Families and Groups Flashcards
Characteristics of Healthy Families
- safety
- open communication
- self-care
- individualized roles
- continuity
- respect for privacy
- broad family focus
- quality of family life
Characteristics of Drug Engaged Families
- Emotionally unavailable parents
- Failure to protect children from
hazards - Neglect and abuse
- Secrets to keep the peace
- Façade of normality maintained
- Feelings hidden
- Children made into confidants
- Scarcity economy
- Drug using parent’s needs come
first - Children feel responsible for adults
- Family’s needs dictate roles
- Roles become rigid, especially
during times of stress - Chaos
- Arbitrariness
- Dissolution of the family
- Parents become intrusive
- Secrets confused with privacy
- No respect for the individual
- Family focus determined by the needs of drug-using adult
- Restricted range of emotions
- Lack of emotional resolution of
issues
Family Systems Concepts:
Hierarchies
* Parental executive sub-system; child sub- system (sibling); extended family system.
- Parents need to function in the executive sub- system.
Boundaries
* Clear; generationally appropriate; engaged but not enmeshed; not disengaged but appropriately close.
Roles
- Age-appropriate; adaptable; equitable and reciprocal, flexible—not skewed; no role reversal; no cross generational coalitions.
Parental Addiction Through a Family Systems Lens
Hierarchies
- Skewed hierarchy as parents do not function in executive system –often isolated; emotionally unavailable; parental absence; heightened conflict between co-parents
Boundaries
- Boundaries can be enmeshed or disengaged. Over involvement; lack of adult supervision
Roles
- Role reversal can occur at heightened levels; greater care-giving responsibilities (sibs and parents)
Impact of Addiction on Parenting
- In-utero exposure leading to physical effects, withdrawal syndrome, cognitive issues –deprivation (maternal substance abuse impact on early child development most researched area)
- Adverse health and child developmental outcomes well documented with drug addicted mothers
- Heightened risk of child maltreatment and neglect
- Attachment disruption – not attuned to children’s emotional and/or physical needs; misreading or missing emotional cues of the child; inability to respond to child’s cues and expressed needs; general emotional unavailability
- Inter-parental conflict
- Child exposure to domestic violence is heightened with
addictions - Two vs one parents addicted –issues enhanced; child welfare involvement more likely; DV exposure more likely
Types of Family Based Approaches in Addiction Treatment
- family orientation
- family education
- family counselling
- family therapy
Types of Family Based Approaches in Addiction Treatment:
FAMILY ORIENTATION
this orientation involves informing family members about the rehabilitation program upon which the identified client is embarking. It is used to enlist family support in the client’s treatment
Types of Family Based Approaches in Addiction Treatment:
FAMILY EDUCATION
this approach is used to inform family members about family-relation issues and how they may be relevant to substance abuse and the substance abuser
Types of Family Based Approaches in Addiction Treatment:
FAMILY COUNSELLING
this is employed to bring about the resolution of problems identified by family members as related to the substance abuse
Types of Family Based Approaches in Addiction Treatment:
FAMILY THERAPY
this method is employed to bring about significant and permanent changes to intractable areas of systemic family dysfunction related to the substance abuse
Family Work in Addiction Counselling Themes:
- All couples and families have problems, but psychoactive drug use prevents resolution of these problems and creates new and more complex ones
- No individual can force another to change
- Personal change comes through accepting responsibility for one’s
own behaviour - All members of the family are involved in the problem, and all have responsibility in finding some form of resolution
- Removal of drugs from the family system represents a necessary beginning in the recovery process, yet is incomplete in itself
STAGES in Family Counselling
- Attainment of sobriety and unbalancing the system
- Adjustment to sobriety and stabilizing the system
- Maintenance of sobriety and rebalancing the system
Four STEPS in Family Counselling
- Family Engagement: the process of enhancing all family members’ involvement and investment in the treatment of the substance misuser.
- Relational Reframing: consists of interventions designed to move away from individual ways of defining problems and generating solutions, and toward an understanding focused on relationships instead
- Family Behaviour Change: aims to teach concrete new skills and encourage individual behaviour changes that will allow for improved overall family relationships
- Family Restructuring: change the way the family system is governed, examining the family’s underlying beliefs, premises, and rules. Family members are encouraged to understand the dynamics of their family, and how these dynamics are linked to problematic behaviours including but not limited to the drug misuse
CRAFT
Community Reinforcement and Family Training
- actively engages non-using family members, typically partners and children, to affect the behaviour of substance misusers
- stresses the importance of relationships in the treatment process
- active listening is stressed between all members of the family unit
- emphasis on self-care
When Not to Engage in Family Counselling
- If there is an alcohol-related crisis that is of greater urgency, family counselling needs to be delayed
- If there is great potential for violence in the relationship, safety concerns override the value of this type of counselling
- f family counselling leads to blaming or labelling, a re- examination of this approach is required
