Family Therapy for Substance Use Disorders and Addiction Recovery

Addiction impacts many families. One study reports that more than one in 10 children under the age of 18 live with at least one adult who has a substance use disorder (SUD), a medical condition in which there is an uncontrolled use of substances despite the harmful consequences.² And according to the National Institute on Alcohol Abuse and Alcoholism, 7.5 million children aged 17 or younger live with a parent who has an alcohol use disorder (AUD), the complex condition defined by the inability to control alcohol consumption despite its detrimental effects.³ Furthermore, the National Center on Substance Abuse and Child Welfare reports that parental substance abuse was the cause behind 38.9% of the cases of children who were removed from their homes in 2019.⁴

Luckily, there are substance misuse rehab programs that treat the whole family, not just the person with the SUD. These services can help spouses, partners, caregivers, children, siblings, and even friends.

Family therapy programs look different depending on who’s being treated and who’s involved, but they are all designed to help improve family-relationship functioning and support the person in recovery. Programs can include a wide range of therapies, support groups, family days, family retreats, parenting classes, play therapy for children, and more.^2,5

What is Family Therapy?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), family therapy, also known as family counseling, includes interventions that reflect family-level assessments, involvement, and approaches.⁶

Evidence suggests that people who have family support are more likely to remain in treatment, stop misusing substances, and stay sober.⁶ The importance of support applies to relationships of all types. For example, a study of couples who participated in behavioral couples therapy experienced improved levels of abstinence and better communication than the more typical individual-based therapy.⁷

Family involvement is important but it’s not for everyone. After dealing with a loved one with substance abuse for a long time, some family members might feel emotionally and psychologically drained, they may fear the unknown, or be wary of sharing family problems with a stranger. Regardless of the rationale, it might be helpful to enlist a family therapist to talk one-on-one with each family member about their concerns. Family members who want to participate in therapy can do so, while unwilling family members can join when they feel ready.⁸

How Does Family Therapy in Addiction Treatment Work?

Family therapy can take different forms in the addiction treatment process. It typically involves the whole family meeting together with a therapist, but sometimes only part of the family meets, or in atypical cases, each person might meet individually with a therapist.⁸ Each session lasts about an hour and may look different, depending on the family’s unique needs. For instance, an entire session might be devoted to talking about each person’s feelings and concerns, while another meeting may involve an education on effective communication and improved listening to reduce misunderstandings.⁸ Based on the specific issues, the therapist may use different types of family therapies, which may include:^6,7,9

• Behavioral couples therapy (BCT). Intended for married or cohabitating couples where one person suffers from a SUD, BCT promotes and rewards abstinence through a daily “Recovery Contract.” This involves the person with the SUD expressing their intent not to drink or use drugs and the partner supporting their efforts to stay abstinent. This therapy can help improve communication, reduce stress, and maintain abstinence.
• Family behavior therapy (FBT). This model has been successful with adults and adolescents with SUDs. It’s sort of a pick-and-choose your own therapy based on a menu of evidence-based treatment options that aim to teach everyone skills to help them all improve their home environment. FBT focuses on how the behaviors of the person with the SUD affect the family as a whole and works to change those behaviors with the involvement of the entire family.
• Brief strategic family therapy (BSFT). Geared toward families dealing with adolescents who have SUDs, this therapy—stretched out over 12-16 sessions—is based on interventions that focus on family interactions. That’s because research suggests that adolescent substance abuse stems from unhealthy family dynamics.
• Functional family therapy (FFT). A therapy used to help families with adolescents with SUDs, FFT focuses on improving family interactions since the underlying belief is that unhealthy family dynamics lead to problem behaviors. Thus, strategies include effective communication techniques, problem-solving, conflict resolution, parenting skills, behavioral contracts, and more.
• Solution-focused brief therapy. This can help families struggling with co-occurring disorders, meaning your loved one suffers from addiction and another mental health disorder, too. It doesn’t involve pinpointing the exact reasons for family dysfunction. Instead, this therapy focuses on finding solutions for specific problems.
• Community reinforcement and family training (CRAFT). CRAFT takes a structured approach to teaching families dealing with SUDs positive reinforcement strategies to encourage the loved one with the SUD to change their substance use behaviors.
• Multisystemic therapy (MST). A model used to help adolescents with SUDs, violent behaviors, and/or criminal records, MST utilizes goal-oriented techniques and family-strengthening strategies to encourage the adolescent to change.
• Multi-dimensional family therapy (MDFT). A treatment approach suitable for diverse populations and adolescents with severe SUDS and their families, MDFT is designed to improve the adolescent’s and family’s functioning through a comprehensive treatment program that also involves the school, legal system, and other relevant parties.
• Family recovery support groups. These provide support to the members of families who have a loved one in recovery from SUDs.
• Family peer recovery support services. Family members—with a loved one in recovery—get education, support, and resources from someone who has also had a family member in recovery from SUDs.

American Addiction Centers offers family therapy at many of our rehab centers across the country.

• Laguna Treatment Center, in California, offers options for in-person family therapy or therapy via Skype.
• Oxford Treatment Center in Mississippi provides a two-day intensive family therapy program during residential rehab and the outpatient phase of treatment, too.
• Desert Hope Treatment Center, in Nevada, hosts a family day every other Saturday and invites patients and their families to participate in an interactive and educational discussion. After the family day programming ends, patients and families have the chance to visit with one another.
• Recovery First, in Miami, Florida, offers a monthly family program and regular family therapy. Additional family programming is available every first and third Saturday of the month, and families can visit patients for a two-hour period on Sundays.
• AdCare, in Massachusetts and Rhode Island, provides seminars, classes, group counseling, family therapy sessions, and more family programming, depending on the location.
• River Oaks, in Tampa, Florida, hosts monthly family programs and regular family therapy. Additional family programming is available every first and third Saturday of the month, and families can visit patients on Sundays.
• See All Rehab Facilities & Programs

Benefits of Family Therapy in Recovery

Research indicates that family therapy for SUDs provides many benefits, such as:^5,6

• Improved treatment retention.
• Improved understanding of addiction and how it affects families.
• Increased family support for the person in recovery.
• A better understanding of what to expect in treatment and recovery.
• Increased awareness of the warning signs of relapse.
• Helping the family make positive changes related to the SUD, such as their patterns of communication and behavior.
• Promoting family strengths.
• A reduced risk of relapse.
• Helping families understand the importance of taking responsibility for their own emotional, physical, and spiritual well-being.

Other Ways Families Can Help and Stay Connected

There are different ways of providing help and support to your loved one during treatment and recovery. The strategies you employ can vary depending on individual circumstances or the type of treatment your loved one seeks. Programs may have different policies and procedures, such as rules regarding phone calls and visits (that can depend on circumstances), or about sending care packages and letters.¹⁰

You should have the opportunity to ask about any concerns in advance so that you know what to expect.¹¹ In general, it’s important to remember that:¹¹

• Your participation and support can make a big difference.
• You’ll need to be patient while your loved one makes important life changes.
• Your acknowledgement of your loved one’s successes can help them feel supported.
• You should ensure that you have enough support of your own and make time to care for your own needs. Participation in a family support group like Al-Anon or Nar-Anon can be helpful.