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Recovery Solutions
For
Families With Addiction
Twelve Do's and Don'ts
For the Family
While the Family Member With Alcohol Use Disorder Is In Rehab
By Peggy L. Ferguson, Ph.D.
Help For Addiction
Your partner has finally entered rehab. After all the events leading up to their decision to seek treatment, you might be experiencing a mix of emotions. Dropping them off at the airport or treatment center brought relief, hope, or perhaps an anticipation of what comes next. There might be a moment of numbness before you wonder about your role moving forward.
You may ask yourself what you can do to support your partner during their treatment. Here are some guidelines for family members:
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If allowed, make brief and simple phone calls to them. Refrain from expecting daily calls and avoid waiting anxiously for their calls. Send supportive cards and letters and continue living your life.
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If they tell you they are ready to leave treatment after before the end of the anticipated length of stay, do go get them without talking to their counselor.
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When communicating with them, recognize that emotions can fluctuate during treatment. Avoid taking everything they say personally or at face value. If you're concerned about their mental health, reach out to the counselor.
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Please resist the urge to point out that you've been telling them the same things for years when they share insights from treatment.
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Offer reassurance of your love and support for their recovery journey. Reinforce their efforts by letting them know you have confidence in their ability to apply their learning to their recovery. Let them take responsibility for their healing process. If they mention cravings, understand that it's a normal part of recovery, and you don't need to solve it for them.
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Refrain from dictating the treatment plan to the counseling team. Share any concerns with the counselor honestly. They can address your worries and provide support.
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Collaborate with your partner on what to tell others about their whereabouts and progress.
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Handle logistical issues at home independently, but don't conceal any crises from the recovering individual.
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Save relationship problem-solving discussions for the family week, when you can have guidance in applying new communication skills to difficult topics.
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Manage your expectations realistically, understanding that change takes time.
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Respect your partner's privacy regarding their recovery materials and written assignments. Don't read their journals or homework assignments.
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Consider attending support groups like Al-Anon or seeking counseling for yourself.
By following these guidelines, you can provide meaningful support to your partner while caring for yourself during this challenging time. Note: This article has been revised and edited from its original version, which was previously published in 2009 on this site. The content has been updated for contemporary language, clarity and accuracy.
Addiction in the Family:
How Family Members Can Help
Each Other Heal
By Peggy L. Ferguson, Ph.D.
Early recovery is a challenging time, not just for the recovering person but for the entire family as well. Relationships are an integral part of a person's recovery process. A family's support and resources can be some of the most valuable recovery assets. The people who love the newly sober person provide love and support. Having a home and family is good infrastructure for building continuing recovery.
Unfortunately, many people expect that when alcohol or other drugs are out of the picture, everything will be just fine. The changes to a family system during recovery can be very trying and even feel traumatic. Active addiction has affected the entire family as the family adjusted to accommodate the changes brought about by the addiction. Everyone was affected.
In recovery, the changes of the recovering person also reverberate through the family system. A lifestyle change is one of the first things that should happen in early recovery. Many people find it necessary to avoid (at least in the short term) other people and environments that are not conducive to continuing recovery. For some recovering people, that might be their family. Social and leisure activities will probably change. Family interactions will change. How family financial resources are allocated or spent might change. Roles, rules, and responsibilities will change.
Family members will have their own sets of fears, unresolved resentments, insecurities, and expectations. Uncertainty is anxiety-producing, and no one knows what to expect. The expectation that everything will be fine without the alcohol or drugs may create pressure. Family members, especially spouses, who have been keeping the family afloat by "doing everything," may expect an immediate return of having a partner. Yet, they may also resist allowing the recovering spouse to be a partner—out of fear and mistrust or not wanting to give up any power. The recovering person may think that no one should expect anything of them besides their recovery. There will typically be many unrealistic expectations that can only be resolved through effective communication.
Communication is also a challenge in early recovery. Many people with addictions have limited feelings identification and communication skills. Recovery does not automatically imbue someone with skills. Family members may also find it challenging to change their modes of communication and problem-solving. Considering everyone in this family was in pain a short time ago, it is reasonable to expect unresolved hurt and anger. Family members, as well as the recovering person, will probably have sensitivity to certain topics of discussion and may have difficulty broaching complicated subjects.
