Nov 20, 2017 in Psychology Category

Family Essay

Family - Based Substance Abuse Treatment

Family - Based Substance Abuse Treatment

The family has a very vital responsibility in the treatment of issues related to health even in matters of substance abuse. Family work has in the recent times been a robust theme of many approaches to treatment. However, there is a challenge that still remains with the widening complexity of the treatment focus on substance abuse from the person to the family. Even though substance abuse counselors ought not to practice family treatment except with proper licensing and training, they can get information concerning family treatment to be able to discuss the matter with the potential clients and get to know when referrals are indicated (Wise, Cuffe and Fischer, 2001). The counselors of substance abuse can also get benefits through the incorporation of the ideas of family therapy and strategies into their work with clients individually, clients’ groups or even in family groups. Thus, this essay paper seeks to define Family- Based Substance Abuse Treatment and highlight matters pertinent to family therapy and its effectiveness in dealing with substance abuse.

Family is a multifaceted term and may take different forms based on the setting, purpose and several other factors. However, it can generally be defined based on a person’s closest connections of emotions. A therapist cannot establish the people who make up the family of the client (Flicker, Turner, Waldron, Brody and Ozechowski, 2008; Ozechowski and Liddle, 2000). In an effort of doing so, the counselor should get to know the most important person to their client. This gives room for clients to point out the people to be included in the administration of therapy.

There is a considerable effect of substance abuse on the families of the abusers. All the same, this depends on the structure of the family. Substance abuse effects by an adult living solely or may be with a partner are usually psychological and economic. A lot of finances could be used for drug use; the role of provision is usually assumed by the person who is not using the drugs. Psychological consequences could take into account the protection or denial of the individual having the disorder of substance use, anxiety, stress, chronic anger, improper sexual behavior, isolation, shame, hopelessness, stigma and neglected health.

The substance use by a parent can have psychological, cognitive behavioral and emotional consequences for the children (Hogue, Dauber, Samuolis and Liddle, 2006a). These include an impaired capacity of learning, a tendency to have a disorder of substance abuse; issues with making adjustments like increased rates of violence, divorce and the urge to manage and influence relationships; other issues like anxiety, low self-esteem and depression. Additionally, the children raised by women abusing alcohol in their pregnancy are prone to disorders of fetal alcohol spectrum. The children of the people with disorders of substance abuse usually have guilty feelings and are responsible for the substance abuse of the parents (Austin, Macgowan and Wagner, 2005). Children who are older could be compelled prematurely to take on adult roles, particularly taking care of their siblings.

Family therapy is a group of therapeutic strategies that are founded in the family level intervention and assessment. Family- Based Substance Abuse Treatment is therefore a substance abuse treatment approach that relies on this foundation. A family is basically system and as expected, there are parts that are related in any kind of system. Therefore, any changes in one of the parts will result into changes in the rest of the other parts. Therapy founded on this stand point utilizes the family strengths to realize a change in a variety of diverse issue areas that includes the abuse of substances (Flicker, Turner, Waldron, Brody and Ozechowski, 2008). Family therapy can however be applied when the safety of all those taking part in it is guaranteed without any legal constraints. It is important for counselors to be trained in dealing with families with neglect and/or violence.

There are differences that exist between the treatment of substance abuse and family therapy. Even though these two are compatible in various ways, the fields of family therapy and substance abuse make use of disparate terms, at times understand similar terms in a different way, have disparate professional expectations and requirements, and are managed through various assumptions. All the same, there should be a demarcation between family therapy and family-based therapy. Family based therapy seeks to make families learn concerning the connection parading that basically add up to the continuation and formation of substance abuse (Hogue, Liddle, Singer and Leckrone, 2005). It is different from the issue of family therapy because family is not the basic therapeutic grouping and again, there is no intervention in the family relationship system. Many substance abuse treatment institutions provide such kind of a family educational strategy.

Family- Based Substance Abuse Treatment is the most comprehensively researched behavioral treatment modality for substance abuse amongst adolescents (Austin, Macgowan and Wagner, 2005; Flicker, Turner, Waldron, Brody and Ozechowski, 2008; Hogue, Liddle, Singer and Leckrone, 2005; Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011; Wise, Cuffe and Fischer, 2001). Most of the findings in these studies suggest that family and individual factors determine attendance for therapy. However, these factors vary based on the mode of treatment. Some strategies of engaging families that have parents limiting the autonomy of their adolescents could enhance rates of attendance for the family therapy.

