1. WORKING WITH THE FAMILY
A SYSTEMS APPROACH

2. FAMILIAL STAGES OF CHEMICAL DEPENDENCY
DENIAL
ATTEMPTS TO ELIMINATE THE PROBLEM
DISORGANIZATION AND CHAOS
REORGANIZATION DESPITE THE PROBLEM
EFFORTS TO ESCAPE
FAMILY REORGANIZATION

3. A NEED TO TREAT THE WHOLE FAMILY
ALL ARE AFFECTED TO SOME DEGREE
SUPPORT FOR THE RECOVERING INDIVIDUAL (ALL PART OF THE SOLUTION)
BREAKING DYSFUNCTIONAL PATTERNS OF INTERACTION (TRIANGULATION)
BREAKING DYSFUNCTIONAL BEHAVIORS OF ADAPTATION (ENABLING)
ADDRESSING FEELINGS
SPOUSAL ISSUES

4. A NEED TO TREAT THE WHOLE FAMILY
PARENTAL SUBSTANCE ABUSE
OTHER STRESSORS INSIDE AND OUTSIDE OF FAMILY
PROBLEMS REGARDING FAMILIAL RULES/ROLES
CONNECTING TO SUPPORT SYSTEMS (AL-ANON, ALATEEN)
FAMILY INTERVENTIONS
BE SENSITIVE TO MULTICULTURAL ISSUES

5. FAMILIAL RULES
DON’T TALK
DON’T TRUST
DON’T FEEL

6. FAMILIAL ROLES DEPENDENT SURVIVOR (CHIEF ENABLER)
HERO CHILD (SUPER RESPONSIBLE)
LOST CHILD (ADJUSTER)
SCAPE GOAT (ACTING OUT)
MASCOT (ENTERTAINER)
PLACATER (HOUSE HOLD SOCIAL WORKER)

7. ADDRESSING CO-ADDICTION (SURVIVOR)

8. DEFINING ENABLING
AN UNWILLINGNESS TO SERIOUSLY CHALLENGE THE DRUG-DEPENDENT PERSON’S DYSFUNCTIONAL BEHAVIOR THUS PERPETUATING THE PRESENTING PROBLEM OF DEPENDENCE OR ADDICTION . (FENELL & WEINHOLD)
SHOULD BE SEEN AS NORMAL IN ADAPTING TO THE DRINKING OR DRUGGING.

9. CHARACTERISTICS OF CO-ADDICTION/SURVIVOR:
THE FOCUS BECOMES ON THE DEPENDENT AS OPPOSED TO SELF
MEETING OTHER’S NEEDS AT THE EXCLUSION OF OWN NEEDS
ENMESHMENT
BOUNDARY DISTORTION

10. CHARACTERISTICS CONTINUED
FEAR OF ABANDONMENT
DENIAL
FROZEN FEELINGS
DEPRESSION
ANXIETY
HYPERVIGILENCE
OBSESSIVE AND COMPULSIVE

11. CHARACTERISTICS CONTINUED
SUBSTANCE ABUSE
STRESS RELATED DISORDERS
TRYING TO CONTROL THE UNCONTROLLABLE

12. SURVIVOR TREATMENT ISSUES
LOOK AT STAGES OF CHANGE MODEL AS COMPARED TO THE FAMILIAL STAGES OF DEPENDENCY * PRECONTEMPLATION * CONTEMPLATION * PREPARATION * ACTION * MAINTENANCE

13. SURVIVOR TREATMENT ISSUES
SETTING BOUNDARIES
BREAKING ENABLING BEHAVIOR
DEALING WITH AND EXPRESSING FEELINGS
EXPRESSING NEEDS & WANTS

14. SURVIOR TREATMENT ISSUES
CARING WITHOUT CONTROLLING
BUILDING SELF-ESTEEM AND OWN IDENTITY
USE OF SUPPORT GROUPS (AL-ANON AND CODA)