SA 201 3-1

1. T I P 3 9 R E V I E W
Family and addiction

2. SA different impact on different family structures
 Preschool age children
 School age children
 Adolescents
 Adult children with aging parents

3. Parental incapacity and inconsistency create:
 Blurred and confusing boundaries
 Inconsistent parental messages
 Lack of ability to express feelings/range of emotion
*Parental Incapacity refers to the significantly limited
ability of a child’s parent(s) to provide adequate care
for the child.

4. Family treatment
 May involve 1 or several members of family
family is defined by culture, belief systems
 Traditional family
 Extended family
 Elected or family of choice
Family involves enduring emotional involvement

5.  Family can be defined by the client as those to whom
they have the closest emotional connections
 Counselor cannot define “family” for the client
 Initial assessments should include an assessment of
who the client considers family support

6. Family counseling assumptions
 Non-summativity- Family as a whole is greater
than and different from individual members
 Circular causality- if one member changes his or
her behavior, all others change as a consequence
 Communication traits- every family has
individualized communication traits which can be
verbal/nonverbal means of expression within the
family
 Homeostasis- families strive for balance within a
self-regulating system

7. Family therapy in SA
Purpose:
 Use the family's strengths and resources to help
develop ways to live without substances of abuse
 Diminish the effects of substance dependency on
both the IP and the family

8.  Family therapy-unit of treatment is the family
 Family –involved therapy – typically involves
education about the impact of substances on the
family. The family is not the primary therapeutic
grouping. Most SA treatment includes some measure
of family-involved therapy

9.  Traditional family therapy models view SA as
maladaptive to the environment- a family systems
model which views SA as a symptom of
dysfunction within the family. The whole family is
the IP
 SA counseling views rely on a disease model of
addiction and see SA as the primary issue resulting
in the family developing maladaptive behaviors in
response to the disease of addiction. The family
member with the SA problem is the IP.

10.  In SA counseling, the primary goal is abstinence for
the IP
 Levels of counselor involvement
1. little or no involvement with family
2. provides family with psycho-education and
information
3. addresses feelings, offers support, education
4. trained family therapy

11.  Levels of recovery for family
1. attainment of sobriety – unbalanced but change is
possible
2. adjustment to sobriety-developing and stabilizing
a new system
3. long term maintenance of sobriety –rebalance (
new homeostasis) and stabilize a new and healthier
lifestyle

12. Goals of SA family treatment
 Interpersonal, intrapersonal, and environmental
changes affecting the IP
 Helps non-using family members to work more
effectively for improved family functioning –
address enabling behaviors, etc
 Prevention of intergenerational progression-
protective factors
 Provide a safe environment for feelings expression,
conflict resolution and improved communication

13. Benefits of family treatment
 Research outcomes – TIP 39

14. Assessment needs in family
treatment
 Co-occurring disorders – may be present in IP,
mental health issues may also be present in other
family members
 Cultural considerations
exploration of cultural views of substances,
seeking help
Gender and age roles within the family
Pathology vs. cultural norms

15. Assess for level of change in family
 Precontemplation
 Contemplation
 Preparation/determination
 Action/willpower
 Maintenance
 Relapse