SA 201 Family assessment and involvement

1. Family assessment
and involvement

2. Benefits of family involvement
 Family involvement in SA treatment is positively
associated with increased engagement for the IP
 Decreased treatment drop out
 Better long term outcomes for the IP
 Family education and involvement increase the family’s
support of the IP recovery process –long term recovery
rates increase

3. benefits
 Family issues can be a focus, allowing family members to
get help they need to change behavior
 Intergenerational impact through education and
awareness of family members
 Reduced resistance from the IP
 Family education can address distorted experiences of
the family around substance controlled behavior
 Family has ability to learn new, healthier skills of
communication

4. Assessment of family
 Should be a coordinated effort – SA counselor and any
other agencies involved in providing services to the
family
 Assessments should be inclusive- families with SA often
have other issues intertwined- poverty, parental
incapacity, IPV, mental illness – SA counselors need to
work in collaboration with others to provide services

5. Assessment of family
 Should include recovery management for the IP, as well
as the family
 Should include a process for identifying immediate needs
of the family , as well as intergenerational issues of
progression
 Assessments should include questions about the impact
of a family members addiction and identification of
enabling behaviors

6. Assessment of family
 Assess stage of change and target interventions
appropriate to that level

7. Levels of counselor involvement
 SA counselors are involved with family at different levels
during a client’s treatment process – these levels assume
the family is an adjunct or collaborative process to the
clients treatment
 Levels vary depending on the family situation and how
well integrated family counseling is into the process of
treatment for the IP
 At each level, family intervention by the SA counselor has
a different function
 Readiness to change determine appropriate level of
involvement

8. Level 1
 Counselor has little or no involvement with the family
 Focus is largely on the client’s SA
 Client may need to be protected from family
 Family impact on the individual IP may be a focus for the
individual client only

9. Level 2
 Counselor provides psychoeducation and advice
 Primary focus is on the client’s SA, but begins to
introduce the concept that family dynamics play a role.
Family secrets may be exposed at this point, such as
other's SA, abuse or other family issues

10. Level 2 involvement
 The SA counselor is open to engaging with family in a
collaborative way
 May advise family on the recovery needs of the IP
 Identify key communicators within the family
 Identify family dysfunction that interferes with SA
treatment
 Offer education regarding SA, may need to refer
individuals within the family or the entire family for more
intensive therapy

11. Level 3
 The counselor needs knowledge about family dynamics
and family reactions to SA and other stressors
 The counselor will ask questions of the family regarding
concern and feelings related to the client’s condition and
impact on the family
 Supports the family through empathic listening and
validation

12. Level 3
 Assess the family’s functioning as it relates to the client’s
SA
 Encourage and support family in their efforts to cope with
and support their family situation
 Provide SA education to the family which matches their
unique needs, situation, concerns, and level of readiness
for change
 Identify family patterns of dysfunction and match
referrals to the unique needs of the family

13. Level 4
 Requires the counselor to have a working knowledge of
family systems
 The counselor needs to understand the therapeutic
relationship, treatment system and their own family
system
 Goals include interventions to define and change
interactional patterns of the family around SA

14. Level 4
 May need to engage family in a series of structured
family meetings within the context of client’s treatment
 Ongoing assessment of the family’s level of functioning
 Insure that all family members have a chance to express
themselves

15. Level 4
 Help family with new styles of collaboration and problem
solving
 Assess referral needs for family therapy specialist

16. Level 5
 Counselors need knowledge and expertise in family
systems and identifying dysfunctional patterns within
family systems
 Ability to handle intense emotion from family members
 Must be able to maintain neutrality despite pressure to
take sides

17. Level 5
 Counselor needs skills in engaging family who are
difficult to engage
 Ability to deal with strong resistance
 Must be able to work effectively and collaboratively with
other professionals involved with the family
 Not appropriate level of involvement for new counselors

18. Factors to consider
 Culture – counselors need to be familiar with the roles,
boundaries, and views of substances for different cultures
(chapter 5)
 Age and gender issues – cultural attitudes about younger
and elder family members, role of gender roles in the
family
 Hierarchies- what are the positions of the family – are
they culturally influenced