What part will the family play in treatment?

Why programs involve families

NIDA's Principles of Drug Addiction Treatment says family and friends can play critical roles in motivating someone to enter and stay in treatment, and that involving a family member or partner in treatment can strengthen and extend its benefits. NIDA's page on treatment and recovery describes family therapy as a way to help people, especially young people, and their families address influences on drug use.

Addiction affects the people around someone, and those relationships are often part of what the person returns to after treatment. Family involvement can help everyone understand what has been happening and what might need to change at home.

What family involvement can look like

Programs differ, so ask what yours offers. Some run education sessions for families about addiction, treatment and recovery. Some hold family days or visiting times. Some offer family counseling sessions, where the person in treatment and one or more family members meet with a counselor together.

NIDA describes some counseling approaches that include a partner or family member directly. For example, one approach involves the person in treatment and at least one significant other, such as a partner or parent. In another, people are sometimes encouraged to bring someone close to them to sessions. NIDA also notes that one alcohol medication can be given in a monitored way, such as by a spouse, which can make it more effective, though that is a decision for the prescriber and the person.

What you might be asked to do

You might be invited to attend sessions, share your experience of how drinking or drug use has affected you, learn about what recovery involves or talk through what will happen when the person comes home. You may be asked to think about your own patterns, such as covering for the person or avoiding certain conversations.

That can be uncomfortable. Being asked about your part is not the same as being blamed. The aim is usually to understand how things work in the family now, so that home can support the changes the person is trying to make.

What you do not have to do

You do not have to take part if it is not safe or not right for you. If there has been violence, threats or abuse, tell a counselor privately before any joint session, and ask whether a separate approach is possible. A family session should not require you to sit with someone who frightens you.

You do not have to agree to things you cannot do, such as supervising someone around the clock or providing housing. It is better to be clear about your limits now than to make promises that break down later.

Consent and privacy

The person in treatment usually has to agree before the program includes you or discusses their care with you. The guide on what a program can tell family explains why. If they do not want family involvement right now, the program may still offer you general education or suggest support for yourself.

Getting ready for family sessions

Before a session, think about what you most want the person and the counselor to understand. Concrete examples are more useful than general accusations: “When you didn't come home on Friday, I stayed up all night calling hospitals” says more than “You never think about anyone else.”

Think too about what you would like to happen when they come home. The guide on what to agree on before someone comes home from treatment can help you prepare.

Support for you, separate from their treatment

Your needs matter whether or not you are involved in the program. NIAAA's treatment booklet notes that changing long-standing patterns is hard, takes time and requires repeated efforts, and it lists family support groups among its resources. ASAM's page on addiction mentions options for people supporting a loved one, including SMART Recovery Family & Friends, Al-Anon and a family approach called CRAFT.

You can use those supports during treatment and afterward, whether or not the person you love keeps going.