Family Therapy For Substance Use Disorder Treatment

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 approaches 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 behaviors and their impact. Many family members may have different perspectives on how to handle these dynamics, making communication skills essential for recovery. 

Improving and addressing family dynamics and family issues 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 problem sequences and family interactions using a variety of approaches. For instance, over time, solution-focused therapy sessions can provide a foundation for family strengths and positive family interactions. Cognitive restructuring techniques may be introduced to help family members reframe negative thoughts and improve emotional intensity and responses. 

A family therapist may work with the family system 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 dealing with 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, coping skills and communication skills. 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. Contingency contracting may also be used to set behavioral expectations for all family members.

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 misuse, and the two may learn to participate in a “daily trust discussion” that supports communication and recovery. Solution sequences are often introduced to provide structured steps for addressing challenges and reinforcing positive behavior. 

There are other forms of family therapy that a therapist may use to improve family life, dynamics, communication and emotional attachments 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, attending individual therapy sessions, or receiving other community-based services.

What are the benefits of family therapy for substance use disorder?

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

Improving contact in family therapy for substance use disorders

It can be challenging for a person with SUD to communicate with family members (including parents, siblings, and other family members) about their emotions and experiences. Family therapy focuses on creating a safe, supportive environment where open dialogue can thrive.  A family therapist may have the tools to enable and improve communication between family members. Positive reinforcement may also be used to encourage open and constructive discussions.

Addressing underlying challenges in addiction treatment

There may be underlying family-based concerns, risk factors, or triggers that can impact a person's substance use behaviors. In addiction treatment, understanding and addressing these family dynamics and family issues is essential to fostering a supportive recovery environment. Working with a family therapist may help to identify these underlying triggers and problem sequences 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 through mental health support

Involvement of family in the treatment of SUD may provide additional accountability and lead to long-term recovery. Integrating mental health support with family involvement can strengthen recovery and enhance overall well-being.  Accountability may be a factor in preventing relapse for individuals with SUD.  

Preparing for the treatment process

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.

Setting realistic expectations for family therapy sessions 

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. It can be valuable to reduce stress through clear goal-setting, which can contribute to improved communication and participation in therapy.  

Choosing a therapist for mental health and addiction treatment

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. A solution focused on substance misuse treatment can be implemented to tailor therapy techniques to the specific needs and the well-being of the family system.

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. Solution-focused therapy may be particularly effective in helping family members feel heard and validated in their concerns.

The benefits of online mental health support and family therapy for substance use disorders

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 during family therapy 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 is to understand how a family functions and interacts with each other and how this impacts 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 successful recovery when transitioning out of family therapy for substance use

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. 

Individuals experiencing substance use behaviors may benefit from connecting with community resources that offer support and guidance at different stages of recovery. A solution-focused approach can help individuals set small, achievable goals that encourage behavior change and long-term success. By learning to respond differently to triggers and stressors, individuals can develop healthier coping mechanisms and reduce the risk of substance misuse. Support programs often positively reinforce progress, motivating individuals to stay motivated and committed to the recovery process.

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.