Family-based treatment clinical innovations take into account the establishment of a detailed therapy, supervision/training, and strict adherence manuals (Hogue, Liddle, Singer and Leckrone, 2005). Various family-based treatments have undergone tests with achievement in controlled process studies and trials. Various versions of a similar strategy could differ on such parameters as the setting, treatment dose, and the characteristics of the client. Development in research incorporates findings that retention and engagement rates for the family-based treatments are advanced to standard treatment retention/engagement methods (Flicker, Turner, Waldron, Brody and Ozechowski, 2008). Again, in clinical trials where they are put in comparison with other interventions, in many studies, the family-based treatments offer superior and robust results with improved decreases on the drug use and alcohol target symptoms and other related issues like family, delinquency and school problems as well as affiliation with peers abusing substances.

Change mechanisms studies support theory foundation of these family-based treatments. For example, developments in the patterns of family interactions connect with decreases in the main target drug and alcohol misuse symptoms. The moment the shadow of the field of adult substance abuse is attained, the young person’s substance abuse area of expertise becomes a distinctive, clinically innovative, and experimental. Suggestions for non-family based involvement in the youthful substance abuse treatment expertise have been provided by surveys and proven advances of kin-founded treatments. Information from teenagers recruited in escapee camps indicate high rates of kin and personal calamities, although a small number of restricted treatment assessment surveys have been carried out. Teenagers recruited in escapee camps are said to have left home for more than 24 hours without their parents consent, as depicted by the united states department of health and human services (Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011). Consequently, these teenagers and their parents are difficult to involve and sustain in substance abuse treatment, which is of detailed concern since the treatment foresees positive treatment results.

Efforts to curb substance abuse have been made by investigators ability to look for predictors of youthful treatment, as surveys report a broad collection of predictors from different collection methods and approaches. The objective of this research was to investigate and evaluate predictors of meeting turnout for three physically oriented interventions with substance abusing teenage escapees and their guardians. Knowledge on the factors connected with meeting turnout is of aid in adjusting involvement efforts initiated in the therapy course with the aim of enhancing treatment maintenance and consequences. It has been noted that in the comparison of family therapy and physical and elegant option treatments, few dissimilarities in general treatment maintenance are established. Research in the three physical treatments has not established any distinctions in the general percentage of probable meetings attended (Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011).

Nevertheless, family therapy is considered to be effective with the engagement of teenagers in comparison to personal therapies. This is pointed out by the fact that a greater number of teenagers are involved in a family therapy (Jackson-Gilfort, Liddle, Tejeda and Dakof, 2001). There is a possibility that parents and their teens encourage one another when subjected to family therapy. Family therapy is alleged to meet the requirements of these families since it permits a debate to talk about any family clashes that resulted to teenage living at the escapee camps. Family therapy produced the shortest appointment period in the course of recruitment and the initial treatment meeting. The creation of a first meeting with families immediately after recruitment was linked with incorporation of additional therapy meetings to those allocated with family therapy. Such kind of research is related with another one conducted in a part in the United States, which comprised of young escapees living in camps (Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011). In such, a number of the results were not carried out in individual therapy positions.

There is a possibility that family therapy could be associated with quickened involvement that allows therapists in assisting the family in resolving escapee disaster, which could develop the assurance and association of the family to the therapy procedure (Flicker, Turner, Waldron, Brody and Ozechowski, 2008). Family therapy has also helped to reunion the teenagers who felt less connected to their families at the fundamental interrogations.

Non-existence of connection with parents is a common grumble amid the escapees living in camps. This calls for the urge to repair the broken relationships among parents and their teenagers. Among the objectives of the family based therapy is to reunite family members, thereby, serving to encourage more families to participate in therapy sessions. It has been noted that teenagers restricted by their parents do not attend many of the sessions. Alternatively, parents who restrict their teenagers are less likely to participate in therapy meetings for fright of loosing restriction power (Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011). Consequently, therapists make efforts to make sure that they build a good relationship with the teenagers and their parents.

Based on gender, a greater number of girls attended therapeutic sessions compared to the boys even though gender diversities were also noted in treatment circumstances (Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011). Numerous studies have reported that girls are more relaxed when it comes to discussions related to emotional and liaison matters compared to boys. Enhanced participation among girls than boys is reflected since the therapy is more focused on individual relations and emotional subjects. However, it is reputed that various substance abuse treatment studies have not yet established diversities in treatment preservation amid teenage boys and girls. Reporters of these differences affirm that girls have a likelihood of attending therapy meetings and reacting positively to discussions compared to boys. Few research reports based on family therapy indicate involvement rates or results by means of sexual category (Jackson-Gilfort, Liddle, Tejeda and Dakof, 2001). The few results could be linked with restrictions in organization linked with undersized illustrations.