Communication and problem-solving skills are developed with practice over time. Skill development begins with taking risks to talk to each other openly and honestly. Each partner expressing their concerns, needs, feelings, boundaries, and expectations is crucial to reconnecting on a relationship level and building those skills.
Both partners need to work on rebuilding trust. While recovery can be the beginning of growth and positive changes in a relationship, it can also reveal deeper issues that must be addressed. Good communication and problem-solving skills are necessary to resolving long-existing problems.
The first year of addiction recovery is often cited as the most challenging period of sobriety, not just because of all the effort it takes to stay sober but because of all the changes in family dynamics. Many marriages that survived decades of alcohol/drug addiction do not survive early recovery. Everyone in the family needs new skills. Each family member should be well engaged in their individual recovery. If you don't know what that would look like, do the research; get help. For your family to survive and thrive, all members should take special care to support each other, communicate frequently and effectively, and spend time together.
Family Dynamics of Addiction: Family Systems Can Work For or Against Your Recovery
By Peggy L. Ferguson, Ph.D.
By now, you probably know and understand that the addiction of a loved one affects everyone in the family. And you have probably heard that family members should seek help, even if they do not have an addiction themselves.
Another essential thing to understand is that families are systemic; each member affects and is affected by the others. Changes in one person impact the whole system. To illustrate this, imagine a mobile with grandparents at the top, parents in the middle, children below, and pets at the bottom. This mobile has a natural balance.
With any additional weight to a figure, the whole mobile adjusts to this change, finding a new balance. Withdraw the weight, the mobile (family) struggles to re-establish equilibrium. Families are just like this mobile.
Family systems with a loved one suffering from substance use disorder shift to accommodate the addiction-related changes in that person. As family members adjust their behavior, they often develop maladaptive coping behaviors and traits. These behaviors and traits may persist after their loved one has achieved sobriety. For example, a non-addicted spouse might take on most of the family responsibilities, inadvertently shifting the power dynamic in the marriage.
As the substance use disorder progresses, so do the family dynamics. Family members may eventually reorganize the structure and function of the system to have a life without the emotionally absent person with a substance use disorder.
When they transition into recovery and sobriety, these recovery changes create a need for another system shift. Family members, having adapted to the disabling effects of substance use disorder, may resist the changes needed for a recovery environment. The spouse who became the "responsible one" might struggle to relinquish this role, viewing the recovering person as untrustworthy. Trust takes time to rebuild--for everyone.
The newly recovering person may struggle to reconnect emotionally or to reclaim their roles and responsibilities, while family members may still be conducting themselves in ways indicative of a pre-recovery system mode, or they may walk around on eggshells, trying to prevent their loved one's relapse. Early recovery is often a very tense time for the whole family.
As a system in recovery, the family is called upon to adapt to the demands of changes in a family member again. Families often resist changes necessary for a recovery-promoting environment. Change can be scary and stressful. Recovery demands new skills for everyone, skills they don't automatically have.
Family members may yearn for old, predictable ways. A family member might even express a preference for the recovering person's behavior when they were drinking or using drugs. The whole family often harbors unrealistic expectations, believing that sobriety will automatically resolve all issues. They may not realize that sustained behavioral changes take time and a learning curve.
Family systems also often contain multiple family members with substance use disorder, creating complex dynamics that can perpetuate substance use. For example, family celebrations might still involve alcohol (or other drugs,) reinforcing old patterns. Defense mechanisms of those family members who still have active substance use disorders may contribute to disdain or derogatory behavior toward sober family members. The sobriety of a family member in a family system of multiple people with substance use disorder can be threatening to the system.
Early recovery involves maintaining sobriety while managing the conflicting expectations of family members. Unmet, unrealistic expectations can create confusion and stress for the newly recovering person. Identity changes in early recovery, and the newly recovering person may not yet know who they want to be. It is also confusing to family members. They don't know who they are "supposed to be." They don't know how recovery will change their relationship, their expectations of them, and whether they want the lifestyle changes conducive to a different life.
Ultimately, each person in recovery is responsible for their own journey. Encouragement and support for each family member is essential. Remember that each person's behavior and changes in the system affect and are affected by others' behavior and changes. The family needs information and communication. The newly recovering person may be able to guide family members toward information, help, and new skills with the tools they received from treatment. Everyone concerned must communicate to navigate these challenging times.
At Wit's End:
The Recovering Parent Trying to Figure
Out Normal Adolescent Behavior
By Peggy L. Ferguson, Ph.D.
