An Unexpected Solution

Wrapping up our several weeks look at many of the various treatments available for individuals who are fighting addiction I wanted to close with what I consider to be the most influential and effective. What it is will surprise many, but there is a lot of evidence that indicates its value.

That something is family. By family I mean biological family if they are still in the picture, often they are not. Spouses, children, friends, and just people that care and are willing to make the long investment in the helping of an addicted person to get to recovery.

One thing I tried to figure out when helping Lauren was what could we, I, do better. Every program we went to would offer a family component. Some of those where informational weekends for big groups of family members. Others were the chance to sit in on sessions with clients and other families to talk. Very often there would be far to few family members. Some programs even offered personalized counseling sessions for the entire family. We used all that we could, but they often where not enough.

I desperately needed to learn what I needed to do differently to help my daughter. I knew that although I didn’t cause this, there had to be things I was doing that just weren’t helping. We wanted to understand more of that and learn to apply what we learned but, we never got the chance, we ran out of time. You do have the chance.

An article I read recently cited that out of 14 studies done  in 2009 about the impact of family on addiction, 7 indicated that Family Based Therapy (FBT) was found to have superior outcome effects for drug use compared to group CBT (Liddle et al., 2001, in press b; Waldron et al., 2001), individual CBT (Liddle et al., in press a; Waldron et al., 2001), psychoeducational approaches (Latimer et al., 2003; Liddle et al., 2001), drug court (Henggeler et al., 2006) and usual care (Henggeler et al., 2002).

FBT also indicated improvements in two very significant areas. The first, retention rates (i.e. completion of a full course of prescribed treatment) in controlled trials of FBT have been uniformly high, typically from 70 per cent to 90 per cent. This is very significant retention rates are often low with programs.

The second area showing improvement is behavioral problems. These are the problems that are associated with substance use such as delinquency, externalizing symptoms (e.g. aggressiveness, oppositionality), and internalizing symptoms (e.g. depression, anxiety). Again, FBT conditions in all fourteen studies indicate a significant decrease in at least one behavioral problem other than drug use, and three studies reported that FBT outperformed alternative treatments in this area (Henggeler et al., 2002; Liddle et al., 2008, 2009). In addition, there was strong evidence that FBT models effectively treat co-occurring behavioral symptoms in substance-using teens (Whitmore and Riggs, 2006).

In all these studies three approaches showed evidence of treatment superiority in the highest quality studies: ecological (therapy that integrates personal and environmental treatment) family therapy, including Multidimensional Family Therapy (MDFT) and Multisystemic Therapy (MST), individual and group CBT, and brief motivational intervention (this is not intervention as in the Johnson model). If you would like to read the article that this data is from click here “Family-based treatment for adolescent substance abuse: controlled trials and new horizons in services research”

The bottom line is that families (however you may define them) can have a tremendous influence on loved ones that are fighting with a mental health or substance use disorder (SUD). Another surprise is that an in-depth survey of over 1800 teens reveals that 71% of teens are appreciative that parents have rules, and that 78% feel their parents still love and support them. Our children still want and value our input. You can read the entire survey here .

One question I am often asked is “Can you help someone that doesn’t want help?” I believe the answer is yes because you do have the ability to influence them toward help.

Helping those we love will take a massive amount of effort and thought, but it can work.

Many Counselors, Psychologists, Psychiatrist, Treatment Programs and Treatment Facilities offer the modalities mentioned above. As the caring family member, you have to initiate conversation about what percentage of these approaches are actually being used in the care of yours loved one. Don’t assume that it will be done, ask.

Another approach families and significant others can use I have mentioned a lot is Community Reinforcement and Family Training (C.R.A.F.T.).

CRAFT was designed to help families/individuals to encourage loved ones with a SUD toward treatment. In two important studies CRAFT was over 70% effective in getting resistant family members battling addiction to enter treatment after being implemented by a family member over a 12 month period. It is an approach created by Dr. Robert Myers of the University of New Mexico. It focuses on two goals: First, helping individuals and families that love someone with an addiction to guarantee that they are well and healthy. Second, be sure that their interactions with their loved ones are moving that loved one to get help. A book Dr. Meyers wrote called “Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening”, the book even includes practice scenarios and exercises for you to do, is an excellent tool for loved ones who care about an addicted person get started in implementing the C.R.A.F.T. principles.

If you would like to learn more about C.R.A.F.T. please read any of these past posts:

A Day I Won’t Ever Forget                                       Safe Landing

Some Decisions Are Really Hard                            The One Thing I Would Do Differently

I’m Sorry Honey                                                        She’s All Better Now

Your Gonna Miss This                                              My Love One is Addicted Now What

A big key to helping your loved one get well is being sure they find the treatment that works for them and supporting them through the process. It’s not easy, but it can be done.

The featured image this week is called “Winds of Change” by Brooke Shaden