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Models of Family Therapy

Addiction has an impact on every member of a household, from the oldest members of the family to teens, kids, toddlers, and even infants. When someone in your home has a drug or alcohol problem, every generation feels the consequences of chemical dependence, and everyone needs help dealing with these devastating effects.

An integrated drug rehab program provides counseling, education and preventive resources for families as well as individuals.

Popular trends in family therapy have evolved over time, but all addiction family therapy models have certain goals in common:

  • Building stronger, more effective relationships within the family
  • Identifying at-risk family members who may be the targets of abuse or violence
  • Preventing younger generations from adopting addictive behaviors
  • Creating a home environment that supports health and sobriety
  • Reinforcing the authority of parents and guardians
  • Helping family members heal from the destructive effects of addiction

What Is Family Therapy?

Family meeting with counselorUnlike individual therapy, which addresses the thoughts, behaviors and attitudes of the person seeking treatment for drug or alcohol addiction, family therapy strives to treat a group or network of individuals who are affected by addiction. There are no pre-determined standards on what constitutes a family.

A family unit may consist of two unmarried partners, a traditional nuclear family, a blended family, or a group of people who share a home and a strong emotional connection. Family therapy provides a neutral setting where people who share a living environment or who have blood ties in common can talk clearly and honestly about the ways that addiction affects their lives. It also gives the people who share a residence the opportunity to talk about aspects of family life that may trigger addictive behavior, such as marital conflict, teenage rebellion, or unemployment.

Family therapy can take place in a counselor’s office, rehab clinic, hospital, or community center. The family therapist may arrange individual counseling sessions for each person in the household, sessions for the entire family unit, or both. The family may also be asked to participate in group meetings or 12-Step programs with other family members, such as Al-Anon.

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Why Family Therapy Matters

Statistics on the relationship between addiction and families are troubling.

The U.S. Center for Substance Abuse Treatment has identified a few common patterns you may find in families that have been impacted by addiction. Do any of these habits sound like your family?

  1. Denial – Individuals often deny that they have a real, impactful substance use problem. Parents may deny that their children have a problem, despite clear signs of addiction and substance use. Sometimes this denial leads to anger and defensiveness, and it may be a cause of family arguments.
  1. Negative talking and thinking – Do you struggle to remember the last time you all had fun as a family? Families impacted by addiction often feel negative about each other. They focus on the negative, and it seems like there is always a problem, a crisis, or an argument.
  1. Inconsistency – Parents set inconsistent rules, and enforce those rules in erratic ways. Family members struggle with assertiveness, aggressiveness, and being passive with each other. Family structure is not organized, and no one seems to know the schedule. Children may act out and get in trouble at school.
  1. Self-medication – Parents model using drugs or alcohol in times of distress, and other family members may also turn to substances to self-medicate.
  1. Anger – Often, family members that are impacted by addiction don’t know how to express anger adequately. They may bottle it up or rage at each other. They may have health conditions related to suppressed anger.
  1. Skewed parental expectations – In adolescent and adult children, parents may expect their child to sober up immediately and treat addiction without any help. Or, parents may just stop expecting anything of their older children. Addicted family members may joke about their problem, dodge the issue, or medicate the pain of feeling inadequate.1

Substance Use is a Pattern

Substance addiction affects family dynamics. Children whose parents or guardians abuse drugs or alcohol are more likely to develop substance use disorders themselves. These children are also more likely to be victims of domestic abuse, sexual abuse, and poverty.

family illustrationWhen one or both parents are addicted, home life is often chaotic, and it’s not unusual for a child to become a caretaker for a parent who’s habitually intoxicated or hungover. In many of these dysfunctional households, one of the children may end up taking care of younger siblings, making excuses for an absent parent, shopping, preparing meals and generally holding the home together.

Family therapy can help correct imbalanced family structures, placing the authority and responsibility back onto the adults in the home.

With so many children being temporarily or permanently removed from their homes in the US, it’s clear that family addiction therapy should be a vital component of a drug rehab program. Unless everyone in the household has the opportunity to heal, chances are that the home will be broken, and children will follow their parents’ examples to become addicts themselves.