When your young adult or adolescent child is displaying signs of relapse shortly after leaving the addiction treatment center, there are steps you can take to address the situation. The discharge planning probably included contingencies about your child returning home and the possibility of relapse. The treatment team and the individual with substance use disorder (SUD probably developed a formal relapse prevention agreement before discharge.
This agreement outlines parental expectations for maintaining recovery-oriented behavior in exchange for residing in the family home and other benefits. If your loved one with (SUD) and their treatment team did not establish a relapse prevention plan or a behavioral contract before your child left treatment, it's not too late to create one. A behavioral relapse prevention agreement isn't about punishment but establishing and upholding appropriate boundaries and structure to support the individual's recovery journey and facilitate a swift recovery if relapse occurs.
Parents who suspect that the minor child or adult offspring who shares their home has resumed substance use should consider conducting drug testing to confirm their suspicions and reduce denial or protestations of innocence. Home drug test kits for a variety of substances are available at local drug stores, or the parent can arrange for a urine drug screen at a hospital or health department. When confronting the individual about their substance use, having tangible test results may facilitate a more honest discussion.
If your child resides in the family home, they likely have access to various amenities such as the house, cars, television, and cell phone. The perks of living in the family home can serve as motivational factors. In the event of a positive drug test, you can establish a behavioral agreement outlining the consequences of future relapse.
A relapse prevention agreement (or behavioral contract) should include the following components:
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In exchange for residing in the family home and receiving support, the individual with SUD agrees to abstain from all mood-altering substances, including alcohol (except for psychiatric medications prescribed by a psychiatrist).
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If specific recovery activities are abandoned or significantly reduced, as a condition of living in the family home, the recovering person agrees to resume the specific recovery activity. If they refuse, the person with SUD may lose privileges, such as access to the car, television, cell phone, etc., until they resume appropriate therapeutic recovery activities. If a relapse occurs, the individual agrees to return to inpatient treatment, a halfway house, or another therapeutic setting pre-agreed upon by all parties.
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If a relapse occurs, the individual agrees to return to a higher level of care, such as intensive outpatient treatment, more frequent counseling sessions, inpatient treatment, a halfway house, or another therapeutic setting.
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The agreement can have additional supportive measures to facilitate recovery maintenance. These include such things as attending a specified number of 12-step meetings per week, undergoing random drug tests, adhering to a curfew, participating in day treatment, or attending outpatient counseling,
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If relapse recurs, the individual may forfeit the privilege of residing in the family home.
Parents should establish their boundaries and commit to enforcing them. If there's a firm boundary that the individual cannot reside in the family home while actively using substances, clearly state it in the agreement. However, empty threats are counterproductive. Parents and offspring confirm their agreement by having it documented in writing, signed, and dated by all parties involved.
For adolescents, it's essential to understand that parents cannot abandon them. If the child cannot continue residing in the family home due to ongoing substance use, alternative living arrangements, such as long-term inpatient treatment or a halfway house, should be arranged.
Community mental health or substance abuse treatment centers often have resources and referrals for such programs.
Parents are encouraged to attend support groups like Al-Anon regularly and seek guidance from individuals who have experience with a child's substance use disorder. Family counseling with an addiction specialist can help navigate emotions and communication strategies, addressing manipulative behaviors.
Educating yourself about addiction and its impact on families is crucial. Remember that you're not to blame for your child's substance use disorder, and you cannot control or fix it for them. By learning about family dynamics in addiction and recovery, you can identify enabling behaviors and encourage healthy boundaries that promote the individual's recovery journey.
More Articles on Substance Use Disorder
By Peggy L. Ferguson, Ph.D.
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Table of Contents
Is Relapse a Family Affair: Family Systems in Recovery and Relapse
Addiction Recovery Tools - Why You Want to Learn To Forgive In Recovery
Befriending Middle Ground in Sustained Recovery from Addiction
Addiction and Recovery: The Emotional Highs and Lows of Early Recovery
Family Dynamics of Addiction And Recovery: 14 Enabling Behaviors For Family Members to Quit Now
Boundaries as a Recovery Concept
Boundaries, Bottom Lines, and Threats: Knowing the Difference Can Empower Family Member Recovery
Family Addiction Recovery: My Loved One with Addiction Went to Rehab, Now What?
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Articles on Adolescents with Substance Use Issues are on the Adolescent Development and Challenges page.