Substance Abuse and Family Interaction

Abstract

The authors propose that substance use and abuse may be understood and effectively treated when the individual user or abuser is viewed in the context of his family or stable living group. This viewpoint attributes an important role in the maintenance of individual substance abuse to interactional processes within the family system. The theoretical assumptions implied by this viewpoint are discussed. A selective literature review examines the available evidence, from both experimental and clinical-descriptive studies, that is relevant to this proposal. The next step toward a more systematic investigation of these ideas is outlined, including testable hypotheses, methodological issues and problems, and potentially useful techniques.

Family therapy and psychopathology: developments in research and approaches to treatment

“…He suggests that the abuser's behaviour functions to provide the parents with a problem that conceals the lack of intimacy in their own relationship. Similar descriptions, based on clinical observations rather than empirical research, have been made (Alexander and Dibb, 1975;Klagsbrun and Davis, 1977;Noone and Reddig, 1976). …”

Expanding the family systems approach: Cultural, class, developmental and gender influences in drug abuse

“…Some studies have focused on adolescent drug abusers (Coleman, 1980;Egger et al, 1978;Kaufman & Kaufmann, 1979;Klagsbrun & Davis, 1977;Madanes et al, 1980;Schwartzman & Bokos, 1979), while others have used a retrospective approach with older addicts (Alexander & Dibb, 1975;Duncan, 1978;Graeven & Schaef, 1978;Stanton et al, 1978). Still other studies examine the re-creation of family-of-origin problems in the family-of-procreation (Harbin & Mazier, 1975;Seldin, 1972).…”

'Can I (let you let me) leave?’ Therapy with the adolescent and his family

“…T h e processes frequently associated with pathology during adolescence are in themselves normal. 'There is some evidence that all families go through a regressive phase during the adolescence of an offspring, their temporary disturbance paralleling the adolescent's turbulent stage of development' (Klagsbrun and Davis, 1977). It is, however, in extreme instances that these processes are most dramatically highlighted.…”

“…I t is unwise to attempt too much too soon, especially with families who have an addicted member. Klagsbrun and Davis (1977) quote Wellisch who maintains that drug-abusing families '(are among) the hardest families to treat, but the family approach is the only approach that will work'. Although an extreme claim, it seems likely that the issues of reentry, differentiation, the renegotiation of family interrelationships, and of separation associated with adolescence in the broadest sense of fifteen to thirty years, are intensified around life threatening situations such as drug abuse (Stanton, 1977), serious suicide gestures (Richman, 1979) and severe psychosomatic illness (Palazzoli, 1974;Minuchin et al, 1978).…”

“…* A structural approach, with an emphasis on family hierarchy was sustained throughout the seven session treatment period. In recent years attention has been given to the r6le of the family in the maintenance of substance abuse (Klagsbrun and Davis, 1977) with an emphasis on structural interventions in treatment (Stanton, 1977;Kaufman and Kaufmann (Eds. ), 1979;Haley, 1980).…”