⋄ Substance abuse affects more than the immediate family.
⋄ Extended family members often report feeling abandoned, embarrassed by, ashamed of, and withdrawn from the substance abusing family member, often choosing to break relational ties.
⋄ Different family structures in which abuse affects the family relationship:
⋄ Client who lives alone or with a partner.
⋄ Both partners need treatment.
⋄ Groups are offered both for addicts and for non-addict partners of addicts.
⋄ The treatment of either partner will affect both.
⋄ Often, codependence is an issue.
⋄ Enabling may have to be explored
o Client who lives with a spouse (or partner) and minor children.
⋄ Parental substance abuse has a detrimental affect on children.
⋄ There may be triangulation or enmeshment issues if children are either placed in the middle or if non-using parent is overly protective and bonded with children due to the substance abuser’s lack of responsibility.
⋄ Issues of neglect or trauma may be present if both parents are abusing drugs.
o Client who is part of a blended family.
⋄ Substance abuse can intensify already shaky ground of newly blended families and become an impediment to integration and stability.
o An older client who has grown children.
⋄ As with child abuse and neglect, elder maltreatment can be subject to statutory reporting requirements for local authorities.
o Client is an adolescent and lives with family of origin.
⋄ Non-using children may find themselves neglected or ignored emotionally due to the focus of parents on the using child.
⋄ Often, at least one of the parents uses as well..
o Someone not identified as the client is abusing substances.
⋄ Issues of blame, responsibility, and causation will arise.
⋄ Scapegoating may be an issue.
⋄ Therapist must work towards uncovering the underlying motivations for substance abuse and other behavioral issues that bring the family into counseling.
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