ve never been in counseling before, you may feel apprehensive about family therapy for substance abuse. Many people have fears of being blamed or having to reveal more than they want. The truth is, family addiction counseling is as much for you as your addicted loved one. A family therapist can help you express how your loved one’s addiction has impacted your life. They’ll help you sort through any anger, guilt, sadness, or grief you’re feeling.

Family therapy for substance abuse typically includes:

  • Addiction education – You’ll learn that addiction is a disease and why your loved one can’t “just quit.” You’ll also hear about the underlying reasons behind addiction, like mental health issues, trauma, and attachment styles.
  • Conflict resolution – As the name implies, you’ll learn respectful, productive ways to resolve disagreements.
  • Coping skills – Your family therapist will teach you new, healthy strategies to deal with stressful situations between family members.
  • Codependency education – You’ll learn how you and other family members are enabling your addicted loved one, and how to change that.
  • Family dynamics – Family members often fall into predictable roles, especially around addiction. You’ll learn to identify these roles and pay attention to any negative feelings and behaviors tied to them.
  • Self-care – Taking care of yourself can fall by the wayside when you’re focused on an addicted loved one. You’ll learn about the importance of self-care and how it helps both you and your loved one.

Types of Family Therapy

Family therapy for substance abuse may take place in a variety of forms, such as:

  • Group sessions at an addiction treatment center with other clients and their own family members in addition to your family
  • Private family therapy sessions involving only family members and a therapist
  • Family addiction education sessions at a drug rehab or elsewhere
  • Twelve-step groups for loved ones of addicted people, such as Al-Anon (not technically therapy, but a helpful form of support through peers going through similar challenges)

There are several family therapy models. Common ones include:

  • Multidimensional family therapy – Frequently used to help recovering teenagers, multidimensional therapy helps adolescents build stable and robust identities. Parents and guardians receive help with communication, parent-child relationships, and setting boundaries and limits.
  • Cognitive behavioral family therapy – It draws on cognitive behavioral therapy (CBT) principles to address harmful behaviors and thought patterns in the family
  • system. Family members learn to replace those negative patterns with positive actions that support their loved one’s sobriety.
  • Structural family therapy – This therapy identifies and transforms unhelpful dynamics and “rules” in family dynamics. It places a strong emphasis on improving communication and setting boundaries.

Family addiction counseling is typically a part of any substance abuse treatment program. An addicted person doesn’t exist in a vacuum, so it’s important for every family member to understand the dynamics and roles that play a part in their loved one’s drug and alcohol abuse.

Inpatient Treatment

Residential treatment centers usually have family programs. The type of programming offered varies but may include some or all of the following:

  • Individual counseling sessions with family members
  • Family therapy sessions for substance abuse with all participating family members
  • Family weekends with education classes for loved ones, as well as family addiction counseling sessions
  • Family addiction groups with loved ones of other clients at the treatment center
  • Couples counseling

Intensive Outpatient Treatment

Many outpatient rehab centers offer some of the options above. Others focus on group sessions with all the clients’ family members coming together with a facilitator. These groups primarily educate families about addiction while providing insight into areas family members can work with an individual therapist more deeply on.

Who Can Attend Family Therapy?

There are no set rules about who should be involved in family addiction counseling and who shouldn’t. Traditionally, the immediate family attends, but “family” has lots of different meanings these days. In SAMHA’s guide to family therapy for people with addiction, family is defined as “a group of two or more people with close and enduring emotional ties.”

How to Make the Most of Family Therapy

Family therapy can be a turning point for your relationship with your addicted loved one, as well as other family members. A family therapist is specially trained to help you identify issues that have always been there but that addiction has brought to the surface. Family therapy can be emotionally uncomfortable, but that’s where the work gets done. If you devote yourself to the process and open yourself to learning new ways of functioning as an individual and family, you can have more fulfilling relationships with your loved ones.

Prepare for family therapy by making a list of questions to ask the family therapist so you understand their style and what you can expect in sessions.

You may also consider journaling or making a list of:

  • The way your loved one’s addiction has impacted you
  • What you’d like your relationship with your loved ones to look like
  • Boundaries you’d like to set with your loved one
  • What goals you’d like to accomplish in family therapy

These types of topics will naturally arise in family therapy, but gathering your thoughts about them ahead of time can give you a good starting point and help you communicate to the therapist what you’d like to focus on.

Participating in individual therapy can also help you in family therapy. An individual therapist will help you further process the emotions that come up in family therapy. They can also help you determine what issues you should bring to family therapy or discuss issues you’re not yet ready to bring to those sessions.

Get Help Today

If your loved one is struggling with addiction, we can help. We’re committed to supporting our clients as they heal from substance abuse. True healing often involves their loved ones as well. Reach out today to see how we can help.

Questions about treatment options?

Our admissions team is available 24/7 to listen to your story and help you get started with the next steps.

David Szarka
Medically Reviewed by David Szarka, MA, LCADC