1. WHY USE COUPLE AND FAMILY THERAPY APPROACHES TO TREAT SUBSTANCE USE DISORDERS? Innovation from individual tx methods JCAHO Necessity of thinking more ecologically and systemically Many family members still do care & want to help Family conflict common trigger for relapse Solid relationships important in RP Family members affected, not just IP...

3. HOW ALCOHOL ABUSE AFFECTS THE FAMILY I. Basic Family Processes Disrupted  Problem-Solving: roles/duties, achieving goals, daily living disrupted  Communication:emotional needs unmet; expression of feelings difficult  Control: processes may be chaotic, unpredictable II.Other Negative Consequences Affecting Family  Indirect e.g., Loss of job, poor job performance  Direct higher rates of verbal/physical abuse; separation & divorce

4. ALCOHOL AND THE FAMILY RESEARCH SUMMARY ALCOHOLIC FAMILIES MORE DYSFUNCTIONAL THAN CONTROLS BUT SIMILAR TO FAMILIES STRUGGLING WITH OTHER PROBLEMS OR DISORDERS ( final common pathway to family dysfunction ) WET vs. DRY FAMILIES

5. FAMILY-FOCUSED TREATMENT APPROACHES Family Models family disease - a parallel process family systems - substance seen as “organizing principle” - symptom may not be the problem - interconnectedness, reciprocity, homeostasis behavioral couples / family - substance use viewed as problem behavior - focus on both recovery and relationships - The Counseling for Alcoholics’ Marriages (CALM) Project

6. FAMILY-FOCUSED TREATMENT APPROACHES Engaging client /couple / family Deciding on therapy parameters & goals -assessment “ Intervention” approach Working with spouses/partners without IP, with intent of helping IP or drawing IP into treatment Working with spouses/partners without IP Self-help group referrals