“[There is a] changing definition of ‘family’ in the United States…the family as an ecosystem within a larger context of society…[which has led to an] evolution of family therapy as a component of substance abuse treatment…[and changes in] the stages and levels of recovery…”

National Center for Biotechnology Information (NCBI), U.S. Library of Medicine

In this day and age, the family of any person, especially boys, suffering from Substance Abuse Disorder (SAD) must play a central rather than peripheral role in any and all treatment and recovery efforts. The challenge lies in broadening substance abuse treatment and recovery from the individual to the family.1

“The road to recovery from substance abuse and addiction is not the same road our struggling grandparents, or even our parents traveled down. They may have gotten to SAD on their own, but they don’t have to get away from there on their own anymore.”

– Anonymous

The Modern Definition of Family in America

There is no traditional family in American anymore. Different cultures, belief systems, sexual orientations, rampant divorce, couples living together instead of marrying, both spouses’ work schedules out of the home, adoptive families, foster care arrangements, more grandparents than ever raising their kids’ kids, stepfamilies, extended families, more emancipated youth, constant change and transition, geography and logistics, and media portrayals of family color the concept of family according to a scale of absolute relativity.

“Families are connected more these days by alliance, than by blood, or even love, and those are based now more on choice, convenience, politics, and money.”
– NCBI

Family in a therapeutic context these days can most accurately be defined according to the closest emotional connections the person who is being treated has  It is now more critical than ever for a therapist to identify people who are important in their patient’s life. No one should be automatically included or excluded.1

The concept of family has changed in the U.S. over the last 2 generations. Society by and large has changed a great deal over that time. The proportion of married couples has decreased, now representing only 24% of all households. And what was once the family norm, has been replaced by many alternative familial arrangements, including blended families, divorced single mothers or fathers with children, never‐married women with children, cohabiting heterosexual partners, and gay or lesbian families.1

The Amercian family is now more like a gigantic ecosystem than anything else. Substance abuse impairs an individual’s physical and mental health, which strains and taxes the agencies that promote physical and mental health. In families with substance abuse, family members often are connected not just to each other, but also to any of a number of government agencies, such as social services, criminal justice, or child protective services. The economic toll that is taken includes a huge drain on employability and other elements of social productivity. The social and economic costs are felt in many workplaces and homes…and not just by the person with the disorder.1

Substance Abuse Treatment

Treatment for substance abuse is essentially all about the elimination of the abuse, a full understanding of the damage that addiction causes, the development of strategies to help make good choices when the urge or temptation is near, and how to develop have a safety net of persons to turn to in times of weakness or great stress…for the individual with SAD. When family therapy is worked into the therapeutic mix, the complex roles that family and friends play in the substance abuser’s life make for a much more complicated treatment, one that prepares and individuals’ loved ones to be treated and be part of the recovery as well.2

Family and friends can be a source of great help throughout the process, or they can be part of the problem that needs therapy too. You can’t send a recovering individual back into a net of persons in their life that can perpetuate the problem that helped facilitate poor choices in the first place. Providing substance abuse treatment services to the whole family and network of friends can improve treatment’s overall effectiveness.1

Family Therapy

In family therapy, the unit of treatment is the family, attempting to make whatever family is involved healthier. It seeks to identify the family’s strengths and resources and builds growth opportunities upon them. In family therapy, the ultimate goal of treatment is to meet the needs of all family members, individually and collectively.1

Family therapy is a therapeutic approach that believes in family‐level assessment and intervention. A family is seen as a system, and in any system, each part is related to all other parts. Consequently, a change in any part of the system will bring about changes in all other parts. Therapy based on this point of view uses the strengths of families to bring about change in a range of diverse problem areas.1

Properly Blending Family Therapy and Substance Abuse Treatment

Family therapy in substance abuse treatment helps families become aware of their own needs and provides genuine, enduring healing for people. Family therapy works to shift power to the parental figures in a family and to improve communication.1

Meeting this challenge of working together calls for mutual understanding, flexibility, and adjustments among the substance abuse treatment provider, family therapist, and family. This shift will require a stronger focus on the systemic interactions of families.1

Substance abuse counselors often focus on the individual needs of people with substance use disorders, urging them to take care of themselves. Family therapists, on the other hand, involved in substance abuse treatment will work to help the family make interpersonal, intrapersonal, and environmental changes affecting the person using alcohol or drugs. And as healing takes place, family therapists and substance abuse counselors must work together to help both the individual and his or her family members understand what is occurring, why, and their role in it.1

1 “Chapter 1 Substance Abuse Treatment and Family Therapy,” National Center for Biotechnology Information.
2 “Substance Treatment Goals,” Serenity at Summit.

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