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

24. Family-Based Treatment 529is therefore no accident that, of 10 adolescent substance abuse treatment programsidentified as exemplary models by the U.S. Department of Health andHuman Services (three of which were modified therapeutic communities), allinclude family members, particularly parents: seven apply family therapy, twoincorporate multifamily therapy, and one has groups for parents (Stevens &Morral, 2003).Over two dozen books have been written about family therapy for adultand/or adolescent substance abusers. These books, plus hundreds of chapters,journal articles, and papers, have described many different modalities of familytherapy, including couple therapy, parents’ group therapy, concurrent parentand index patient therapy, therapy with individual families (both inpatient andoutpatient), sibling-oriented therapy, multifamily therapy, social network therapy,and family therapy with one person. However, rather than reviewing thisvast literature, the intent in the present chapter is, first, to set forth some of thefundamental methods, or principles, of family/couples assessment and treatmentwith substance abusers and their families, and, second, to summarize thedocumented effectiveness of family- and couples-based therapies for this patientpopulation. Readers interested in further pursuit of this subject matter arereferred to overviews by O’Farrell and Fals-Stewart (2002, 2003) and Rowe andLiddle (2003), plus other literature cited later, for a more detailed understandingof the full range of theoretical and clinical approaches within the overallfamily/couples therapy approach to substance abuse. In addition, a brief synopsisof family systems concepts and theory is given in Stanton (1985), while aclinically oriented presentation of the foundations and key elements in familytherapy, per se, may be found in Hanna and Brown (1999).FAMILY PATTERNS OF ADDICTIONAddicted people are commonly in close contact with their families of origin orthe people who raised them (Bekir, McLellan, Childress, & Gariti, 1993; Cervantes,Sorenson, Wermuth, Fernandez, & Menicucci, 1988; Douglas, 1987/1988; Stanton, 1982). Either they live with one or both parents (at five timesthe national rates for same-age adults) or are in touch on a daily or weekly basis.This pattern extends to adult alcoholics (Stanton & Heath, 2004). Overall, 30of 32 reports, across seven countries, attest to such living arrangements or regularityof contact (Stanton, 2004; Stanton & Heath, 2004). These data indicatethat addicted people’s families are important to them, and that they are importantto their families.Stanton, Todd, and Associates (1982) summarized a number of other characteristicsthat distinguish drug-abusing families from other seriously dysfunctionalfamilies. The distinguishing qualities include the following: