Family therapy is a well-established treatment intervention for drugs and alcohol. Unlike other forms of psychotherapy that focus on the individual, the family-based approach addresses substance abuse and its causes through the systemic lens of the family unit. The context of these core family relationships and the quality of their interpersonal dynamics are thus the main raw material for any 60-90 minute session involving the family therapist and (typically) more than one family member
Today there are multiple schools and models of family therapy, as well as a sea of accompanying evidence pointing to their various long-term benefits for recovery from drug and alcohol addiction. Clinically conducted outcome research suggests family therapy can prevent substance abuse, halt its progression, and increase abstinence rates. This article takes a closer look at some of these supporting studies, with a view to illustrating how family therapy can boost long-term recovery.
Recovery Goals of Family Therapy
Like other treatments belonging to an individualized plan of substance abuse care, family therapy is most effective when it addresses the specific needs and goals of the particular family affected by substance abuse. These will depend on family structure, which in twenty-first century America can vary widely: a “family” may constitute the more traditional, two-parent household; it may also refer to childless couples, single parents with children, gay or lesbian couples, unattached elderly persons or co-habitant best friends. Families considering therapy thus do well to consult a certified family therapy provider for an initial assessment of their specific needs and goals.
In more general terms, however, family therapy seeks to achieve the following goals, the completion of which often predicts better recovery outcomes:
- Improved family functioning
- Increased self-awareness about patterns of relating
- Stronger mutual understanding, emotional connection and support
- Improved daily coping and problem-solving skills
Family Therapy for Teen Substance Abuse
One of the ways family therapy has proven effective is in the area of parental drug abuse intervention (and prevention) with at-risk teens. Child and adolescent mental health depends to a great degree on the strength of the parent-child relationship, after all — so much so that early disruptions in this critical relationship carry negative repercussions that persist well into adulthood. Greater susceptibility to substance abuse is one of these repercussions.
Still other studies have emphasized the important role of parents in addressing underage drinking. Strong family bonds and strong parental involvement, including parental monitoring and clear rules of family conduct, are among some of the most crucial factors in protecting teens from alcohol abuse, according to a research-based guide for parents by the National Institute on Drug Abuse (NIDA).
It follows that family therapy which promotes parenting skills, family functioning and adolescent health, and which addresses home and school-related problems, yields positive treatment outcomes for teens at risk of substance abuse. And so the studies indicate. For example, when researchers at Columbia University followed 63 families receiving therapy for teen drug abuse, they found the following treatment outcomes just one year later:
- A marked decrease in symptoms of teen drug abuse
- Greater family cohesion
- Less family conflict
- Strong gains in family functioning and youth outcomes
Elsewhere, researchers at the University of Miami have documented a number of clinical studies showing how “Brief Strategic Family Therapy” (BSFT) an approach that identifies and corrects unhealthy patterns of family interaction, reduces teen drug abuse. In contrast to the families that received generic group therapy, the families that received BSFT reportedly experienced “significantly greater reductions in self-reported marijuana use,” with 60 percent of the BSFT-receiving teens reporting an improvement there.
Among the University of Miami findings was another study showing that BSFT boosted drug-using adolescents’ engagement in recovery — and the greater the engagement, the better the long-term treatment outcome.
Family Therapy for Alcoholism and Alcohol Abuse
An extensive body of research in the area of alcoholism and alcohol abuse also attests to how family therapy can facilitate recovery and prevent relapse, as summarized by the National Institute on Alcoholism and Alcohol Abuse (NIAAA). These empirical findings include the following observations related to individuals with alcohol use disorders:
- Family involvement boosts both their compliance with treatment and their treatment outcomes.
- The participation in therapy of just one “supportive significant other” (not just spouses but also an adult’s parent, grandparent, child or best friend) improves both their retention and treatment outcomes.
- Their motivation to change depends greatly on the support and pressure of family members and “significant others.”
Family Therapy for Co-Occurring Disorders
The presence of a mood disorder or other co-occurring mental illness correlates with a higher risk of substance abuse and can compromise treatment outcomes for drug or alcohol addiction. In this overlapping domain of mental health, family therapy has proven effective, too, thereby also boosting substance abuse treatment outcomes. For example, patients with depression who received couple’s therapy alone “did significantly better” than those who received an antidepressant alone, according to findings published in the journal Advances in Psychiatric Treatment. Additionally, schizophrenic patients with relatives receiving family intervention evidenced both higher rates of medication compliance and lower rates of relapse, in a 2010 study.