Whatever form an addiction takes (substance-related or behaviour-based, like gambling) and whatever the modality of treatment (rehab, inpatient clinic or outpatient treatment centre), one thing is certain: the involvement of the family, wherever safe and feasible, is highly recommended to aid the purpose of recovery, not only of the “identified patient” but also of the family as individuals and as a whole.
There is convincing evidence to indicate that family involvement is likely to help improve outcomes. When it comes to addiction treatment, the terms “holistic” and “integrative” need to be redefined to ensure that they encompass high quality support for families, both in relation to their addicted family member undergoing treatment as well as in their own right. Family members have been shown to experience high levels of stress and related mental health problems, partly as a result of co-dependent approaches to living with addiction. The harmful effects of anxiety and associated counter-productive behaviours, can be ameliorated quite quickly with the right help.
Until comparatively recently, everyone, including the addiction treatment provider and the family, tended to focus almost exclusively on the person with the evident problem. Mistakenly, treatment services often saw the family as being of only peripheral importance. Meanwhile the family co-dependently staked all its expectations and hopes for its own improved wellbeing on the recovery of the addicted family member. Given the often alarming state of their loved one’s mental and physical health, this was hardly surprising. However, such a unifocal approach failed to take account of the family context and its influences upon the individual. While everyone was worrying – sometimes obsessively – about the person with the overt signs of addiction, no-one turned to the other members of the family to ask simply, “And how are you?”
The much needed shift to a more systemic perspective took place. Consequently, practitioners began to help families change their point of view. They were now invited to recognise addiction as having emerged in the family through one of its members, affecting them all as a result. This approach also helped to defuse moral judgements and the impact of stigma. The solution was now to be found in the family taking responsibility individually and collectively for the recovery of one and all.
This work can begin in the treatment service where skilled therapists can facilitate family meetings that include the person undergoing treatment. The family dynamics determined by addiction can be understood and a range of feelings can be explored, while healthier personal strategies are identified. A great deal of education about addiction, its influence over family functioning and the steps that can be taken to release its hold, is generally required. Together, the family can work to recover from addiction and co-dependency and to build a degree of individual and collective resistance to their return.
