Bepko and Krestan's Theory of Substance Abuse

Bepko and Krestan's Theory

• Theorists: Bepko and Krestan (1985)
• View of Substance Abuse:
  • Focuses on both the individual who abuses substances and the substance itself as part of a larger system.
  • Considers intrapersonal, interpersonal, and gender systems.

Goals of Therapy

• To help all family members achieve appropriate levels of self-responsibility while decreasing inappropriate responsibility for others.

Three Phases of Treatment

1. Presobriety:

   • Objective: Unbalance the existing system which is centered around substance abuse to facilitate sobriety.
   • Goal: Promote a shift away from reliance on substances.

2. Early Sobriety:

   • Objective: Establish balance around a self-help group; create a supportive context while recognizing that individuals may alternate between feeling pride and self-loathing.
   • Goal: Maintain engagement in a corrective environment to encourage healthy relationships.

3. Maintenance:

   • Objective: Achieve a deeper rebalancing of the system by addressing and completing unresolved developmental tasks.
   • Goal: Support ongoing growth and recovery beyond initial stages.

Strategies and Techniques

Pre-sobriety

• Interrupting Emotional and Functional Over-responsibility:
  • Utilize the pride-system of both the spouse and the individual with a substance use disorder to halt counterproductive dynamics.
  • Referral to Self-help Groups: Encourage participation in community support for substance abuse recovery.

Early Sobriety

• Same-sex Group Therapy:
  • Implement a specific therapeutic model designed for members of the same sex.
• Reparative and Restorative Work with Children:
  • Create safe environments for children to express feelings and process their experiences related to substance abuse.

Maintenance

• Anger Management:
  • Address and manage anger issues that may arise during recovery.
• Dealing with Toxic Issues:
  • Confront and resolve issues such as sexual abuse which can impact recovery.
• Examination of Gender Stereotypes:
  • Analyze the influences of gender, power dynamics, anger, and control within relationships.