Family therapy may prevent addiction in the adult children of substance abusers. Treatment can help prevent alcoholism and drug addiction in adults who grew up with alcoholic parents. This research suggests that cultivating strong family bonds may have a protective effect against the development of alcoholism later in a child’s life.

Popular Family Therapy Models

Addiction family models have changed over time. Therapy models, which provide a context for therapists and counselors to work with, usually reflect the predominant contemporary social theories. These four family therapy models may give you an idea of what therapy your family may need:

  • The Family Systems Model

    The Family Systems Model operates on the belief that a family unit tends to arrange itself around substance abuse, in spite of its destructive consequences. The goal of this model is to teach the family members how to build healthier organizational patterns. For example, if an addicted family member is encouraged to continue drinking because alcohol helps him work more productively, therapy would be directed towards helping the family correct this maladaptive behavior.

  • The Family Disease Model

    The Family Disease Model is based on the concept that addiction is a disease, and that this disease can affect a whole household unit. Family members who aren’t addicted may become codependent on the addict for their emotional or material stability. This model aims to treat the entire family by approaching addiction as a condition that can be cured through modifications in behavior or environment.

  • Multi-Dimensional Family Therapy

    Multi-Dimensional Family Therapy draws from a number of therapeutic techniques to help families become stronger and healthier. Behavior, emotion, cognition and the household environment may be addressed as part of multi-dimensional family therapy, or MDFT. Each of the factors that contribute to addiction may be approached from a different perspective in this multi-faceted approach.

  • Cognitive Behavioral Family Therapy

    Cognitive Behavioral Family Therapy, or CBT, aims to improve family relationships and promote sobriety by correcting the destructive behaviors and thought patterns that contribute to addiction. Family members are taught to identify the trigger events that prompt addictive behavior and to find healthier ways to resolve conflict. CBT is widely used in personal therapy, as well, to help the addicted individual correct negative, self-defeating thoughts and habits.

What Makes Family Therapy Effective?

The family therapy model that is used to heal a home may not be as important as the family’s motivation to change. In spite of the devastating consequences of addiction — conflict, abuse, financial troubles, social isolation, legal difficulties — families may be attached to the status quo and might be afraid to see their situation change.

If abuse or violence is taking place in the home, there could be a fear of having these situations exposed in therapy. If a couple has developed a codependent relationship, the emotional symbiosis may seem too powerful to break.

Family TherapyA family therapist must address the fact that addiction serves a real purpose, albeit a dysfunctional purpose, in many homes. In families that have been torn apart by addiction, therapy may help parents and children reunify after a legally enforced separation.

What do all successful approaches to addiction family therapy have in common? In all of the major family therapy models, addiction is addressed not just as an individual problem, but as a disease or maladaptive behavior that affects everyone who shares the home. In order for family therapy to be effective, family members must take the treatment seriously and must be just as committed to sobriety as the person entering rehab.

To show your support for someone in your home who’s addicted to drugs or alcohol, you can:

  • Attend all scheduled individual or group meetings, to the best of your ability.
  • Honestly address any of the enabling behaviors that might contribute to a loved one’s addiction.
  • Make any necessary changes in the home to promote abstinence.
  • Educate yourself on the nature and causes of addiction by attending support groups like Al-Anon or AlaTeen.

Getting Help for Your Loved Ones

If you’re trying to get someone in your home into treatment, finding a rehab center that offers family therapy should be one of your goals. When you hold your intervention, you can reassure your partner, child, or parent that you’ll support him or her throughout the process of rehabilitation by attending counseling sessions and applying the therapist’s advice to your daily lives.

Addiction treatment won’t be effective unless everyone in the household helps in a healthy way and accepts his or her role in the process. Regardless of the model of family therapy that an addiction counselor follows, the most effective way to help your loved one succeed is to give 100 percent of your energy and hope to recovery, all with healthy boundaries.

If you’d like help staging an intervention for your loved one, contact us today at 269.280.4673. We can answer any questions you have and guide you through the process.


1 Substance Abuse and Mental Health Services. Substance Abuse Treatment and Family Therapy. Treatment Improvement Protocol (TIP) Series, No. 39. Impact of Substance Abuse on Families. 2004.