Family structures in the United States have become more complex. Today, other than the traditional nuclear family, there exists single-parent families, stepfamilies, and foster families, among others. Substance abuse significantly affects family members regardless of the household’s structure. Recent research into alcohol and drug abuse points out that substance abuse harms the addict, destroys relationships, and creates emotional turmoil for family members. The emotional stress on the family members emanates from them witnessing the struggles of their addicted relatives, which is why such dependence is considered a family disease, and for it to be cured, household members and the addict need to be included in treatment therapy. Alcohol and drug abuse have significant impacts on families and children, therefore, households can incorporate the use of family therapy to solve issues of addiction, and therapists can utilize various therapy theories and techniques to address such issues.
Although different family structures might experience distinct effects of addiction, there are common ways in which all these families are affected the matter. One of the effects of substance abuse is instability within the family system (Akin & Gomi, 2016). In many instances, addicts are unreliable, and in such a case, family members assume the responsibilities of the addict (Akin & Gomi, 2016). Conflict and instability within their families then ensue. Drug addiction also leads to mistrust, lying, and stealing (Daley et al., 2018). Once an individual becomes an addict, he or she might turn to lying and stealing to hide and support the substance abuse. Such behavior, in turn, creates mistrust and emotional turmoil within their families (Daley et al., 2018). Furthermore, substance abuse leads to financial distress in a family and on the addict as well. Substance abuse can lead to absenteeism and decreased productivity, among other work issues, which may lead to dismissal from work and leaving the family without a source of income. Consequently, members of the family could face dire consequence, such as evictions (Nadeem et al., 2017). Such a family may not even afford proper healthcare and nutrition, leading to poor health.
Other effects of substance abuse on an addict’s family include conflict amongst the members, shame, and denial. Nadeem et al., 2017 addiction often leads to negativism and lack of communication within various family structures. In such instances, anger and resentment cause family members to lash out at one another, and complaints and criticism become the norm in such households. Substance abuse leads to family members being subjected to shame and denial within society. Thus, many households affected by a member’s addiction tend to work hard in life to cover up consequences such as denial and shame (Nadeem et al., 2017). At times, some members resort to substance abuse to cope with the shame and denial thus compounding the problem.
Substance abuse affects every member of a family although children and adolescents are worst hit by a parent’s addiction. Children tend to experience neglect and abuse as a results of addiction amongst parents. In the United States, 40-80 percent of all child abuse cases are related to parents who are substance abusers who leave their children to fend for themselves (Nadeem et al., 2017). Moreover, according to Nadeem et al. (2017), drug addiction leads to parental inconsistency, which leads to children receiving mixed teachings from parents about acceptable behaviors. In such circumstances, children may lack a clear picture of what is right or wrong thus they may engage in inappropriate behaviors thinking they are right.
Role of Family Therapy
Family therapy plays significant roles in addressing issues of addiction with various households. Family therapy is a collection of approaches that share a belief in family-level assessment and intervention. A family is regarded as a system, and in each system, all the parts are related to each other. Consequently, a change in one area impacts other parts of the family systems. Family therapy attempts to use the strengths of families to bring change to a wide range of challenges that a particular household might be facing (He, 2017). It has numerous roles in helping to solve issues of substance abuse within American households. These include improving the mental and physical states of entire households that have been affected by a member’s addiction; assisting the substance user to regain his or her awareness and good behavior; improving communication styles and relationship qualities within the affected families; helping the affected households to understand enabling behaviors; and addressing codependent behaviors amongst the addicts that may be preventing their quick recovery (Henggeler, 2018). Other roles of family therapy involve preventing other members from engaging in substance abuse or the behavior that could spread down to the family’s future generations and permitting households to gain self-care interventions to help them improve their well-being.
Bepko and Krestan’s theory is one of the most applicable models in solving the issue of drug addiction within a family. The approach focuses on a substance addict and the substance of abuse as a system (Reiter, 2019). Moreover, it explores the interpersonal, intrapersonal, and gender systems. The objective of this therapy is to help an addict’s family to be responsibile for themselves and eliminate the need to assume other people’s roles. The theory asserts that a family should incorporate three treatment techniques, including pre-sobriety, early sobriety, and maintenance, to achieve this objective (Reiter, 2019). The theory contends that in pre-sobriety, the family is expected to block emotional responsibility to an addicted member and ask him/her to go to the self-help group for rehabilitation (Reiter, 2019). In early sobriety, children are allowed to express how they feel related to a family member’s addiction problem, and how they have been affected, while maintenance focuses on dealing with anger management and self-control amongst the family members.
Specific Family Therapy Interventions appropriate for Nurse Practitioners
Some of the family therapy interventions that are appropriate for nurse practitioners in addressing issues of substance abuse within households include solution-focused therapy, Stanton’s therapeutic techniques, and multisystemic therapy. Solution-focused therapy focuses on the options that are available to a family to help address a particular addiction issue (Taylor, 2019). According to Taylor (2019), the goal of this therapy is to help families find solutions to their problems, to build strong relationship amongst family members, and help a client realize that he or she can stop using alcohol or drugs and maintain sobriety. Taylor (2019) asserts that nurse practitioners can use this therapy in identifying and developing intrinsic solutions for a family facing the challenge of living with an alcohol or drug addict. A nurse can also use the therapy to help a family realize that it has to play a role in ensuring an addict maintains abstinence from substance abuse.
Nurse practitioners can also use Stanton’s therapeutic techniques to address an addiction issue within a particular family. This concept asserts that nurse practitioners should negotiate with the family members at the beginning of the treatment (Reiter, 2019). After that, the nurse practitioner is required to assign behavioral tasks to various subsystems within a family and attempt to offer effective solutions that might bring change to the entire family system. As mentioned, another family therapy intervention that might be appropriate to nurse practitioners in addressing addiction issues within a family is multisystemic therapy (Henggeler, 2018). In this therapy, nurse practitioners are required to address risk and protective factors as they impact the family in context and identify the strengths of each subsystem and their relationship to substance abuse.
Numerous agencies across the United States address the issue of substance abuse in families including the Substance Abuse and Mental Health Services Administration (SAMHSA) and National Center for Biotechnology Information (NCBI). SAMHSA addresses the issue of addiction within families by urging all grantees to provide a tobacco-free workplace and to promote abstinence from all tobacco products. SAMHSA offers a solution to its grantees on how to resolve tobacco addiction amongst their workers and family members. Moreover, it contends that its grantees should find appropriate behavioral treatment and support for individuals who suffer from drug addiction. The United States National Center for Biotechnology Information (NCBI) is another body that addresses how issues of addiction amongst families can be solved. The body contends that therapists can incorporate various techniques to help solve issues of addiction amongst families, such as dry abstinence, sobriety or early recovery, and advanced recovery. In dry abstinence, therapists can help clients to cope with problems revolving around the use of substance use. Regarding sobriety, therapists can help clients to engage in health-sustaining behaviors that promote abstinence from substance abuse. Lastly, in advanced recovery, therapists can help substance addicts to develop strong relationships with their family members and help them to fully recover from substance use.
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Daley, D. C., Smith, E., Balogh, D., & Toscaloni, J. (2018). Forgotten but Not Gone: The Impact of the Opioid Epidemic and Other Substance Use Disorders on Families and Children. Commonwealth, 20(2-3). https://doi.org/10.15367/com.v20i2-3.189
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Taylor, E. R. (2019). Solution-Focused Therapy with Children and Adolescents. https://doi.org/10.4324/9781315166674