Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

CHAPTER 24Family-Based TreatmentStages and OutcomesM. DUNCAN STANTONANTHONY W. HEATHThe importance of the family in the genesis, maintenance, and alleviation ofsubstance abuse has been well established. Although it is widely acknowledgedthat genetic and/or other biological components are important in the etiologyof many alcohol and drug abuse cases, addiction generally develops within afamily context, frequently reflects other family difficulties, and is usually maintainedand exacerbated by family interaction. Other factors can also be critical(e.g., environmental, economic, cultural), but family variables hold a positionof salience in addiction.Not surprisingly, treatment focused on changing family dynamics has afirm footing in the substance abuse treatment field. Family-based therapy iscommonly part of most successful substance abuse treatment programs and isusually considered an essential element in relapse prevention. As Craig (1993)has noted in an overview of the field, “The need to address family issues in acomprehensive treatment program is now widely recognized in drug abuse treatment”(p. 185). More specifically, a national survey by Fals-Stewart andBirchler (2001) of 398 randomly selected adult outpatient alcohol and/or drugtreatment programs found that 82% offered family- or couples-based counseling.Regarding younger patients, a review of treatments for adolescent substanceabusers by Williams and Chang (2000) concluded that “outpatient familytherapy appears superior to other forms of outpatient treatment” (p. 138),and that it should be a component of any treatment program for such youth. It528