Family Systems and Family Therapy of Substance Abuse: An Overview of Two Decades of Research and Clinical Experience

Abstract

Substantial recent progress has been made in the study of family systems and in the field of family therapy. The gradual application of these new technologies to the field of substance abuse is discussed. A shift has occurred toward quantitative assessment of the three generational systems of the substance abuser as well as inclusion of that entire system in the family therapy. Family therapy treatment methods have been developed to motivate substance abusers, detoxify them, and work with the family when the identified patient is not involved in treatment and to restructure the entire family. The field of family therapy evaluation is in its infancy but plans are underway for elaborate scientific investigation of efficacy.

Involving significant others in the care of opioid-dependent patients receiving methadone

“…BCT generally requires the participation of spouses or romantic partners. The majority of opioiddependent patients receiving methadone are either uninvolved in stable intimate relationships or highly resistant to recommendations to include their stable partners in the treatment process (e.g., Kauffman, 1985;Kidorf, Brooner, & King, 1997). These problems combine to limit the feasibility of BCT to a potentially small proportion of patients receiving methadone, and the therapy requires a level of experience and expertise that routinely exceeds the resources available in many programs using methadone (Fals-Stewart & Birchler, 2001).…”

Community reinforcement and family training (CRAFT): engaging unmotivated drug users in treatment

“…To our knowledge, the only controlled evaluation to date of a strategy for counseling CSOs of drug-dependent individuals is that of Szapocznik et al (1983Szapocznik et al ( , 1988, whose research focused on adolescents, and who conducted unilateral family interventions through the drug abuser. Family-engaged strategies more generally have shown promise once drug abusers are in treatment (Stanton and Todd, 1982;Kaufman, 1985;Kaufman and Kaufman, 1992), and a parallel literature shows substantial benefit from the inclusion of CSOs in the treatment of alcoholism (McCrady, 1989;O'Farrell, 1993). Research on posttreatment trajectories also indicates that family and social support play a key role in the maintenance of outcomes (Moos et al, 1990;Constantini et al, 1992).…”

Estimate of global research trends and performance in family therapy in Social Science Citation Index

“…On account of the two studies, healthy family structure and communication patterns between family members became the concerns of many family therapists. Later on, family therapy was applied in a number of studies with such topics as anorexia-nervosa and bulimia-nervosa (Barcai 1971;Russell et al 1987), substance abuse (Kaufman 1985;Mclellan et al 1993), and depression (Topper and Curtis 1987;Brent et al 1997) as well as adolescents (Kerdman and Cooper 1966;Brent et al 1997), children (Safer 1966;Minuchin et al 1975), and couples (Olson 1970;Stanton and Shadish 1997).…”