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

532 V. TREATMENTS FOR ADDICTIONSin determining whether or not someone remains addicted, and the social contextof the abuser must be changed for treatment to “take hold.”Families can prove to be a highly positive influence in recovery as well.Eldred and Washington (1976) found that heroin addicts rated their families oforigin or their in-laws as most likely to be helpful to them in their attempts togive up drugs; the addicts’ second choice was their partner. Similarly, Levy(1972) found, in a 5-year follow-up of narcotics addicts, that patients who successfullyovercame drug abuse most often had family support, while Simpsonand Sells (1990) got 75% crediting family as a major reason for their enteringtreatment. In short, family therapists enlist the inherent leverage of familymembers.Like other treatment professionals who have worked with substanceabusingfamilies, family therapists know the difficulty involved in treating substanceabuse. Only by working together with extended families, specialists in thefield of chemical dependence, physicians monitoring pharmacotherapy, andself-help programs, can substance abuse and its related problems be ameliorated.Finally, professionals must talk to each other, if therapy is to succeed. Forexample, outpatient family therapists must visit local treatment centers and getto know the treatment teams. This investment facilitates referrals to residentialtreatment and subsequent referral for continued therapy upon release.STAGES OF FAMILY THERAPYOur purpose here is to present a model of the stages of family therapy thatsynthesizes much of the literature on family/couple therapy with (1) alcoholicadults (e.g., Berenson, 1976a, 1986, 1992; Davis, 1987; O’Farrell, 1993;O’Farrell & Fals-Stewart, 2000, 2001, 2002; Steinglass et al., 1987), (2) drugabusingadults (e.g., Fals-Stewart, O’Farrell, Birchler, Cordova, & Kelley, 2005;Kosten, Jalali, & Kleber, 1982–1983; Stanton & Todd, 1992; Stanton, Todd, etal., 1982), and (3) substance-abusing adolescents (e.g., Alexander & Parsons,1982; Fishman, Stanton, & Rosman, 1982; Henggeler & Borduin, 1990; Landau& Garrett, 1998; Liddle & Hogue, 2001; Piercy & Frankel, 1989; Stanton& Landau-Stanton, 1990; Szapocznik & Kurtines, 1989; Todd & Selekman,1991; Waldron, Slesnick, Brody, Turner, & Peterson, 2001). One reason wecan do this is because there is already a relatively high degree of consensusamong many of these authors. Although detailed descriptions of the techniquesof family therapy are, again, beyond the scope of this chapter, the literaturecited herein comprises a veritable treasure chest of useful family therapy methods.This presentation will, however, additionally incorporate a more recent,integrative model, developed in great part from working with substance abusers,