Lee has been married for almost 16 years. He has three children, a 15-year old son and 12-year old twin daughters. He has also been addicted to alcohol for almost the same time as his marriage. In the past recent years, he has been trying other drugs. In a meeting between Lee’s spouse and his primary counselor, his spouse informed the councilor that paraphernalia had been found in his car and their son’s bedroom hence the conclusion that the two were using the drug. She also informed the councilor that it is possible she will be filing for divorce. She planned to ask for custody of the two girls and leave the son with his father as she did not want to deal with another addict. She hints that there is someone else who is better than Lee who will give her a better life. She also says that the other person cares about her and he would raise the twins better than Lee could. She goes ahead to grin and wink at the councilor nodding knowingly. She then asked the councilor not to discuss this with Lee.
After the last family meeting, Lee confided to the councilor that in the recent past he had cheated on his wife and he had recently tested positive for a sexually transmitted disease. He does not want his family to know about this as it will hurt them and may result in a divorce because it is not the first time this has happened.
According to the agency’s regulations, a counselor is not supposed to keep secrets from the family or about family members. This is because the agency is of the opinion that family secrets only makes things worse and do not help families get better or healthy. As a primary counselor, the counselor is required to coordinate and provide services to this family. This paper aims to describe the kind of services that this family needs in addition to Lee’s substance use treatment. Since Lee’s addiction seems to have affected his son, and his addiction and behaviors have led to his wife seeking comfort from someone else and wanting a divorce, the best course of action is family therapy on top of Lee’s substance use treatment.
Substance Use Treatment and Family Therapy
Family is very important when it comes to treating any health problems; this includes substance abuse. The challenge is to make the two disciplines which have different perspectives work. In substance abuse treatment, the client is the person in the family with a substance use problem. In family therapy, the focus of treatment is to help all family members. Family therapy focuses on family relationships and how these relationships affect the patient as well as other family members whether positively or negatively. Family therapy intervenes in these relationships to help them change in ways that help everyone in the family.
Families play a very big part in the treatment of substance abuse. Family can help the treatment process, but they must also deal with the effects of the addicted person’s behavior. Every member of the family cares about the identified patient’s substance abuse, but they also have their own lives with their own goals and problems. Hence, offering help to the entire family can improve the effects of treatment.
For this to work, there is a need for mutual understanding, compliance, and adjustments among everyone involved and this include, the counselor, family therapist, and the rest of the family. This collaboration will need to focus more attention on the interactions of the family, and many conflicting practices must be integrated. For instance, the counselor usually sets goals with the patient. Therefore, goals are personalized and fixated mostly on the patient. When this happens, the family is not involved in setting goals which could affect the healing process of the entire family.
Coming up with ways to make the two disciplines work together will require a long look into the common rules of the two fields. Substance abuse counselors often pay attention to the personal needs of their patients, encouraging them to take care of themselves. This viewpoint does not address the effects the actions of the patient have on other members of the family. When patients are encouraged to take care of themselves, they are not made aware of the reactions of the other family members to the transformations they are going through, and mostly they are not prepared to adjust to the reactions. Alternatively, most family therapists assume that causing good changes in the family system simultaneously could help the problem of substance abuse. This assumption has a tendency to downplay the endless, sometimes overwhelming process of addiction.
Both these assumptions are conforming to their corresponding fields, and each has a very powerful explanation, but none of them is enough on its own. Addiction is a very powerful force in people with an addiction problem. People with substance abuse problem live within a family system. Therefore, in a complete substance abuse treatment plan centered on family therapy, both family and individual functioning play a very big part in the transformation process (Liddle " Hogue, 2001).
Family Therapy
Family therapy is a compilation of therapeutic practices that have the same conviction in family-level evaluations and intervention. A family is a structure, and in every structure, every part is connected to all other parts. Therefore, if a change in one part of the structure occurs, it will cause changes in all other parts. Therapy centered on this viewpoint uses the strengths of families to cause a change in a number of different problem areas such as substance abuse.
