Family Involvement in Addiction Treatment

By Psychotherapist & Camino Recovery’s Programme Director Don Lavender

Residential addiction treatment for alcoholism started in the 1940s. After a decade the clinicians made a remarkable discovery.

This was that patients who had some level of family involvement in the treatment had greatly improved chances of achieving long-term sobriety.

It may have been only weekend visits back then, but at least those close in their life were being supportive of a patient’s efforts to get well. This commitment led to the most positive results.

Involvement of loved ones has evolved since then in terms of intensity, but also in broadening the involvement of others beyond blood relations. For instance, Camino has successfully carried out family programmes involving work colleagues and friends.

In most cases, the ripple effect of an individual’s behaviour on those around them extends well beyond the family. Likewise, the success of their recovery is often enhanced by those outside their family supporting them, including taking part in treatment programmes.

Why alcoholism is a family disease

In 1956, the AMA (American Medical Association) declared alcoholism an “illness”. Less than a year later, the WHO (World Health Organization) agreed with the AMA that alcoholism was a
disease, then took it one step further: by declaring alcoholism a “family disease”

This is not merely because addiction to alcohol – and other substances or such as gambling and other process addictions  – could have a hereditary factor, but because alcoholism hugely destabilises a home and deeply affects the emotional and mental health of everyone there.

It will create divisions and disunity. These destructive consequences are often further fuelled by an individual’s denial and shame around the disease and the problems they have. Alcoholism is a disease that causes dismal family dis-ease.

Yet despite this being known for more than half a century, many treatment programmes still do not offer a family programme. Without this, it’s akin to only offering half a treatment, at best.

Family workshops for addiction support

What is needed is a comprehensive four to five-day family workshop. This needs to offer education, communication exercises, confrontations without blame or judgement, and closure with amends and boundary setting. These give the skills to deal with complex everyday situations that often arise when an addict is in the house or such as the workplace

The programme we offer combines these aspects. It has evolved over the past 50 years and been used in the successful treatment of thousands of people with addiction problems and those close to them

Yet most people who seek care for alcoholism, other addictions, co-dependency, depression, anxiety and mental/nervous disorders are often left to do their own recovery work. They are cast away to recover without their family’s help.

It can easily happen because the family will implore treatment centres to take their troubled loved ones and fix them. The family has had enough. They are at their wits’ end – and simply don’t know what else to do.

So it is imperative that any treatment programme establishes a safe environment in which family members can voice their fears and concerns. This creates a healthy framework to build new sustainable relationships.

With this clarity they can set boundaries. This means they learn to self-care in a new way.

Family disease means a family recovery

Families must be taught to communicate in ways that stop the endless cycle of violence which prohibits recovery for everyone – patient and family members alike

The most effective rehabilitation centres employ this sort of programme for their patients and the families of patients. In your search for a rehab, it’s useful to ask if you can speak with a family member who has experienced the centre’s family programme.

That person should be able to share how they came to understand that the family member in treatment was the designated patient, most likely the one scapegoated for all the family’s ills – but, in reality, the entire family system was responsible for those ills and, in the future, responsible for all the family’s successes as well.

Don’t play the blame game

Every family of someone in need of help through rehab needs to know how they could be hindering recovery rather than helping – due to enabling behaviours. Blame, for example, is a hindrance.

Family members usually do the best they can. Yet if they are being manipulated or even abused by someone active in addiction, they often return abuse with abuse, bury their head in the sand or shrink into a quiet victim world unsure of what to do next. They frequently feel they have exhausted all optionsCamino recovery centre

What is needed is clear and direct communication without blame or judgement. The creation of healthy boundaries is vital to stop the unhealthy enabling. Families need to re-enter a level playing field from where all learn their imperfection, thus make amends – as well as see the undoubted potential in each other

This is more complicated than patting each other on the back. It’s about a new beginning of communication in which negatives and positives are accepted – and then everyone can successfully move forward.


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