Results with no gender sensitivity were established in comparisons of involvements not based on the family. The difference in this outcome and the recent studies could be brought about by relational dynamics that are specific to escapee families. Family therapy associations are not deeply engaged on emotional links compared to the modern family association. However, studies are required to explore the role of sexual category in treatment maintenance. Research on substance abuse treatment maintenance among boys and girls is yet to be established. This is because a small number of studies examine the restrained sexual responsibilities. Gender disparity on matters family based treatment for substance abuse has had significant contribution in the therapeutic processes and relationships (Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011). Boys getting family-based treatment that emphasize basically on relational and emotional matters could need targeted involvement approaches to assist them control the associated stress and anxiety.

The need for the inclusion of family therapy in the program for adolescents for serious abuse of substances was been based on two major issues (Flicker, Turner, Waldron, Brody and Ozechowski, 2008). For one, it has been for the reason of moving the young people from the edge position of marginal participation to a role that is more central and pertinent to the treatment of the young people, and; again for the purposes of putting together the knowledge from the substance abuse treatment filed with those emanating from the family therapy field.

Family therapy is an amalgamation of therapeutic strategies based on the excellence of family level intervention and evaluation. Therefore, a change that affects a part of the family system goes a long way in impacting on the other parts. The unit of treatment in family therapy is the family and/or the person in the family system context. The individual abusing substances is termed as a subsystem within the system of the family. This is actually the individual with serious implications symptoms for the wider system (Jackson-Gilfort, Liddle, Tejeda and Dakof, 2001). The familial connections inside such a context are the therapeutic interest points and the intervention for the counselor.

The family based therapy enhances discussion with usually the whole family group or subsets thereof and at times with only one participant, who could or could not be the individual with the disorder of substance abuse. Therefore, it is the emphasis on the family, more than the incorporation of many people that gives definition to family therapy (Hogue, Liddle, Singer and Leckrone, 2005). With this in mind that various systems affect individuals encountering substance abuse and an actual systematic strategy must offer consideration to the person, cultural, community, family, societal and economic considerations.

The application of family systems strategy implies that members of the family are seen as interconnected and interrelated. What happens for a particular member of the family and impacts on the others again affects the other members of the family (Wise, Cuffe and Fischer, 2001; Ozechowski and Liddle, 2000). In a framework of family systems, the individual using drugs is a member of the family who shows symptoms taking into account co-occurring challenges and drug use. Such challenges are indicative or understood at least partly of other things taking place in the system of family.

Families are the most enduring and the strongest force in the development of adolescents and children as well (Austin, Macgowan and Wagner, 2005). As a result, family-based treatments have been researched as interventions for those abusing substances and have been seen as effective in dealing with both substance abuse and other related problems and behaviors happening at the same time. Addiction to opiate amongst the adolescents does not take place in isolation. It takes place along with other challenges and behavioral problems. Such problems that co-occur can be very difficult for the system of the family as the addiction along with the addiction-linked behaviors.

Family therapy has been applied as a treatment intervention. In various controlled trials meant for family therapy in the problem of drug use, treatments including partners or other members of the family were much more successful than strategies that actually did not, even though the findings have been confined to evaluations of the use of drugs (Slesnick, Erdem, Collins, Bantchevskab and Katafiaszb, 2011). The retention and engagement of treatments based on the family have produced superior results to those that have been attained in a standardized treatment procedure, and that in most of the studies, treatments based on the family had high and robust results, with major decreases in symptoms of drug use and alcohol and other problems related to it like delinquency, family and school problems and affiliation with peers abusing substances.

Regardless of the well-documented negative consequences that substance abuse has on the system of the family, interventions have seemed to emphasize on the substance abuser while little attention has been given to the families. In the recent past, the inclusion of families as having an increasing role in the treatment of substance abuse has been established. On matters of influencing and/.or preventing the substance abuse course, enhancing substance linked consequences for the individual and assisting in the reduction of the negative effects for the other members of the family. Families have continued to be been seen as agents of the change anticipated in therapy and that can assist in reducing symptoms relapse.

Thorough assessment realized that family treatment achieved in high degrees of retention and engagement when put in comparison with other kinds of psychotherapies with substance users (Hogue, Liddle, Singer and Leckrone, 2005). The significance of family therapy as an intervention procedure is based specifically on the focus on retention and engagement in such services of the people with many psychosocial challenges.

From the past, family-based treatment of substance abuse has been founded on two important pillars: the family plays a significant role in the making of conditions pertinent to the substance abuse; and that some family surroundings and parent-child relationships could both protect the children from the misuse of drugs and provide antidote for the use of drugs that has already started. All the same, these constructs do not apply in a framework that is multidimensional of adolescent substance abuse. When the focus is put on interacting and simultaneous influences a lot of these in an indirect way takes into account the family. For instance, the diverse neighborhood disorganization realms, an association with peer groups with deviant behaviors, age at initial use and school failure (Austin, Macgowan and Wagner, 2005). Well, these are independently robust adolescent substance abuse predictors.

