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Published byClifton Oliver Bond Modified over 9 years ago
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No single definition Usually defined as- “A group of people with common ties of affection and responsibility who live in proximity to one another”
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Types of Family NuclearJointExtendedElected
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Drug use by client Poor family interactions/ behaviors
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Each family has its own pattern on communication (verbal as well as non-verbal) ◦ IDU threatens to run away from home- family members get him injections or ◦ Family members beat up client for using injections Each family tries to reach a balance ◦ Family covers up drug use and act normally
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Psychological Health Economic Impact on minor children
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Psychological
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Health
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Economic
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Impact on minor children
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Why is it important to include family in treatment process?
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Approaches that include assessment and intervention at the family’s level Important to consider “family” from client’s point of view
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Co- dependency EnablingBoundaries Sub-system Adjustment to abstinence Triangulation
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Co-dependency Being overly concerned with problems of IDU while neglecting one’s own needs
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Enabling Process of encouraging drug use by un-intentional behaviors It diffuses impact of drug-use and does not allow the client to realize his problem
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Boundaries Separates one family member from another Dysfunctional patterns in families of IDUs: Over-involved and interfering Completely aloof
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Sub-system Clusters of family members separated by clear boundaries. E.g. parental sub-system or sibling sub-system
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Adjustment to abstinence Families may show negative reactions to abstinence as hidden conflicts come to surface
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Triangulation Occurs when the IDU becomes the scapegoat for two family members who do not want to discuss their conflictual issues
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Important to address needs, expectations and wants of family members Make the family feel comfortable Identify each family member by name Assure them of confidentiality
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Very important to facilitate the “un-burdening of family’s emotions Use active listening skills Let family members decide what they want to discuss
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Includes following areas: ◦ Family member’s knowledge about drugs ◦ Impact of drug use on financial status ◦ Available social support to the family ◦ Maintaining factors for drug use (eg. Peer pressure, withdrawal etc.) ◦ Health status (e.g. screening spouse for HIV) ◦ Quality of relationship of IDU with his family members ◦ Communication patterns in the family
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Craving and withdrawal Risk associated with injection use Safe sexual practices Reproductive health Process of change Treatment process Harm-reduction process
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Lack of will-power not sole determinant of relapse Elaborate phenomenon of craving and withdrawal- as predictors of relapse
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Family member need to be told about various health risks associated with injection use Also should be told where to get medical/legal aid as and when required
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IDUs is a high risk group for getting sexually transmitted infections/diseases Wife needs to be taught: ◦ Importance of regular condom use ◦ Condom negotiation skills ◦ Taking care of personal hygiene ◦ Common symptoms of infections (e.g. itching in vaginal area, excessive/smelly white discharge) ◦ Getting regular check-ups done
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Wife should also be counseled regarding: ◦ Maintaining reproductive health ◦ Spacing between children
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Family goes through cycle of hope (when patient abstains/reduces drug use) despair (when previous patterns of use are resumed Family needs to be made aware of “process of change” in addiction
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Drug use as chronic, relapsing condition Need for regular, long-term follow-up Family should also keep in touch with counselor
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Family may often blame counselor- “You are supposed to make him quit, why are you giving him needles?” Important to make family aware of Harm reduction concept
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Triggers (internal/external) can lead to relapse
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Family’s role as a trigger should be identified using A-B-C charting* DateAntecedent (What was the situation at that time? What were you thinking/feeling?) Behavior (What did you do?) Consequence (What happened after that? Family should be taught appropriate coping method
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Managing roles and responsibilities Managing finances Managing time
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Family to be considered from client’s point of view Families may resist treatment process as they have become hopeless- the counselor should not give up Be non-judgmental. Remember the issue of confidentiality When in doubt, remember, the IDU is the index client, not family members
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Family has important role in IDUs life Can be a protective factor or a risk factor Important to address family’s needs, myths and expectations- from client and treatment process Involving family in treatment positive outcome
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