There are two main aims of family therapy in substance abuse treatment. One, It endeavors to use the strengths and resources of the families to help come up with ways to exist without substances of abuse. Secondly, it relieves the effects of substance abuse on both the patients and their family members.
Goals of Family Therapy
The addition of family therapy to substance abuse treatment is still not very common. Family therapy in substance abuse treatment provides families with an opportunity to realize their needs and provides real, long-term healing to everyone. Family therapy functions by passing on authority to the supportive members in a family and to help them communicate better.
Whoever has the substance use problem, whether it is a child or an adult, the whole family system has to change, not just the patient. Therefore, family therapy comes in handy in helping the family make personal, emotional, and environmental transformations affecting the person with a substances abuse problem. It helps the other members of the family to function better and come up with their personal goals for therapy other than the overall goal of the family functioning better. As many transformations come, therapy helps all members of the family come into terms with what is going on. This common understanding helps the addict to realize that they all are in this together.
A very important goal of family therapy in substance abuse treatment is preventing other members of the family from substance abuse, especially, from one generation to another. Many studies have shown that, if a family has one person who has a substance use problem, the rest are at a higher risk of developing the same problem. The most risk factor of people developing the same problem to substance use and finding it mentally difficult is a parent who has a substance abuse problem (Johnson " Leff, 1999).
A family with no history of substance abuse can prevent adolescents from engaging in the behavior of using drugs even when faced with the temptations of peer pressure. If the person with a substance abuse problem is an adolescent, getting treatment reduces the probability of siblings engaging in the same behavior. Adolescents receiving treatment early for substance abuse reduces the probability of bad consequences while adults such as never holding on to a job, continued substance abuse, and illegal behaviors.
Therapeutic factors
Therapeutic factors possibly describe the advantages of family therapy such as improving communication. Another reason why family therapy is important in substance abuse treatment is that it offers a neutral opportunity where family members can solve their problems. Such an opportunity where the family can express their feelings is usually not available, and a lot is left unsaid. If such an opportunity came, people would raise their voices and accuse each other.
During family therapies, people can talk about their issues. As the therapist mediates and manages conflicts, it is possible that people will talk about the things that they would not normally do when alone. It is the therapist’s job to make sure everyone is heard. The family members are free to express their feelings of fear and concern and sometimes they can be surprised to find out that they are not the only ones who feel the way they do and new avenues of communication open up. Family members get a clear picture of what they are going through which may lead to change. Each of these changes is important, whether the substance use problem is resolved immediately or not, it is a step forward for it is important to have a stable family while trying to abstain from substance abuse.
Conclusion
Research has shown that substance abuse treatment that includes family therapy have better results than other treatments (Stanton et al., 1982). Therapy helps people engage each other while receiving treatment, helps the patient reduce using drugs, and helps stabilize families. In the case of Lee and his family, going through family therapy could help open up communication channels which seem to be absent in this family. They seem to have a lot of secrets. It could help him and his spouse talk about their problems and maybe save their marriage. Therapy could give everyone a chance to talk about their feelings and be heard including the twins. Most importantly, it could help their son get treatment in case he also has a problem before it is too late. Also, it could help stabilize this family who could prevent a relapse.
References
Johnson J., " Leff, M. (1999). Children of substance abusers: Overview of research findings. Pediatrics.
Liddle, H., " Hogue, A. (2001). Multidimensional family therapy for adolescent substance abuse. In: Wagner, E.F., and Waldron, H.B., eds. Innovations in Adolescent Substance Abuse Interventions. New York
National Center for Biotechnology Information. (2004). Substance Abuse Treatment and
Therapy. Available at: https://www.ncbi.nlm.nih.gov/books/NBK64269/
Stanton, M.D., Todd, T.C., " Associates. (1982). The Family Therapy of Drug Abuse and Addiction. New York: Guilford Press.
