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Your Loved one

INTRODUCTION

We, as human beings, are not just our thoughts, feelings, and behaviors. We are also, as Sheldon Pearlman ¹ suggests, social beings.

If you are impacted by the problematic substance misuse of a family member or partner, this section is for you. You may be dealing with addiction in your family of origin (your mother, father, or sibling) or in your current family (spouse, child, or partner). If you have a parent that is struggling with addiction, you may be familiar with the term “adult child of an alcoholic.” If you have a child or spouse with an addiction, you may have heard the term “codependent.”

This section attempts to provide an overview of family therapy so that, by understanding the various approaches, you will be that much closer to finding the help you need not only for your loved one but for yourself as well.

Before we look at current approaches to family therapy, however, let’s answer a basic question: why should a family that is struggling with addiction bother with family therapy?

(1) Source: Pearlman, Sheldon in Theories on Alcoholism (1988) C. Douglas Chaudron, D. Adrian Wilkinson (Eds.), Alcoholism and Drug Addiction Research Foundation, Chapter 8 – Systems Theory and Alcoholism, pg. 290.

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THE BENEFITS OF FAMILY THERAPY

Why involve our partners and family members in the treatment of an individual with an addiction? As mentioned above, all individuals with substance abuse have a family of origin and many have families of their own. When substance abusers communicate with their family these interactions can have no effect on the problem, maintain the problem, make the problem worse, or help resolve the problem.

As far back as 1974, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) identified marital and family therapy as “one of the most outstanding current advances in the area of psychotherapy of alcoholism” ¹. Since then,  
A number of studies have shown the effectiveness in family therapy. In 1996, McGrady and Epstein ² concluded that “a rich body of empirical literature provides strong support for family-based models and for the effectiveness of treatments based on these models.”

(1) Source: Keller M, ed. (1974), Trends in treatment of alcoholism. In: Second special report to the U.S. Congress on alcohol and health. Department of Health, Education, and Welfare.

(2) Source: McCrady, B.S., & Epstein, E.E. (1996). Theoretical bases of family approaches to substance abuse treatment. In F. Rotgers, D. Keller, & J. Morgenstern (Eds.), Treating substance abuse: Theory and technique (pp. 117-142).

Involvement of the Family of Origin

Research has shown that people who abuse alcohol or other drugs remain closer to their parents and siblings ¹,² than the general population.

Examples of instances when working with the family of origin may prove beneficial include:

  • Parents (particularly mothers) who continue to protect their teenage or adult child from the consequences of their substance abuse (known as “enabling”)
  • Parents who are so focused on their teenage or adult child that they begin to neglect their own personal well-being (known as “codependency”)
  • Siblings who do not have problems with substance abuse but carry resentments toward the addicted sibling. These resentments can be due to the addicted sibling’s negative impact on the well-being of the rest of the family or for constantly being the center of attention.

 

(1) Source: Bekir, P.; McLellan, T.; Childress, A.R.; and Gariti, P. (1993) Role reversals in families of substance misusers: A transgenerational phenomenon. International Journal of the Addictions 28(7):613-630.
(2) Source: Douglas, L.J. (1987) “Perceived family dynamics of cocaine abusers, as compared to opiate abusers and non-drug abusers.” Ph.D. diss., University of Florida at Gainesville, 1987.

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Involvement of Current Family (Partner, Adult Children)

Involvement of the current family is typically provided as marital or couples therapy and, to a lesser degree, therapy involving adult children. Research has found that marital therapy produces better marital and treatment outcomes than non-family methods ¹. Harvard Medical School showed more than 50 percent of alcoholic husbands who participated in couples counselling were abstinent after one year after treatment compared to 30 percent of husbands who were treated with individual therapy ².

