2014 DBHR WA State Provider Survey
Recognition that family involvement may be important for many clients’ successful recovery was clear, but barriers were noted, including estrangement from family and family disinterest or inability to participate. [more about the survey]
Substance use affects everyone in the family. Therefore, it is important that family members are involved in the treatment and recovery process of adults and youths. In fact, most patients substance use disorder treatment because of positive family involvement and intervention.
Engaging a single family member, or "concerned significant other" can be enough to strengthen the whole family system, reinforcing and motivating change in the client, and helping them to stay fully engaged in their recovery process1,5.
Family members can be involved by:
In the best circumstances, families can find it difficult to adjust along with the person who is recovering, who is behaving differently than before, and who needs support. Even after a family member begins treatment and recovery, other family members may continue unhealthy behavior patterns. Family therapy can help the family as a whole to recover and heal. Each family member may be adjusting to changes, starting to deal with past conflicts, and establishing new routines. Family therapy can help each member of the family make specific, positive changes that can help the whole family heal from the effects of substance use disorders.
Children & Teens
Families with alcohol and other drug problems usually have high levels of stress and confusion. Highly stressed family environments are a risk factor for early and risky substance use, as well as mental and physical health problems. It is important to talk with children about what is happening in the family and help them to express their concerns and feelings. Children need to trust the adults in their lives and believe that those adults will support them. Children living with alcohol or drug abuse in the family can benefit from participating in educational support groups in their school student assistance programs.
In addition, the family plays a key role in both preventing and intervening in youth substance use and misuse10. Parents, especially, can increase risk or promote youth resilience and prevent substance use, depending on the relative health of the parent/s and involvement with the child10.
Healthy parental involvement in adolescents' substance use disorder treatment strengthens the relationship between the parent(s) and teen, increases adolescent self-disclosure, and results in greater reduction of adolescent substance use7. Furthermore, family therapy may be an effective treatment for adolescent substance use and can improve retention and engagement of youths in treatment8.
Note: The "Talking to Clients" training module in this toolkit contains a section with more information about engaging family members and friends and may be helpful for both counselors and front desk staff -- anyone who interacts with clients regularly at your treatment agency.
Some Advice from NIATx
Two success stories (from NIATx)
Gosnold, Inc. in Falmouth, Massachusetts has a member of the admissions staff greet the family in the lobby. The greeter explains what to expect, answers questions, and instructs family and friends to inform the counselor if the client wants to leave treatment. Gosnold offers a handout for providers on involving family (Becoming Family Informed, Family Involved), as well as a fact sheet and training program for family members themselves, explaining the ins and outs of the treatment process.
STEPS at Liberty Center in Wooster, Ohio found that clients with family support had higher completion rates. Of the clients who indicated that they had support from their families, 77.3 percent completed six sessions, whereas those who did not have family support had a completion rate of only 45.5 percent.
For Staff and Clinicians
For Clients and Families
References & Readings