Social workers can assist these clients by looking for signs and symptoms of parental substance use while observing the child’s behavior in social settings and in play behavior. Social workers should look for how the child’s presenting symptoms serve a function in the family system to maintain homeostasis. Providing family therapy, parent training and education, play therapy, social skills training, and coping skills training either in individual or group therapy in an outpatient, school or in-home therapy setting are ways that social workers can be helpful. Social workers can help by using trauma-informed, attachment-informed, and systems-based approaches to direct practice in individual therapy and family therapy with special attention to multigenerational trauma and substance abuse. The role of the social worker may include providing in-home therapy supporting parents in being more effective with parental supervision, providing structure, and facilitating healthy caring communication. Social workers may serve on multidisciplinary teams to advocate for a child who is adjudicated, abused, and/or neglected.
For instance, in newly formed blended families, conflicts are typical between parents on how to parent and between a parent and stepchild on the rights of who can discipline, who holds authority, and so forth. Common challenges for single parents include the stress of balancing many responsibilities while parenting. Understanding family types can help counselors anticipate expected and normative family issues that SUDs can complicate (Exhibit 1.4). Integrate specific family counseling models, techniques, and concepts into SUD treatment to enhance effective family coping and healthy communication patterns—paving the road toward recovery for everyone in the family.
Directory of Family-Based Residential Substance Use Disorder Treatment Programs for Parents with Children
Strengths Oriented Family Therapy (SOFT)55–56 has some initial efficacy evidence in the treatment of adolescent substance use.57 Adolescents are seen in family and multi-family groups for about two hours each session. SOFT was specifically developed in an effort to build on previous family therapy treatments by substance abuse counseling adding motivational components, solution-focused terminology, and a strengths assessment. The emphasis on both youth and parent motivation shows the importance of the family context in adolescent substance use, while the strengths assessment attempts to leverage protective factors for the benefit of the youth.
- More recently, there has been an increased interest in the expectations of
negative outcomes that individuals hold about substances. - Patients also may have evidence-based expectations, based on their previous history and experiences in the offices of health care practitioners.
- Students explore these concepts in various biological, situational, environmental and cultural contexts to implement evidence-based practices when working with diverse populations of all ages.
- Mariah is a freelance writer who has written content related to higher education, career development, finance, and travel.
- It is often necessary to help the client change
the passivity and sense of helplessness that often accompany low
self-efficacy. - The preferred timeline for family therapy is not more
than two sessions per week (except in residential settings) to allow time to
practice new behaviors and experience change.
Although active substance abuse can impair attachment and healthy modeling for affect regulation, sometimes the consequences of severe and ongoing substance abuse on the part of a parent can result in parent and child separation. In extreme cases, the separation may be due to the substance-related death of the parent from overdose, motor vehicle accident, or medical complications due to substance abuse. The significant increase in out-of-home child placements in the 1980s and 1990s closely paralleled the pandemic drug addiction in the United States during those decades (Jaudes & Edwo, 1997). Any long-term separation will have a negative impact on the child’s ability to attach, regulate affect, and can lead to a trauma response of numbing or hyperarousal (inability to discriminate and respond appropriately to stimulus). These impairments in the psychological emergency response system are directly related to, and substantially increase, subsequent traumatic victimization.
Are Therapists Qualified to Treat Substance Use Disorders?
There can also be differences in which parent makes which types of decisions for the family. For instance, a sister may have a private conversation with her sibling, which the sibling then shares with everyone in the family without the sister’s permission. Another example is a child privy to too much adult information about a sibling, parent, or other person. However, some families have very strict boundaries that keep people outside the family from engaging with or providing support to family members. Similarly, rigid boundaries can restrict communication or discussions across generations. For example, a father may state, “This is just the way it is in this house,” without allowing discussion of the rule or boundary in question.
However, in contrast to drug treatment, less evidence is
available concerning the effectiveness of such contingency management
approaches in the treatment of alcohol problems (Higgins et al., 1998). The aim is not to remake
personality, but rather to help the client address specific, identifiable
problems in such a way that the client is able to apply the basic techniques and
skills learned in therapy to the real world, without the assistance of the
therapist. Behavioral therapy focuses more on identifying and changing
observable, measurable behaviors than other therapeutic approaches and hence
lends itself to brief work. Treatment is linked to altering the behavior, and
success is the change, elimination, or enhancement of particular behaviors. According to behavioral theory, changes in behavior come about through learning
new behaviors. Because substance abuse behavior is learned, it can be changed by
teaching the client more adaptive, alternative behaviors aimed at achieving the
same rewards.
Pharmacotherapies for alcohol use disorders
Currently, an individual or a family member seeking treatment for an addictive disorder is not likely to be offered a treatment drawn from the extensive list of well-studied and empirical evidence-based practices provided previously. How, and whether, an evidence-based intervention is translated and implemented into routine clinical settings may be the final element of evaluating its evidence base. For example, an intervention could not be considered effective in clinical practice if it is found to be too costly to do, ethically untenable, too complicated to implement, not economically supported, not suitable for regular patients, or too complex for most clinicians to learn.
