What Is Family Therapy?

Family therapy is talk therapy for family members and couples who want to improve their relationships. Its goals include:

  • Decreasing stress
  • Increasing coping skills
  • Helping families work together to resolve problems

Family therapy for addiction treatment helps family members recognize how they influence the behaviors of members who misuse substances. It also helps them learn how to respond differently, which can lead to positive changes.

As an addiction counselor, I worked with many family members, and one of the most common focus areas was teaching them the difference between enabling and helping behaviors. Family members often don’t realize they enable addiction behaviors to relieve the stress and painful emotions they feel. For example, enabling stops the begging or verbal abuse from their loved one that causes them anxiety and hurt. It becomes easier to give in. Enabling also allows their loved one to continue misusing substances that may lead to adverse consequences.

- Susanne Reed, PhD, Certified Alcohol and Drug Counselor

Family therapy helps each member gain confidence, set healthy boundaries, and apply new skills to assist their loved ones in getting the help they need.

How Does Family Therapy In Addiction Treatment Work?

Family therapy in addiction treatment is a process involving different stages of growth and learning. Therapists often work with families both as a group and individually to assess and understand family dynamics, strengths, weaknesses, and areas for improvement. Together, they create a treatment plan focusing on positive changes to address a family member’s addiction and any personal mental health issues.

Family therapists utilize various methods to teach clients healthy coping skills, build support, resolve conflicts, and strengthen family bonds. Because the family is the client, therapists help set family goals and take steps to reach those goals. Therapists also facilitate and monitor progress.

Family Therapy in Inpatient and Outpatient Rehab

Rules for family visits will vary among inpatient and outpatient rehabs. However, family therapy is one of the best ways to get involved and show support for a loved one’s recovery. Typically, residents entering an inpatient program cannot see or talk to family members for the first few days, a week, or longer.

In the initial stages of treatment, the focus must be on physically and mentally stabilizing. This also gives your family time to adjust to changes. Your therapist may start family therapy when they feel confident you are committed to recovery and the process and motivated to make healthy changes.

In outpatient treatment programs, participants may still be living with family, which makes family therapy crucial. Most addiction treatment programs incorporate family therapy at least once a month, sometimes more. The family attends therapy at the treatment center in designated areas.

Your treatment team will determine when it is best to begin family therapy, which involves various treatment techniques chosen by a licensed therapist.

Virtual Family Therapy

Virtual family therapy options may be available when family members can’t attend therapy at the treatment center. Your therapist can plan online family therapy sessions for the most convenient time for multiple people in your life who can impact your recovery. Your therapist’s techniques during in-person sessions can be applied to virtual family therapy.

Virtual family therapy can be conducted via home phone, cell phone, laptop, tablet, or desktop computer. The treatment center will use a safe and confidential online platform to connect with your family members. For many families, virtual therapy offers convenient and flexible alternatives to in-person sessions.

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Family Therapy and Aftercare

Once you complete a treatment program, services do not have to stop. Your treatment team will help you create an aftercare plan that connects you with community resources that support recovery. Examples may include peer support groups, job placement services, education, housing, or childcare support. Another type of aftercare service is family therapy.

Family members are part of your environment and must learn skills to provide the healthiest environment possible to help you avoid relapse. In addition, your family members are in a form of recovery themselves. They need support to maintain boundaries, stop enabling behaviors, and work on their physical and mental health. Aftercare services for families may involve 12-step facilitation groups or working privately with a family therapist.

Benefits Of Family Therapy In Recovery

Family therapy in recovery has rewards and benefits for each family as a whole and for each member separately. The uses of family therapy in addiction treatment typically include the following:

  • Restore broken family relationships
  • Replace negative interactions with positive processes
  • Teach positive behaviors to support healing and growth
  • Improve communication within the family
  • Provide education regarding addiction
  • Foster healing from the effects of addiction
  • Leverage the family to influence change

Family therapy promotes change and healing in dysfunctional families. It also increases the likelihood of a loved one entering and staying in recovery treatment and maintaining recovery long-term.

When Is Family Therapy Not Recommended?

Not all family members will be receptive to participating in family therapy. Sometimes, even if your family is receptive, it may be recommended to avoid family therapy, like in situations where it can do more harm than good. Examples may include:

  • If there is a current or past history of violence or abuse within the family.
  • If a family member has an untreated mental health condition that could interfere with progress.
  • If a family member cannot participate consistently due to demographics, attitude, or any other reason.

If a therapist feels family therapy is too toxic, they may work with you on establishing healthy boundaries and coping skills. Implementing self-care techniques may influence other family members to do the same, and when they are healthier, family therapy will be beneficial.

Types Of Family Therapy

Family therapists can access numerous types of family therapy techniques for treating substance use and mental health disorders, which are often co-occurring. They choose techniques based on family issues, needs, and dynamics. The following are different types of family therapy.

Psychoeducation

Psychoeducation refers to when a licensed therapist provides tools and resources to family members of a loved one with an addiction. It teaches families about the disease of addiction and helps them engage in the treatment process. Psychoeducation goes beyond providing handouts and other printed information. It helps families understand the importance of their involvement in getting loved ones engaged in treatment and recovery.