Examples of instances when couples therapy may be beneficial include:

  • Partners who may resent changes in the life of the addicted partner such as increased participation in meetings (NA, AA, etc.) or the amount of time spent with other people who are in recovery
  • Partners who lack trust in their partners who wish to resume family responsibilities that were not possible during the active stage of addiction
  • Changing roles where the partner in recovery is resuming responsibilities

 

(1) Source: Lowinson, J.H.; Ruiz, P.; and Millman, R.B. (1997) Substance Abuse: A Comprehensive Textbook, 3rd ed.
(2) Source: Harvard Counseling for Alcoholics’ Marriages Project

Circumstances when Family Therapy is NOT Recommended

There are few instances in which involving family members does not provide at least some benefit to an individual with substance abuse problems. Exceptions, however, do exist and include when a client is:

  • unwilling to work with partners and family members
  • struggling to come to terms with separation or divorce
  • a victim or perpetrator of physical, emotional, or sexual abuse
  • part of a family that includes other members who are also actively using substances, violent, excessively angry, or deny that the client has a substance abuse problem

 

In these instances, individual rather than conjoint therapy (where partners or families are together in therapy) is recommended.

A historical review of the role of family in addiction treatment will also provide a better understanding of the various approaches to family therapy.

Source: Treatment Improvement Protocol (TIP) 34: Brief Interventions and Brief Therapies for Substance Abuse, Chapter 8 – Brief Family Therapy (2004) Substance Abuse and Mental Health Services Administration (SAMHSA).

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THE ROLE OF FAMILY IN ADDICTION TREATMENT FROM A HISTORICAL PERSPECTIVE

There are now many approaches to involving significant others with substance abusing family members. Furthermore, family therapy has been effectively utilized with a number of special populations such as those with co-existing mental illness (dual diagnosis), military veterans with substance abuse disorders, older adults with substance abuse disorders, and HIV-positive clients with addictions.

However, the early days of family therapy were a far different experience for partners and significant others of individuals struggling with drugs and alcohol.

Partners and Family Members as the Root Cause of Addiction

When it comes to being a family member of someone with an addiction, you should know that the history of helping people in your situation has been, unfortunately, one of “social stigma, public neglect, and professional misunderstanding” ¹.

Rather than crediting parents and spouses for keeping the family together despite the addicted individual’s destructive ways, many addiction professionals often view family members as a nuisance or threat to the treatment process.

For example, in 1936, Richard Peabody believed that domineering mothers and shy, despondent fathers created low self-esteem and anxiety in their offspring which would, eventually, lead to alcoholism ².

Some therapists of the era, including noted addiction researcher E.M. Jellinek ³, even recommended that alcoholics isolate themselves from family members.

In the early 1950s, Thelma Whalen (4) characterized alcoholics’ wives as being equally responsible for marital misery due to their own dependency issues while Futterman (5) described wives of alcoholics as egomaniacs, happy only when their husbands were drunk and helpless.

In 1961, Day (6) went one step further and suggested that an alcoholic’s family of origin, particularly the overly protective, overindulgent mother and strict, distant father created a low tolerance for pain and frustration and hampered efforts by the alcoholic to live independently.

(1) Source: All in the Family: Addiction, Recovery, Advocacy (2003) William White and Bob Savage.
(2) Source: Peabody, R. (1936) The Common Sense of Drinking.
(3) Source: Jellinek, E.M. (1942) Alcohol Addiction and Chronic Alcoholism.
(4) Source: Whalen, T. (1953) Wives of alcoholics: Four types of observed in a family service agency. Quarterly Journal of Studies on Alcohol, 12:632-641.
(5) Source: Futterman, S. (1953) Personality trends in wives of alcoholics. Journal of Psychiatric Social Work, 23, 37-41.
(6) Source: Day, B. (1961) Alcoholism and the family. Marriage and Family Living, 23, 253-258.

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The Rise of Al-Anon, Alateen and the Adult Children of Alcoholics Movement

Faced with such disregard from health professionals, and recognizing the power of peer support, wives of the then male-dominated self-help group Alcoholics Anonymous (A.A.) began to form their own groups. This growing movement led Lois Wilson, wife of A.A. founder Bill Wilson, and her friend Anne B. to eventually co-found Al-Anon Family Groups in 1954.

Three years later, a separate peer group called Alateen was started to provide mutual support for 12- to 20-year-olds affected by alcoholism.

In 1954, Joan Jackson 1 published addiction research based on interviews with family members. This research, made possible by the advent of Al-Anon, found that, contrary to popular opinion, family members were more often the victim than instigator of a significant other’s substance abuse.

