What To Know Before Starting Family Therapy For Substance Use

Substance use disorder (SUD) is a condition in which a person tends to experience difficulty controlling the use of alcohol or other substances, such as prescription or recreational substances. Individuals with substance use disorders may experience a variety of symptoms as a result of alcohol or drug use (formerly called “drug abuse”), including an increased tolerance of a substance, impulsive or reckless behavior, and social or emotional challenges. Substance use disorder can be highly impactful for both individuals and their entire family. 

According to the Substance and Mental Health Services Administration (SAMHSA), treating substance use disorder may involve, such as cognitive behavioral therapy, to change thought patterns and reduce symptoms. Family therapy for substance abuse (now often called “substance use") may be a way to resolve family conflict that occurs as a result of substance use. In this article, we’ll take a look at the benefits of family therapy for substance use disorder and what you might want to consider before starting family therapy sessions.  

Is someone in your family living with substance use disorder?

Connecting with a family therapist may help

Understanding the goals and approaches of family therapy

The goals of family therapy may be multidimensional and change over time from family to family. However, one main goal is typically to improve communication. During family counseling sessions, family members may be encouraged to engage in open and honest dialogue. This can help family members understand each other’s viewpoints and feelings regarding substance use and its impact. 

Improving and addressing family dynamics may be another major goal of family therapy. How each family member interacts with and supports others can be important. During the recovery process, a family therapist may help to identify and address unhealthy family interactions. Over time, family interventions and therapy sessions can provide a foundation for positive family interactions. 

A family therapist may work with the family of a person experiencing substance use disorder (SUD) to provide recovery support. A therapist may look at the family system as a whole and equip family members with strategies to cope with the challenges of having a loved one with SUD. A mental health professional may use one or a few different approaches when supporting families facing SUD. The following are just a few: 

• Systemic family therapy (SFT): SFT views the family as a system in which each member affects the whole. A therapist may examine and change patterns of interaction and communication within the family system to foster healthier relationships that support the individual with SUD.
• Functional family therapy (FFT). FFT may target dysfunctional behaviors and patterns and seek to improve family functioning. During FFT sessions, a therapist may combine cognitive-behavioral and systemic approaches, emphasizing motivation and behavior change to improve family functioning and support positive changes. 
• Behavioral family counseling. During behavioral family counseling, a person with SUD and a family member typically attend a series of 12 sessions that can build trust and enhance communication. The family member typically supports the person’s desire to abstain from substance use, and the two may learn to participate in a “daily trust discussion” that supports communication and recovery. 

There are other forms of family therapy that a therapist may use to improve family dynamics and communication while treating SUD. It may be important to note that family therapy sessions are not stand-alone interventions, and they may occur at the same time that a person with SUD is undergoing other treatments or attending individual therapy sessions. 

What are the benefits of family therapy for substance use?

For individuals experiencing substance use disorder, there can be many benefits to attending family therapy sessions. These benefits may include: 

• Improving communication. It can be challenging for a person with SUD to communicate with family members about their emotions and experiences. A family therapist may have the tools to enable and improve communication between family members. 
• Addressing underlying challenges. There may be underlying family-based concerns or triggers that can impact a person's substance use. Working with a family therapist may help to identify these underlying triggers so that family members are aware of them. 
• Providing support and reducing stigma. Research shows that many people experiencing substance use disorder may feel loneliness. Family therapy can be a way to build support around a person with SUD and help family members see the disorder as a treatable medical condition. 
• Encouraging long-term recovery. Involvement of family in treatment of SUD may provide additional accountability and lead to long-term recovery. Accountability may be a factor in preventing relapse for individuals with SUD.  

Preparing for family therapy

If you or a family member is experiencing SUD and thinking about starting family therapy, there are a few things that you can do to prepare for therapy sessions. It may be helpful to start by assessing each family member’s willingness to participate. This might be as simple as inviting them to participate. In some cases, you may need to explain how family therapy can benefit the whole family and not just the person living with SUD. If a family member is reluctant or refuses to participate, they may not be ready for family therapy yet, and it can be important to recognize this and allow them to participate when they are ready.

Before attending a family therapy session, it may be important to set realistic expectations for therapy sessions. This can include setting goals and objectives before starting therapy and monitoring them throughout. Having family members understand what they are hoping to get out of family therapy as well as what the limitations of family therapy techniques are can play an important role in the success of a session.  

Choosing the right therapist

Finding the right therapist can be an important part of having productive family therapy sessions. It may be important to find a therapist who has a certification or licensure specifically in family therapy. You may also look for patient referrals or feedback to see if they have a track record of providing effective therapy to families. 

Choosing the right therapist may also come down to how compatible they are with your family and your family’s needs. It can be important to meet with a therapist before sessions and to keep in mind that you can change therapists at any time. What may be most important is finding a therapist whom you and your family trust and who has the skill set to provide the support that is needed. 

If you’re seeking support through family therapy, finding a local therapist who meets your family’s needs can be a challenge. Online therapy may be a convenient option if there are limited therapists in your area or if you have difficulty coordinating family schedules. Online therapy requires only an internet connection and a device, which can offer flexibility when searching for a therapist. With online therapy, family members can attend sessions from anywhere in with an internet connection, which means that you do not have to find a single location for all family members to attend. You can communicate with the therapist and each other via video chat at a time that works for everyone.

Research shows that online family therapy can be an effective way to work through a variety of mental health conditions. In the online environment, a therapist can implement several family therapy techniques to engage and involve family members and provide support for the individual with SUD.  

What to expect in sessions

Although all family therapy sessions and techniques may be slightly different, there are a few things that you might expect during a session. In the beginning, the therapist may begin by assessing the family as a whole. This can include asking for each person’s thoughts or feelings about a topic and understanding each member’s history within the family. The therapist may begin to drill down on certain topics or areas of contention. The goal here is to generally understand how a family is functioning and interacting with each other and how this is impacting the person with SUD. 

After a general assessment, the therapist may formulate a treatment plan or try various strategies to build connections or to understand the family dynamics better. A therapist may ask the family to engage in role-playing, write letters to one another, or engage in collaborative problem-solving to help family members learn how to communicate and work with each other. At the end of a session, a therapist may assign homework or materials to help continue the work outside of therapy.

Is someone in your family living with substance use disorder?

Connecting with a family therapist may help

Long-term strategies for success

For long-term success, it may be important to continue to develop a strong support system for both the individual with SUD and their family. These support systems can help to build accountability for the person with SUD and may reduce social isolation and loneliness. It also may be beneficial to provide continued check-ins and continue family therapy work even outside of family therapy sessions. 

As the family transitions out of family therapy for SUD, it can be important to continue to build awareness and keep up with the latest research related to substance use. In the long term, it may be beneficial for the individual with SUD and their family to remain aware of signs of relapse and continue to monitor symptoms.