Substance Abuse Treatment & Family Therapy | Family Involvement in Treatment

About Family Involvement in Substance Abuse Treatment

Families of drug or alcohol abusers go through a lot of painful feelings as they struggle with their loved ones’ addiction. Sometimes these family members are overlooked as help is being offered to the person with the drug or alcohol problem. New initiatives have been formed in recent years that focus on substance abuse treatment and family therapy, and it has proven to be a benefit to not only the user, but also to his or her family as well. Support groups have also been organized that help family and friends deal with those with addictions.1

Support for Spouses of Individuals Struggling With Addiction

It has been said that alcoholism is a family disease, affecting the entire family.2 Perhaps spouses are the first to notice a problem with addiction, and their lives may change the most. A once-loving spouse and parent to their kids becomes withdrawn, depressed, unreliable, and hard to spend time with. It is very painful to watch someone you love wreck themselves over substances.

Support for Parents of Individuals Struggling With Addiction

Parents go through much pain also as they watch a child struggle with addiction.3 Feelings of helplessness, failure, and embarrassment are common in these situations, and often parents question where they went wrong and don’t know how to fix it.

family therapy & involvement in substance abuse treatment

Support for Children of Individuals Struggling With Addiction

Children, however, may often suffer the most. To not have the parent around to care for them properly or to spend time with them takes its toll on children. Abuse and neglect commonly go along with parents that do drugs or are alcoholics, and these kids suffer greatly. It is common for these kids to go on to abuse substances themselves one day.4

In fact, it has been shown that children of parents struggling with addiction are more than twice as likely to develop a drug and/or alcohol use disorderby young adulthood than their peers.5 Moreover, these children may also be at risk for a variety of additional negative outcomes, such as social, behavioral, and emotional problems, as well as cognitive and educational challenges.6 Considering the debilitating effects of substance abuse on children and their development, it is crucial for treatment facilities to offer appropriate family support to mitigate the associated risks.

Substance Abuse Treatment and Family Therapy

Many drug and alcohol treatment facilities also offer help to families and encourage family therapy.7 This offers benefits to family members, and it may improve treatment for the individual struggling with addiction. Often, families can provide support and resources to help the user live without the substance. Sometimes the family is even motivation for an abuser to succeed in treatment, such as a mother who works extra hard to overcome addiction in order to be with her children again.


Because addiction has such a strong effect on the family of an individual struggling with addiction, it is important for families to receive support themselves. Al-Anon and Alateen (for younger family members) offer help and hope to addicts’ families. Al-Anon holds regular meetings throughout the country for family members to share their experiences, learn from other people’s stories, and be encouraged to find their own strength and happiness.

The Importance of Family Therapy in Substance Abuse

Family involvement has a crucial role to play in substance abuse treatment and a complex one at that. Family members can be a source of support and help to the addiction treatment process. however, they should also be provided with adequate resources for managing the consequences of their loved one’s addiction. Offering support for the entire family can be of immense benefit for the overall effectiveness of treatment.8

For those family members suffering in silence while a loved-one abuses drugs or alcohol, there is help out there for both the user and the family. It is important to encourage the user to get treatment and counseling to overcome the addiction. It is also important for the family to receive treatment in order to move on with their lives. And even if the drug user or alcoholic won’t free themselves from the substance, their family members can and should get help so they aren’t left suffering alone with the problem.

Frequently Asked Questions

  • Substance abuse is associated with a great number of social and family problems which may create a significant burden for the user, their family, and society. Some of the adverse effects of addiction on the user’s family and friends may include:9
      • Emotional burden on the family, such as anger, anxiety, fear, worry, frustration, guilt, and shame.
      • Economic burden on the family caused by spending money on the substance or money problems related to job loss.
      • Relationship dissatisfaction or distress caused by tension and conflict resulting from substance abuse.
      • Family instability resulting from abuse, violence, or family breakup due to divorce or separation.;
      • Effects on child development caused by substance use during pregnancy (neonatal abstinence syndrome), as well as an increased risk for neglect or abuse, poor emotional regulation, poor impulse control, behavioral issues, impaired academic performance, mental health issues, and the development of substance abuse.
    • Effects on parents of children struggling with substance abuse may include feelings of guilt, helplessness, anger, frustration, or depression.

    The effects of substance abuse on the specific family or concerned friends of the user can vary depending on the severity of the disorder. They can also depend on the presence of other issues such as psychiatric illnesses, available support, and the coping mechanisms used by the family and other concerned individuals.

