Substance Abuse and Family Counseling

Substance Abuse and Family Counseling

When someone in the family uses substances whether it is drugs or alcohol, their substance use affects everyone in the family. The whole family suffers and plays different roles for the substance user. Whether they are enabling, or in denial that there is even a problem, or trying to just get through each day, everyone is affected.

Often times it takes many times and many things to happen before then substance user come to the point of truly wanting or being forced to get help. It may come to their spouse leaving with the children, the children being removed from the home by Child Protective Services (CPS), or for some other legal issue to arise like jail time. Everyone has their own rock bottom point.

In the case of the substance abuser being a teen, the parents may have the feeling that their child would not have a problem, or the parent uses too so they all think this is normal, or they may be in total shock and not sure what to do. The family members may be trying to figure out where to get help and how to get help not only for the substance user but for the family as a whole.  

The bottom line is the substance user is at the point of needing to seek counseling. They may even have it forced on them by the judicial system. In other words, they are mandated by the courts to seek counseling for the addiction. Usually this happens after they have gotten in trouble with the law.

Coming from the point of view of Family Systems Theory, the whole family needs to be involved in the counseling process. There are reasons their family member is using drugs or alcohol and those reasons effect each member individually as well as the family as a whole. These things need to be worked out in therapy not only for the substance user but the individual members of the family.  

If it is the case of a parent with substance use problems, the children and spouse are probably very hurt and angry. There are most likely issues of trust, or lack thereof, in the family because the substance user has lied or manipulated other family members. These are all issues that need to be addressed in family counseling. Children need to be able to express themselves in a safe place to their parents what they think and feel.

Part of my case load is working with the children and teens of substance users. These children are hurt and angry. They know what their parent is doing is not okay, but they are children so they don’t know what to do about it. They are stuck. In some cases children are taken away from their substance using parent and live someplace else because their parent or parents just can’t get it together to take care of them properly. These children get placed in foster care or go live with another family member.

Some children end up with the sober parent and they are trying to figure out what to do next. They again know what their parent is doing is not okay, but yet their parent still “chooses” alcohol or drugs over their family or children. Children feel neglected, angry, scared, and frustrated. 

The spouse needs to be able to express their feelings about how the substance use has affected the family. Counseling the family as a whole is an important part of restoring the family unit.  For some couples the best thing to help is marriage counseling to help figure out what to do and how to handle the substance use and other issues. For a couple to have marriage counseling to help restore the relationship and help support the substance user is just as important as family counseling.

In the case of teens that use, parents need to take a step back and realize that their teen is in serious trouble. The teen needs support and love in order to recover from their substance use issue. Parents need to realize their role in their teen’s recovery and what parents can do to help their teen. This could be change in rules, consequences, in general being held accountable for their actions.

Teens usually have reasons to use, like any substance user. Teens usually are trying to cover some kind of hurt or pain in their lives. If this is the case, your teen needs counseling not only for the substance use but also for the hurt and pain in their life. When I counsel teens I include the parents in the counseling process.  I as a therapist can only do some much to help a teen in my office once a week. They need tools they can use at home too. Then they need parents that will help them when they want to use in order to cope with a stressor.

Many believe the reason teens use is peer pressure. While this is true to a point, teens develop a substance use issue to cover some kind of trauma, divorce, abuse, low self-esteem, bullying, and so on. Teens want to fit in and pretend that everything is “normal.” The job of a counselor is to help them with the underlying issues and hopefully help with the substance use issue as well. The most effective way to do this is to involve the parents and other family members. 

While counseling for individual family members is important and needed, counseling for the family as a whole is also needed. The family needs to talk all together about issues and work things out together as a family unit. There may be things that the substance user isn’t even aware that happened that need to be worked out, or family dynamics that are not healthy that needs to change to make the family function better.

The sibling needs to be able to express to their sibling substance user how they feel about their substance use. A parent needs to hear the hurt that was caused by the parent to their child during a drunken fit. A parent needs to hear from their substance using teen why they use, even if that reason is because their parents got a divorce.

In order for the family to be made whole again, the family as a whole need to talk out issues that cause the substance use. They also need to talk out the issues caused by the substance use, divorce, financial problems, fighting, neglect, hurt feelings and so on. Until this happens there will continue to be problems in the family.

The key is finding an appropriate therapist or group of therapists that can work with the individual family members as well as the family as a whole. As well as helping the family to plug into resources in order to have complete care and recovery for every family member. Finding a therapist that not only understands substance addiction but also family dynamics is what would work best. As frustrating as it may be to have a family member who abuses substances, still understand your family as a whole needs help and to not be afraid to reach out to get the help that is needed.