Furthermore, Jackson went on to study how alcoholism led to developmental problems in children of alcoholics ². This research eventually led to the Adult Children of Alcoholics (ACOA) movement, which reached its peak in the mid-to late-1980s (see below).

For more information on Al-Anon, Alateen and other self-help groups see the 12 Step Support Groups section.

(1) Source: Joan K. Jackson (December 1954) The Adjustment of the Family to the Crisis of Alcoholism, Quarterly Journal of Studies on Alcohol, pp. 562-86.
(2) Source: Joan K. Jackson (1964) Drinking, drunkenness, and the family. In D. Pittman & C. Snyder (Eds.), Society, Culture and Drinking Patterns (pp. 472-492).

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The Recognition of the Family Dynamic in Addiction

The dynamic nature of family interactions and its effect on substance abuse has been recognized as far back as 1937 ¹. To understand the family dynamic, consider a couple where the husband is an alcoholic. When the therapist asks the alcoholic husband why he drinks, the alcoholic may say his drinking is caused by his wife’s nagging. On the other hand, when the therapist asks the wife why she nags her husband, she may explain that she nags her husband because he drinks so much. So, as you can see, the cause-effect of the substance abuse depends on who you ask. Family therapists will assert that focusing on the interaction between the couple and its dynamic effect on drinking or drug use is a better approach.

The growing recognition of the alcoholic family as a dynamic system, however, did little to dispel the notion that the alcoholic’s spouse and family of origin had their own psychopathologies and were often the cause, or a complicating factor, in the persistence of alcoholism.

Considered in its historical context, it is little surprise that spouses and family members would come to resent the commonly-held clinical theory that they were to blame for addiction in the family. With little support from clinicians of the day, Al-Anon would continue to grow in popularity and a new theory, addiction as a “family disease”, would rise to prominence.  

(1) Source: Lewis, M.L. (1937) Alcoholism and family casework. Social Casework 35:8-14.

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The Origins of Addiction as a “Family Disease”

Just as the disease concept of alcoholism was able to provide solace to alcoholics and drugs addicts in the 1960s that were often characterized as having a moral deficit, the addiction as a “family disease” theory provided an alternative explanation to explain why families are often unable to resolve an addiction in the family.

According to White and Savage ¹, the theory of addiction as a ‘family disease’
“. led to research in how the disease altered family structure (roles and interactions among family members), family rituals, and family boundaries.”

In the 1970s, two primary mechanisms of the disease model were identified that helped explain why families seem incapable of effectively dealing with problems associated with addiction: (1) denial and (2) enabling.  Denial is defined as consensual agreement that denies or minimizes that alcohol or drugs are the root cause of problems experienced by the addicted individual and his family.  Enabling is defined as behaviour practiced by family members that protect addicted individuals from experiencing the negative consequences of their drug or alcohol use.

Furthermore, the theory of addiction as a family disease led Reverend Vern Johnson ² to develop family interventions based on the idea that families could “raise the bottom” by withholding financial and emotional support until the addicted family member entered treatment.

In the 1980s, two overlapping movements would evolve out of the “family disease” concept – Adult Children of Alcoholics (ACOA) and Codependency.

(1) Source: All in the Family: Addiction, Recovery, Advocacy (2003) William White and Bob Savage.

(2) Note: For more information on Vern Johnson and family interventions see the Family Intervention Help section.

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The Growth and Decline of the Family Disease Model

In the 1980s, Claudia Black ¹ and others produced national best-sellers that described the developmental consequences of parental alcoholism on children and the psychological consequences that endured as these children became adults. No longer was the focus on the alcoholic or addict. Instead, family members had access to their own treatment and support services. According to Stephanie Brown ², between 1983 and 1990 the National Association for Children of Alcoholics (NACoA) organized more than 1,500 local support groups.

In the middle 1980s, the family disease model would find new advocates with the growth of the codependency movement. Codependency (or codependence) is characterized by a preoccupation that the family member has with the addict, especially in trying to change the behavior of the addicted adolescent, adult child, or spouse. This “enmeshment” with the life of the addict came to be defined as a “disease” by codependency advocates, an obsession similar to how “loss of control” is described by some as the “disease” of an addict or alcoholic. Furthermore, just as abstinence is advocated by some as the way out for the addict, loving detachment holds similar promise for the codependent.