  • Since substance abuse tends to affect the entire family, joint treatment of family members is often required. In fact, family involvement can play an essential role in the diagnosis of substance abuse and follow-up treatment.;

    Considering that substance abuse may be a response to a variety of fluctuations in the family system,involving the family in the treatment process can help solve the underlying conflictsthat may have given rise to substance abuse. This may help prevent relapse and extend clean time for the individual struggling with substance abuse, as well as provide the necessary treatment and support for all family members affected by it.10

  • The term “parental substance misuse” is used to refer to parents or caregivers who struggle with long-term misuse of alcohol and/or drugs. This may include:11
    • Parents who consume excessive amounts of alcohol that lead to accidents and health issues.;
    • Parents who are dependent on using alcohol.;
    • Parents who use drugs excessively and regularly.
    • Parents who are dependent on using drugs.;
    • Parents who are unable to supervise children due to their substance abuse.;

    Parents and caregivers who struggle with substance abuse often lead unpredictable and chaotic lives. This may render them unable to recognize and meet the needs of their children, which may put the children at risk.;

  • Parental substance abuse may cause lifelong issues if the child is not provided with adequate treatment and support, includingappropriate family therapy options. Common effects of substance abuse on parenting include the following:12
    • A parent may neglect or forget parenting responsibilities because of substance abuse.;
    • A parent may leave their child alone in order to seek, obtain, or use the drug.;
    • A parent may be impatient or angry with their child because of substance abuse and its effects.;
    • A parent may fail to provide for the child’s basic hygienic, medicinal, or nutritional needs.
    • Parents may go out and stay all night due to intoxication, leaving their children alone.
    • If the drug requires preparation, e.g. “cooking”, the child may be at an additional risk of fire, explosions, and unintentional absorption of the drug.
    • A parent struggling with addiction may have depressive episodes or anger outbursts and create an unstable home environment for their children.

  • A parent or a caregiver of an individual dealing with substance abuse can play a crucial role in getting them the treatment and support they need. Here’s how they can help:13
    • Communication: as a parent or caregiver, you may be able to help an addicted individual by expressing your concern, offering support, and creating a loving, judgment-free environment.;
    • Compassion: being patient and expressing a willingness to provide a loved one with the resources they need can be of great help in their recovery process.;
    • Openness: if relevant, discussing family history of substance use and/or mental illness may help the individual struggling with addiction feel less alone.;
    • Education: parents and caregivers can learn how to better support their adult or teenage children struggling with substance abuse by educating themselves on the nature of substance abuse itself and the available forms of therapy and treatment.;
    • Seeking support: family interventions and whole-family involvement in substance abuse treatment have shown great promise in achieving long-term recovery and mitigating the effects of addiction.14

    Family therapy can help not only the individual struggling with substance abuse, but also the family as a whole. It can help the family make the necessary intrapersonal, interpersonal, and environmental changes to improve family functioning and help the loved one who is abusing drugs or alcohol.

1. Ameral, V., Yule, A., McKowen, J., Bergman, B. G., Nargiso, J., & Kelly, J. F. (2020) A naturalistic evaluation of a group intervention for parents of youth with substance use disorders. Alcoholism Treatment Quarterly, 38:3, 379-394.

2. Center for Substance Abuse Treatment. (2004). Substance abuse treatment and family therapy. Rockville (MD): Substance Abuse and Mental Health Services Administration.

3. Chassin, L., Pitts, S. C., DeLucia, C. (1999). The relation of adolescent substance use to young adult autonomy, positive activity involvement, and perceived competence. Development and Psychopathology, 11(4), 915-932.

4. Daley D. C. (2013). Family and social aspects of substance use disorders and treatment. Journal of Food and Drug Analysis, 21(4), S73–S76.

5. Hussong, A. M., Flora, D. B., Curran, P. J., Chassin, L. A., & Zucker, R. A. (2008). Defining risk heterogeneity for internalizing symptoms among children of alcoholic parents. Development and Psychopathology, 20(1), 165–193.

6. National Society for the Prevention of Cruelty to Children. (2020). Parental substance misuse.

7. Saatcioglu, O., Erim, R., & Cakmak, D. (2006). Role of family in alcohol and substance abuse. Psychiatry and Clinical Neurosciences, 60(2), 125–132.

8. Solis, J. M., Shadur, J. M., Burns, A. R., & Hussong, A. M. (2012). Understanding the diverse needs of children whose parents abuse substances. Current Drug Abuse Reviews, 5(2), 135–147.

9. Substance Abuse and Mental Health Services Administration. SAMHSA families: Family support guide.

10. Substance Abuse and Mental Health Services Administration. The effects of substance of abuse on behavior and parenting handout.