This is the guidebook I wish I had when I was first learning about addiction and mental health disorders when I was a young woman. It’s the book I give to every client who walks through my door. It is Family Focused, Practical, Hopeful and full of real life examples to help you understand and have the courage to change your experience.

2. Addiction In The Family
Dr. Louise A Stanger LCSW, CDWF, CSAT-1, CIP
Oct . 2021

3. About Dr. Louise
-Clinician-Educator-Interventionist
• “Interventionist of the Year” -2019 DB
Resources and McLean Hospital-An
Affiliate of Harvard
• Falling Up A Memoir of Renewal- Amazon
• The Clinicians Guide to Addiction
Interventions-Routhledge, 2018
• Addiction in the Family:Helping Families
Navigate, Challenges , Emotions and
Recovery ( Rockridge Press, 2020)
• Widow, Wife, Mother, Grandmother
• Soul Seeker, Adventurer

5. 5

7. Major Assumption
7

8. Assumptions
We are emerging from or still in a
Trauma Bubble
Mental Health and SUD are at an all
time high
Sleep is challenging
Decision fatigue and Reentry Anxiety
are high
Complex clients and families are the
Norm Abundant
Yes it is possible to survive Yes it is
possible toThrive
8

9. 1 in 12 American Adults (18.7 million)
have SUD
1 in 5 (46.6 Million) have Mental illness
8.5 Million have SUD and Mental Illness
Do You Know?

10. Spending on Alcohol has Increased

11. Marijuana Sales Doubled in Covid
“Cannabis sales increased in all four states coinciding with state stay-at-home orders.”

12. Center for Disease Control
U.S. Had Most Drug Overdose Deaths on Record in 2020,

14. Suicide

15. Why Addiction In The Family?

16. I Met Substance Abuse. Mental Illness ,Trauma at a Young Age

17. 18

18. 19

19. Objectives
To help practitioners -help families when they
call and ask What can I do, what do I say ,
where can I go for help and how can I take
care of myself
To illuminate family roles
To illustrate how shame, guilt, denial and
anger manifest themselves
Illustrate how to set boundaries thru case
studies
Identify and define treatment options
Discuss recovery tools for families and loved
ones

20. 21
Table Of Contents

21. What is Addiction
ASAM Sept. 2020
22

22. Addiction is a treatable , chronic medical
disease involving complex interactions among
brain circuits , genetics , the environment and
an individual’s life experiences
2021

23. 24

24. 25

25. 26

26. 12 Common Myths About Addiction
Addiction can’t happen to be or my
family
Addiction is just really a lack of willpower
Addiction is not treatable
In order for someone to want treatment ,
they have to hit bottom
If someone you love had a substance
abuse problem you would easily
recognize and solve it.

27. More Myths
My loved one has a great job and appears
functional and happy. Things must be ok.
Prescription drugs are safe and THC isn’t
addictive
Interventions do not work
If you can handle your liquor then you don’t
have a problem
Addiction is a moral failure
Detox is all you need to fight addiction
You need religion to get sober

28. Family Roles
The Problem Child or Adult
Chief Caretaker-Enabler
The Hero
The Scapegoat
The Mascot
The Lost Child

29. Families learn
Roles they have unconsciously played
Learn how to use “I” Terms and how to
share feelings
Respond without reacting
Not to Threaten, preach, nag control
How to talk
To Breathe

30. Addictions Arsenal
Denial
Manipulation
Shame
Blame
Secrets

31. What should I say ?
What Do I do?
Use I statements- I love you and
care about you
Be Specific about what you saw
or heard
Offer support-Know there is
always hope and always a
solution
Admit you may not have always
had the answers
Hit Pause
No More Secrets

32. Lets talk about Henry
35 years old
Lives at home
Third DUI
Mother makes his lunch and
Mother cleans his room

33. Lets talk about Julie
Beautiful , Bright, Creative
Shame based Mom of a 6 year old
Family of 5
Entitled
Cocaine, Ketamine, prescription drugs

34. Do You?
Do you rescue ? Do You disregard your own needs ?
Do you feel responsible for actions of another, Are you a cleanup pro?
Are you afraid of being alone or yelled at ? Are you walking on
eggshells?
Do you Blame yourself for another’s Misery?
Do you ignore or minimize unacceptable behaviors?
Do you continue to give help even when it’s not disregarded or
unappreciated ?