Substance abuse and use in the period of adolescence are strongly connected with other behavioral problems like school dropout, delinquency or sexual behavior. Any emphasis on drug abuse or use to the segregation of such compares, regardless of being antecedent, consequent or contemporaneous, destroys the phenomenon by way of emphasizing on only a single aspect or a general pattern component (Etheridge, Smith, Rounds-Bryant and Hubbard, 2001). While drug abuse by teenagers is a behavior that is personal, it is glued to a socio-cultural framework that stalwartly determines its manifestations and character (Hogue, Liddle, Singer and Leckrone, 2005). At this present age, family-based treatment models are defined as conceptually multi-component based on intervention.

In conclusion, there is increasing strong evidence that has shown full support for family-based and social network based interventions in the abuse of substance treatment. The field of family-based treatment for substance abuse research has gone through developments in the recent past. This has offered a contextually oriented structure with interventions that correspond and has significantly contributed to the larger specialty of substance abuse amongst adolescents. The counselor needs to understand family systems theory. Family systems theory is a method employed to mitigate or offer treatment through the encouragement of the spirit of interdependence among members of the family and the society at large instead of laying focus on people in isolation from the entire family or community. Family systems theory takes into account modern methods of family therapy. It seeks to establish the knowledge about something in the process of finding a solution to it. As though this was not enough, everyone wants to know what life is and how it arose. Who and what can give the vivid description of the complexity of life especially for the substance abusers? Language and mind are also amazing in how they emerged. The function ability of the brain also remains a puzzle to many despite the many efforts put to establish the same.

More and more evidence has come up in the support of interventions that are focused on the family when dealing with substance abuse. The knowledge about something like substance abuse amongst the adolescents could be as a result of the social interaction of a person with others. The society in which a person lives could be a foundation of the knowledge that they posses. The knowledge possessed and applied by the people around could be easily transferred from one person to another. The beliefs and conviction of many people have been found to be transferable from one person to another. This idea has formed a foundation of knowledge for most cases. This can happen in a scenario where there is a leader and other people who work under him or her. The acquaintance of two different groups will lead to the distribution of knowledge between them. This relationship will amount to more understating of the subject by both parties involved. Both sides learn from the social contact and interaction. The way an individual relates with the world has led to the emergence of factual information about the systems of the world.

The origin of a new concept could be obtained from the relationship between the world and the organisms therein. This plays an important stage in getting the ground information about something. There is no self –foundation in the study of knowledge. The origin of the knowledge about something must come from a known foundation. Family-based treatment for substance abuse can thus be achieved in this way. The impact of family-based treatment for substance abuse has gone a long way in bringing about effective therapy. The advantages and usefulness of family-based substance abuse treatment has been widely seen from various researches and has found a major application across the globe. Even though the area has remained fragmented and lacking room for methodological enhancement, the evidence realized has supported the concept that the involvement of the family can amount to enhanced results for both the members of the family affected through the substance abuse, the substance abuser and the impact on the wider contextual challenges.

References

Etheridge RM, Smith JC, Rounds-Bryant JL, Hubbard RL (2001). Drug abuse treatment and comprehensive services for adolescents. Journal of Adolescent Research 16:563–589

Flicker SM, Turner CW, Waldron HB, Brody JL, Ozechowski TJ (2008). Ethnic background, therapeutic alliance, and treatment retention in functional family therapy with adolescents who abuse substances. Journal of Family Psychology 22:167–170

Hogue A, Dauber S, Samuolis J, Liddle HA. (2006a). Treatment techniques and outcomes in multidimensional family therapy for adolescent behavior problems. Journal of Family Psychology, 20:535–543

Hogue A, Liddle HA, Singer A, Leckrone J. (2005). Intervention fidelity in family-based prevention counseling for adolescent problem behaviors. Journal of Community Psychology, 33:191–211

Jackson-Gilfort A, Liddle HA, Tejeda MJ, Dakof GA. (2001). Facilitating engagement of African American male adolescents in family therapy: a cultural themes process study. Journal of Black Psychology,27:321–340

Ozechowski, T.J. & Liddle, H.A. (2000) Family-based therapy for adolescent drug abuse: knowns and unknowns. Clinical Child and Family Psychology Review, 3, 269- 298.

Slesnick, N.; Erdem, G.; Collins, J.; Bantchevskab, D. and Katafiaszb, H. (2011). Predictors of treatment attendance among adolescent substance abusing runaways: a comparison of family and individual therapy modalities. Journal of Family Therapy 33: 66–84

Wise BK, Cuffe SP, Fischer T. (2001). Dual diagnosis and successful participation of adolescents in substance abuse treatment. Journal of Substance Abuse Treatment, 21:161–165

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