During psychoeducation, families learn how to improve their coping, communication, and stress management skills. This method is best suited for family members who want to be involved in finding a solution for their loved one’s problems. Three phases are implemented, including:

  • Introductory sessions
  • Education
  • Ongoing group support

Multi-Dimensional Family Therapy (MDFT)

MDFT focuses on treating adolescents and young adults with substance use disorders (SUDs) and their family members. It can also include schools, welfare programs, and other forms of support. MDFT teaches problem-solving, communication, and coping skills. It improves parenting skills and functioning while reducing family distress.

MDFT can be used in various settings, including detention centers, residences, counseling offices, treatment centers, and schools. Its four main goals benefit families. The first is to make healthy changes in the person with a SUD. Then, your therapist will work to make healthy parental and family environmental changes. Finally, they will help your family improve other influential relationships outside the family.

Behavioral Couples Therapy (BCT)

BCT is for couples in intimate relationships where one person has a SUD. BCT has techniques to maintain abstinence and techniques to enhance relationships. BCT also has secondary benefits, including improved parenting, communication, and problem-solving skills.

BCT typically occurs in a clinical setting with a licensed therapist and a couple using techniques such as the Gottman method, cognitive-behavioral, and emotionally-focused therapies. However, there are numerous types of couple therapy strategies. BCT works best for couples experiencing distress in their relationship and wanting to make healthy improvements.

Behavioral Family Therapy (BFT)

BFT is a technique that uses positive reinforcement to change and maintain healthy behaviors. In some scenarios, it is known as contingency management, and families are rewarded for abstinence and positive milestones. BFT involves contingency contracting, skills training, and cognitive restructuring.

BFT assesses each family member and allows a therapist to tailor treatment to each person’s needs. Clinical or residential settings can implement BFT. The goals are to improve individual behaviors and relationships to strengthen the family unit.

Brief Strategic Family Therapy (BSFT)

While BSFT’s primary goal is to stop youth from misusing substances, it focuses on the whole family as part of the solution. It typically includes:

  • Establishing a relationship with each family member
  • Implementing activities to assess and improve family interactions
  • Installing healthy boundaries
  • Resolving conflicts
  • Identifying roles that support recovery rather than addiction

BSFT identifies unhealthy habits and behaviors, and a therapist helps clients change them in their home, academic, and social settings. Sessions are brief and last up to three months. Each session involves intense, solution-focused therapies that produce positive changes in limited timeframes.

Functional Family Therapy (FFT)

FFT focuses on changing family behaviors to facilitate change in a family member who is misusing substances. How the family interacts can encourage or hinder risky youth behaviors. FFT teaches the family how to interact in a way that changes dysfunctional behaviors. Stages of FFT include engagement and motivation, behavior change, and generalization.

FFT usually occurs in the family home and is another brief and intense treatment model. It is best for families who need to help an adolescent with delinquent, violent, or addictive behaviors. It can also help to improve the teen’s academic and social skills.

Solution-Focused Brief Therapy (SFBT)

SFBT helps families set specific goals and actionable steps to achieve the goals surrounding one problem, such as addiction. Methods may include:

  • Creating a vision for what the family wants their future to look like
  • Identifying problem sequences or how the family typically handles a problem
  • Developing solution sequences or how they will handle issues in the future

SFBT helps families understand what their lives will look like when they resolve the problem.

SFBT avoids focusing on the past unless previous situations explain current behaviors. It is a forward-focused model with specific steps for creating and envisioning goals and then setting steps to achieve those goals. It changes the mindsets of individuals and family members from thinking there is no hope of change to achieving change.

Community Reinforcement and Family Therapy (CRAFT)

CRAFT is another contingency management program that lasts about six sessions. The focus is on teaching family members to reward behaviors that lead to treatment engagement and recovery. CRAFT helps family, friends, and social networks leverage their power and influence to motivate someone with an addiction to seek treatment.

Therapists implement numerous CRAFT techniques based on the family’s needs. Session length varies among families but may last up to 12 weeks in a clinical setting, depending on the issues needing resolution. Once families begin implementing the techniques they learn, they will likely see changes in their loved one’s behaviors, such as them entering treatment within a few sessions.

Other Ways Families Can Help And Stay Connected

One of the most critical ways families can help is by staying connected to support resources even when their loved one with an addiction is receiving treatment and entering recovery. If family members do not heal from the effects of addiction, they cannot effectively support someone in the recovery process. Suggestions for families include the following:

Families should continue engaging in family therapy even after their loved one seeks treatment. Each family member is affected differently by someone’s substance use disorder and deserves treatment that focuses on their healing.

Are You Ready For Family Therapy In Addiction Treatment?

If someone in your family has an addiction, the best time to seek help is now.

Reach out to a treatment provider and tell them you want to learn about treatment options for your loved one. They can answer your rehab-related questions and help your loved one start their recovery journey.