When parents struggle with drug addiction, what effective help is available?

Parental Substance Abuse Treatment: Family Treatment
Brandon Bruce Dellario LMSW LASAC

     There are several essential factors regarding family recovery, in treatment planning for a substance abusing parent.  Once a substance abuse disorder has been diagnosed in a parent, client-specific treatment methods can be found.

     There are helpful instruments such as The Interpersonal Support Evaluation List (ISEL) which measures the adequacy of the client’s social support network.  Family involvement in a using parent’s treatment “can have a positive impact on client outcomes such as abstinence, reduced relapse, general functioning, psychiatric symptomatology and client treatment engagement (Biegel, 2007).”  Successful treatment methods focus on the particular issues surrounding a client and family, tailored to the individual family members, addressing behavioral problems of children and development of the parental support systems.  Social Workers can provide information to the family about the problem and strategies of addressing it (Biegel, 2007).

     Multifamily Therapy Group (MFTG) involves individual family therapy sessions as well as weekly multifamily therapy group sessions involving four or five families at a time with a maximum of 15 group members.  MFTG includes techniques and interventions from solution-focused therapy, structural family therapy, interactional approach and mutual aid approach.  MFTG is a future-oriented, strength-based approach which encourages goal development, partnership with the client and collaboration with possible resources (Springer, 2002).  Behavioral Couples Therapy is an evidence-based treatment useful for substance abuse disorders to increase functioning of relationships between couples.  The mental health treatment of a Psychoeducational Intervention has also proven effective with improving family relationships in this category, be they spouse or parent.  It helps families to understand substance abuse related behavioral issues through education.  Family education and other outreach programs like family support groups are important to a family’s recovery, although they have been under utilized in the field of substance abuse treatment (Biegel, 2007).

Many patients who receive treatment for substance abuse disorders also have mental health issues, whether they are drug-induced or otherwise present.  The term for this is dual-diagnosis or co-occurring disorder.  This information is valuable to the social worker who works with problem users.  Both disorders must be taken into account in a treatment intervention.  There is a program currently utilized for co-occurring disorders by Community Mental Health and Substance Abuse Services (CMHSAS) called Integrated Dual-Diagnosis Treatment or IDDT.  Welcoming, engagement and motivational interviewing with individuals at various stages of change are some of the essential ingredients of IDDT.  CMH hosts a program for families of dual-diagnosis individuals which also serves as a support group for those families.  It is called Families In Action.  Social workers can look to these programs for information and referral when working with families of people with co-occurring disorders.

When social workers are faced with families of substance abusing parents, workers must be aware of the natural supports already in place for the individual, the family and supports for them within the community.  It may be easier for someone to utilize a support that they normally use, have some previous experience with, or is provided at no expense to them.  A friend, a known social worker, or just a convenient place they like to go where supportive people gather might be a great familiar resource.   

Most urban areas have self-help, mutual-help, support groups or 12 step programs where peers help each other deal with situations of any kind.  For substance abusers there are a variety of meetings one can attend such as Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, Dual Recovery Anonymous, Smart Recovery and so on.  For loved ones of substance abusers there are programs like Alanon, Naranon, Co-dependents Anonymous, Adult Children of Alcoholics, and so forth.  These links to the recovering community can be a valuable resource to the parent or anyone looking for help with a substance abuse disorder, personally or within the family.  They are often assigned as a part of a continuing care plan at discharge from substance abuse treatment.  These programs are also widely known to be a key ingredient for effective recovery maintenance.

There are many additional options following inpatient treatment.  Studies have found that involving families in an individual’s treatment and maintenance can drastically reduce the likelihood of relapse.  The family is in a central position for support and encouragement.  A clinical social worker with specialized training in substance abuse can be very effective in aiding the family to find help.  The worker can directly provide, arrange or refer the family to ongoing assistance for the problems caused by a parent’s past or present substance abuse.  Today there are number of strategies for the continuum of care such as family-centered home-based services, outpatient treatment, counseling, help-lines, support groups, parenting classes, and advocacy.  These services can be utilized to provide an atmosphere of recovery and education which may in-turn foster healing for the family as a whole. 

One family-centered home-based service named the Strengthening Families Program, a part of the Detroit Safe Haven program, has been found effective for treatment of the issues surrounding the family of a substance abusing parent.  This and other similar programs are focused on long term support “to improve family communication, organization, expressiveness, and cohesion; increase parenting efficacy and parent-child bonding; and improve the child’s school performance, positive behaviors, and association with positive peers (Gruber, 2001).” 

Families of parents in recovery have a broad spectrum of critical areas that a social worker can look to in developing an intervention.  Person-centered assessment and treatment planning methods, used in conjunction, can establish a blueprint for a client to follow.  As a using parent finds their particular path to a healthy lifestyle, they can take more steps out on their own, gaining self-efficacy and competence in their own recovery.  A comprehensive, recovery support network lays the foundation for the individual and family to gain wholeness.

Biegel, D.E., Ishler, K.J., Katz, S., Johnson, P. (2007). Predictors of burden of family caregivers of women with substance use disorders or co-occurring substance and mental disorders. Journal of Social Work Practice in the Addictions, 7(1/2)

Gruber, K.J. (2001). In-home continuing care services for substance-affected families:  the bridges program. Social Work, 46, 3, 267-278

Rhodes, R., Johnson, A.D. (1996). Social work and substance abuse treatment: a challenge for the profession. Families in Society, 77, 3, 182-186.

Springer, D.W. (2002). Families helping families: implementing a multifamily therapy group with substance abusing adolescents. Health & Social Work, 24, 3, 204-208

Young, N. K., Boles, S.M., Otero, C. (2007). Parental substance use disorders and child maltreatment: overlap, gaps, and opportunities. Child Maltreatment, 12, 2, 137 149.

Way, I. (2009). SWRK 6610: social work practice with individuals and families. Western Michigan University School of Social Work, Fall 2009, Thursdays 10am-12:20pm, 1087 CHHS, Kalamazoo, MI.