Family counselling

The family has a central and pivotal role to play in the treatment of any health problem including psychiatric disorders, substance abuse problems and process addictions. The family’s involvement not only increases the rate of change but also makes it easier to maintain the changes necessary for the successful outcome of treatment.

I offer an integrated approach to helping families deal with the devastating effects of psychiatric illnesses and addictive processes which involves counselling, psycho-education and preventative strategies and resources to bring about healthier communication channels, behavioural changes and strengthen ‘connections’ within the family system.

The family intervention and counselling that I offer entails:

• Exploring the meaning of illness within the family and the maladaptive roles family members have developed in relation to “it”;
• Helping family members heal from the destructive effects of illnesses;
• Focusing on eliciting the strengths of every family member;
• Building stronger, more effective relationships within the family, focusing on expectations of change and testing new patterns of behaviour;
• Identifying at risk family members who may be the targets of abuse or violence;
• Preventing younger generations from adopting addictive behaviours as well as learned helplessness;
• Creating a home environment that supports health and sobriety;
• Reinforcing the authority of parents or guardians;

A family unit may consist of:

• two unmarried partners,
• a traditional nuclear family,
• a blended family or a group of people who share a home and a strong emotional connection.
• It may also include others who are in the client’s inner circle – ‘concerned others’ which could range from work colleagues to
• friends to any significant person in the addicted person’s life.

The majority of those that are seriously impacted by addiction, are not in addiction themselves, but have an important caring relationship with those who are.

Family members are often remarkable in their ability to carry on despite the chaos, shame, guilt, worry, fear and stress brought into their lives by the addiction of another. In most cases the family has endured the brunt of the consequences for the loved one’s addiction (including financial stresses and life adjustments to accommodate the addicted person’s lifestyle). The illness twists love concern and willingness to be helpful into a host of enabling behaviours and co-dependent patters that only help to perpetuate the illness.

The help that family and friends offer and engage in is often the wrong kind. Families may be attached to the status quo and might not want to see their situation change. Couples may have developed a co-dependent relationship and the emotional symbiosis may seen too powerful to break. I therefore, address the function and purpose that addiction and illnesses serve within the family and assess the family’s level of motivation and commitment to the change process. If directed towards effective strategies and interventions the family can become a powerful influence in helping their loved one receive the necessary help. At the very least, families can detach themselves from the painful consequences and cease their enabling behaviour.

There are 3 different aspects of family-involved counselling that I offer:

1. Prior to treatment – Interventions

For the family and/or friends surrounded by addiction, addressing the addiction is one of the most difficult aspects of helping the person get the necessary treatment that they need. Each family is different and the best way to approach family involvement with addiction therapy will differ with every person.

I offer families, (which initially may or may not include the client), an intervention process of how best to facilitate moving the struggling and suffering person towards treatment and what form of treatment would be best for that particular person. I assess what the unique needs are of both the family and the client; evaluate the motivational factors of both the family and the client and make recommendations about the movement towards recovery.

2. During a Client’s Substance Abuse Treatment Program:

There are number of options available when seeking treatment for the client and family:

• Residential in-patient program at a treatment centre – the family will be involved and included in this treatment process;
  Outpatient programs – usually 8 weeks duration-for substance abuse and process addictions – the family are included and involved in the treatment process;
• I offer individual psychotherapeutic sessions for the family on an outpatient basis;
• I offer family members individual psychotherapy in their pursuit of change which includes working with co-dependence and adult children of alcoholics ;

The attendance of 12 Step Groups are of fundamental importance for the family.

While the client is engaged in a treatment process I remain purposely peripherally involved (to avoid splitting), liasing with the therapeutic team with the clients consent. I do, however, continue to see the family members individually or as a unit, in order for them to gain a new perspective and to focus on their own unhealthy patterns of behaviour and communication.

3. After the Client Has Completed a Program:

There is no clear-cut ‘end’ to the addiction and recovery treatment process and attending both therapeutic sessions and 12 Step meetings, for ongoing support and education, makes an enormous difference to the outcome of effective treatment for all those in recovery.

I would highly recommend ongoing care for the family at this tender stage of recovery.

I have provided 14 ways that family members and/or ‘concerned other’ can help their ‘loved one’ and themselves:

THE DO’S:

1. Learn the facts about addiction (substance and or process). Obtain information about addiction and how to live in relation to “it” through supportive individual psychotherapeutic counselling with an addictions specialist as well as attending open 12 Step meetings, for example, Al-anon, Nar-anon etc. Refer to SUPPORT STRUCTURES under LINKS on my website.
2. Be honest – tell the person you have been concerned about them and what you will and won’t tolerate. The addict’s behaviour and consequences are informative and telling versus what they say.
3. Be vigilant – don’t ignore or deny the evidence that something is not working, as painful as this is.
4. Be gentle – help guide and assist the person to get help for themselves. Seldom do people change without the threat of a loss or a loss, so there is always external pressure facilitating the addicted person towards treatment. If they are in denial or too young to be responsible for themselves, consult a professional about a structured intervention.
5. Join a family group and/or support group or seek individual supportive therapy for yourself.

THE DON’TS:

1. Don’t rescue the addict due to your own anxiety. Let them experience all the consequences of their addiction.
2. Don’t financially support the addict or their addiction
3. Don’t analyze the addict’s using or addictive behaviours. Don’t look for underlying causes at this stage. It is an unhelpful circuitous process.
4. Don’t make idle threats. Say what you mean and mean what you say. If an agreement is made, then stick to it.
5. Don’t extract or believe promises or accept lies and being outsmarted. A person in active addiction cannot keep promises and will always manipulate and lie to protect their ongoing usage/addiction.
6. Don’t preach, lecture, moralise, scold, threaten or argue as this will be not only be discounted by the addict but also provide an opportunity for the addicted person to wage ‘an external war’ and engage in destructive conflict.
7. Avoid the reactions of pity and anger for and towards the addict.
8. Don’t accommodate the disease or be exploited, for example, adjusting your lifestyle, work schedule, family home and attitudes for the addict.
9. Don’t delay. Things will only get worse.

Each of these suggestions can be approached separately as individual goals. When you begin to make changes for yourself, on how to be in relation to ‘it’, you will begin to feel more empowered as you commit to end your entanglement in the destructive and damaging chaos. It may be met with resistance, no doubt, by the addict or possibly other family members, but finding a strategy to end enabling behaviour and withdraw inappropriate support might be the ‘difference that will make a difference’ for both the addict and the family members.