Family Involvement in Addiction Treatment....we will take a look on how the family may be involved
Family therapists have borrowed the biological term homeostasis to refer to a family’s tendency to maintain stability or equilibrium. When a change is introduced, whether it’s good or bad, families can struggle to keep that balance.
For example, the early stages of addiction can place a lot of stress on other members of a family, resulting in unhealthy coping skills. But soon, this can become the new sense of normal for a family. When the individual seeks treatment or successfully completes treatment, families can fight to maintain that homeostasis, and dysfunctional behaviors can remain.
“Put simply,” author Jerome Levin says in Introduction to Chemical Dependency Counseling, “human beings and their relatives do not change gladly.” Some families will cling to the status quo, even when it is unhealthy.
Common Issues and Roles
Family members can experience common issues and fill similar roles in an effort to cope with addiction. Two of the most common problems are codependency and enabling.
Codependency occurs when a family member is controlled by the addict’s behavior. The spouse or other family members often feel compelled to take care of the addict, to the detriment of their own wants and needs. The SAMHSA publication Substance Abuse Treatment and Family Therapy describes the codependent as someone who is excessively compliant, wants to avoid rejection, is oversensitive and remains loyal.
Enabling takes place when someone helps or encourages the addict to keep using alcohol or drugs, directly or indirectly. This person, who is often also a codependent, might give the addict money hoping that it will lead to recovery. An enabler might also lie for the addict or hide the addict’s behavior from loved ones.
In an effort to cope with the addict’s behavior, family members can develop, to some degree, certain codependent roles. They often exist in children, but can be used to describe adults that take on the same characteristics. The unhealthy roles add to the dysfunction of a family facing addiction.
The Hero: The hero tries to make the family look good, often by overachieving and being successful. This person seems put together and balanced, but often feels isolated and unable to express his or her feelings.
The Mascot: The mascot tells jokes and keeps things on a superficial level to turn the focus away from the painful truth of the situation. Although this can distract others, the mascot is often fearful, embarrassed and angry.
The Scapegoat: The scapegoat engages in negative behavior to turn attention away from the addict or to react to positive attention that the hero receives. In trouble at work or school, the scapegoat often turns to high-risk behaviors such as drugs or alcohol.
The Lost Child: The lost child is the family member who withdraws from the situation. He or she cares deeply, but emotionally checks out to avoid trouble and drama.
The Caretaker: The caretaker wants to make everyone happy and feels responsible for keeping the family going. As a result, the caretaker enables the addict by taking over the person’s problems and duties; the caretaker also enables other codependent family members.
Family involvement in the treatment process is greater with an outpatient program, since the patients are not separated from their normal home environment. This is not the case for an inpatient program. Family involvement can happen occasionally, helping both the patient and the family take a step back from a negative environment. But isolation is not the goal; families can still support loved ones in an inpatient program. Visitation throughout the week and weekends is common, and workshops can educate families and provide an ideal atmosphere for family recovery.
Family members play a critical role in the treatment process. Not only do they provide support, but families can receive needed rest from the presence of addiction. This, along with services at the treatment program and help from outside resources, can strengthen family members.
Family members of addicted individuals are strongly encouraged to attend meetings at a support group, which can help them address their loved one’s addiction while also giving them the opportunity to interact with other families going through the recovery process. The addict does not need to be seeking or receiving treatment for family members to look for a support group.
The following organizations offer support groups that are free to attend.
Al-Anon: Al-Anon groups provide fellowship for families and friends of alcoholics.
Nar-Anon: Nar-Anon programs are for friends and family members of drug addicts.
Families Anonymous: Families Anonymous meetings are designed for relatives and friends of people who have a substance abuse or related behavioral problem