Brief Family Therapy

Flashcards on Brief Family Therapy and Substance Abuse

Family Therapy

Suggested when a client's substance abuse is influenced by family behaviors or communications. Aims to examine factors maintaining substance abuse by considering family structure, hierarchy, roles, rules, alignments, and communication patterns.

Contraindications for Family Therapy in Substance Abuse

Active substance abusers in the family, violence, denial of the client's problem, or excessive anger among family members.

Importance of Family Involvement in Substance Abuse Treatment

Changes are faster, easier to maintain, and the client gains a built-in support system. Addresses cases where family members inadvertently reinforce the problem.

Research on Family Therapy and Substance Abuse

Studies show people with substance abuse disorders maintain close ties with families and family therapy methods are strongly supported for substance abuse treatment.

Project CALM

Harvard Counselling for Alcoholics' Marriages Project which showed that couples counselling in context of treatment for alcohol alcoholics, resulted in over 50% of husbands remaining alcohol-free within the first year.

Clinician Skills for Family Therapy

Requires a good understanding of family systems, dysfunctional family patterns, power struggles, and communication. Alcohol and drug counselors can learn to work with families, especially if they do not hold the family responsible for the substance abuse.

Appropriateness of Brief Family Therapy

Long-term family therapy is not usually necessary except in long-term residential treatment. Short-term therapy maintains clearer boundaries.

Situations Best Dealt With Individually

Client unwillingness, issues of separation and individuation (although conjoint family work often helps complete this process), or physical, emotional, or sexual abuse by a family member.

Benefits of Family Therapy

Focus on change, testing new behaviors, teaching family system dynamics, eliciting strengths, and exploring the meaning of substance abuse within the family.

Defining Family in Therapy

Some therapists believe that it is possible to "create" a family by drawing on the client's network of significant contacts.

Network Therapy

Views substance abuse disorders from a cognitive-behavioral perspective, regarding significant nonfamily members as useful resources available to assist the client.

Conjoint Couple's Therapy

Therapy that addresses couples issues within the family. Key therapeutic themes include expectations of each partner, needs from the other partner, resentments, gender roles, views on parenting, and ways to communicate dissatisfaction.

Multifamily Groups

Used for educational purposes and as support groups. Often help with boundary setting and reestablishment of the parent-child hierarchy.

Multiple Family Therapy Concerns

Inadequate internal family development, family systems and role imbalance, selected socialization variances within the family, and dysfunctional, ineffective family behaviors that maintain the problem.

Theoretical Approaches - Family Systems Models

Regard substance abuse and dependence as symptoms of dysfunctional interpersonal dynamics within the family. The substance abuse meets a need on some level for the family as a whole and inadvertently reinforces the substance abuse.

Strategic Family Therapy

Targets the positive interpersonal aspects of substance abuse, acknowledging its benefits to the family and the negative consequences if the substance abuse were to end.

Structural Family Therapy

Looks beyond specific family dynamics to more general imbalances in family relationships that might maintain substance abuse, such as extreme disengagements and inappropriate coalitions between family members.

Bowenian Family Therapy

Focuses on family-of-origin emotional attachment patterns and unresolved separation issues to make sense of substance abuse disorders.

Contextual Family Therapy

Emphasizes ethical legacies and unconscious loyalties passed along from one generation to the next.

Behavioral Marital Therapy (BMT)

Concentrates on teaching and practicing guidelines for clear communication and conflict resolution, marital enhancement, and substance abuse-specific coping skills.

Alcohol-Focused Spouse Involvement (AFSI)

treatment includes the same drinking-specific assessments and interventions but also assesses the couple so assess the couple can reinforce abstinence and decrease consumption triggers.

Community Reinforcement Approach (CRA)

A brief systemic/family intervention and therapy model that has shown good results through training the significant others of treatment-resistant clients with alcohol abuse disorders. Encourages sobriety by reinforcing abstinence while allowing the drinker to experience negative consequences from intoxication.

Community Reinforcement and Family Training (CRAFT)

Brief systemic intervention and therapy model that works through the concerned other to analyze behavior patterns surrounding substance abuse, seeking triggers and consequences, interpersonal cues, and positive consequences for sober behaviors.

Multidimensional Family Therapy (MDFT)

A brief family therapy model that has demonstrated significant long-term clinical effectiveness in treating adolescent substance abuse and conduct disorders, integrating structural/strategic family therapy with research findings on adolescent development.

Duration and Frequency of Family Therapy

Mostly short-term, sessions may be 1 1/2 to 2 hours long. Timeline is not more than two sessions per week, lasting 6 to 10 sessions, depending on purpose and goals.

Opening Session of Family Therapy

Clarify the problem, identify family goals, ask open-ended questions to each member, educate on the therapeutic process and biosocial issues, and provide feedback.

Native Americans in Brief Family Therapy

The therapist encouraged father and son to express both their resentment and their appreciation of each other in letters read aloud to each other. Through this process, the client began to remember what his father had been like as an alcoholic and saw that he himself was in danger of making the same mistake.

Cultural Issues in Family Therapy

Therapist need the family's permission to share their closely held secrets and to understand the family's ethnic and cultural background.