35. You are important to me
Self Care Activity
Gratitude rewires our brains
Every morning write 3 things you are
grateful for
Every night write 3 things you are
grateful for
Read your grateful list aloud
Share with another
Practice for 90 days

36. When is the right time for treatment ?
“ There is never the wrong time for
treatment”
“The only Failure is the Failure to act”
Creating a Positive Crisis
One does not have to “hit bottom”

37. Behavioral Health Options
Early Intervention Services
Intervention Services
Medical Detoxification Services
Outpatient Services
Intensive outpatient services and partial
hospitalization

38. Behavioral Health Care Options
Hospitalization
Residential Services
Medically Managed intensive Outpatient
Programs
Support groups

39. Co-ocurring Disorders
Depression
Anxiety
Bi-polar
Schizophrenia
PTSD
Anti-social
Borderline

40. Beyond Dual-Triple Threat
Chronic Paim
Other Physical Maladies
Process Disorders
Trauma
Grief and loss
Legal Etc

41. Tell me about -Questions for Centers
How long in Business, what level of
treatment, accreditation’s , license etc
What is your philosophy-staff credentials
Costs- Specialty
What does a Day look like ?
How do you address co-occurring
issues, gender issues
Do you do medical Detoxification/

42. MORE Questions
Do you have a Family Program
How do you Define Success
How is aftercare handled
What else can you tell me about your
program

43. Louise A Stanger
Interventions are an Invitation to Change

44. Collective Intervention Strategies
2021

45. Why CIS?
• Collective - In that to be successful there must be a team of
Families, Friend, Collegues, Associates, business partners
, managers or co-workers assembled to bring about change
• Intervention- In that we seek to move (i.e/ motivate a
person to a place of change)
• Strategy, in that nothing is set in stone ; we may adapt the
process as needed

46. Harry and Anna

47. What to Expect from a Family Program
Psychoeducation
ABCS’s of Addiction
Stages of Change
Communication Skills
Family Mapping
Learn Feelings
Identify Healthy and Unhealthy Behaviors
begin to attend Appropriate Support Groups

48. Setting Healthy Boundaries
Change Agreements

49. “I love you and care about you and will only support you in
health and wellnesss”

50. The 7 C’s
I Did not Cause
I Cannot Cure
I Cannot Control
I Can help take care of myself
I can Communicate my feelings
I Can make healthy Choices
I Can celebrate Myself

51. Mindfulness as Self Care

52. The 5 Phases Of Recovery
Excitement
Questioning
Boredom
Surrender
Acceptance

53. Recovery
Abstinence
Continued Support
Attention to Co-occurring Disorders
Exercise
Rituals
Good Nutrition
Professional Service
Connection

54. Roadblocks to Recovery
Shame and Guilt
Fear
Anger
Grief

55. “I see there is no use talking to you now. we can discuss
later when you are in a respectful mood”.

56. Paola
Relapse

57. Signs of Relapse or Recurrance
Not going to meetings
Firing Ones Sponsor
Stopping Counseling’Discontinuing Prescribed Meds
Short tempered
hanging out with Old Friends
Having a bIg Ego
Expressions of extreme feelings
Stopping Exercise, unhealthy eating
Drinking
Being Exhausted or Run Down

58. Signs Family Members Relapsing
Nagging
Yelling
Scolding
Controlling
Anger
Fear

59. Family Members Can
Take 5
Decide if this is a Big Problem or Little
Problem
Do Not talk to Someone if Intoxicated
Practice Self Care
Make the most of your Conversation
Honor Your Boundaries

60. Alan’s Family Holocaust Survivors

61. “I love and care about you. I am not comfortable with what
you our doing. Our agreement says you can live here as
long as you do x,y,z. I am saddened that does not seem
possible so I am inviting you to leave.” LAS

62. Josh

63. “For my Mother’s day Present I am inviting you to Live on
the Streets, you are no longer welcome in my home”

64. Alice
I am no longer able to keep your secrets or watch your daughter for you

65. Recovery Is A Beautiful Thing

66. Support Groups are the Key To Connection.

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