In 1987, Melody Beattie would become a sensation with her bestselling book Codependent No More ³. The following year, John Bradshaw would bring additional attention to the dysfunctional family with his best-selling book and PBS television series, Healing the Shame That Binds You (4).

In the 1990s, however, the ACOA and codependency movements would become victims of their own success. As the concept grew in popularity, more programs were established in cities all across America. With so many programs in need of more and more clients, the definition of codependency was expanded to include virtually anyone who grew up in a dysfunctional family. With no empirical research to support codependency, a growing list of critics (5), and a condition that seemed to be universal, insurance companies successfully argued first for cutbacks on treatment duration. Eventually, insurance funding ended for many addiction treatment programs, leading to the closure of many facilities.  

Although the glory days of the 1980s are over, the ACOA movement has left a lasting legacy which, according to Margolis and Zweben (6), “placed increasing pressures on treatment centers and clinicians to respond to the needs of family members who had previously been ignored in more traditional chemical dependency treatment programs.”

  1. Source: Black, C (1982) It Will Never Happen to Me!
  2. Source: Brown, S. (1995) Adult children of alcoholics: The history of a social movement and its impact on clinical theory and practice. In M. Galanter (ed.), Recent Developments in Alcoholism. Volume 9: Children of Alcoholics (pp. 267-285).
  3. Source: Beattie, Melody (1992) Codependent No More: How to Stop Controlling Others and Start Caring for Yourself.
  4. Source: Bradshaw, John (1988) Healing the Shame that Binds You.
  5. Note: See Codependency Critics section below.
  6. Source: Margolis, Robert D. & Zweben, Joan E. (1998) Treating Patients with Alcohol and Other Drug Problems: An Integrated Approach.

Note: For the full version of the history of family addiction and treatment see All in the Family: Addiction, Recovery, Advocacy written by William White and Bob Savage.

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Family Addiction Treatment Survives

Despite the great philosophical and economic assaults on family addiction treatment in the early 1990s, help for families with addictions has survived due to:

  • Family programs
  • Research supports

Family Programs, first developed in the 1960s as weekend sessions provided in a multifamily group (typically four or five families) setting ¹ for education, therapy, and mutual support. Family Programs grew from a few hospitals in Minnesota to a standard feature of most private treatment centers in North America.

By 1994, family therapy for addictions had grown to such an extent that noted family therapist Steinglass ² remarked:

“Twenty-five years ago families were by and large ignored by alcoholism clinicians . one is now hard pressed to find a credible alcoholism treatment program that does not at least give lip service to the importance of including family members in the treatment plan.”

These family-based models are the subject of the next section – Family Therapy Modalities.

(1) Source: Kaufman, E., and Kaufmann, P. (1979) From multiple family therapy to couples therapy. In: Kaufman E., and Kaufmann, P., eds. Family Therapy of Drug and Alcohol Abuse.
(2) Source: Steinglass, P. (1994) Family therapy: Alcohol. In M. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment (pp. 315-329).

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FAMILY THERAPY MODALITIES

The term “family therapy” refers to a wide variety of treatment methods, techniques, and interventions in which an individual’s family members, partner, and friends are involved in the therapeutic process of treating an addiction or mental illness.

Family Therapy as an Adjunct or Stand-Alone Treatment

Some clinicians, such as Kaufman ¹, view family therapy as “a valuable and often necessary adjunct to treatment particularly when integrated into a comprehensive program.” Family programs are an example of family therapy as adjunct therapy.

Others, such as Timothy O’Farrell ², have developed family therapy as a stand-alone treatment for drug and alcohol addiction. Marital and family therapists use O’Farrell’s approach as well as others in their outpatient practices, both individualized and in group.

Note: For more information on Timothy O’Farrell see the Behavioral Marital Therapy section below.

The following family therapy approaches reviewed below (with the exception of disease model family therapy) have all shown positive long-term approaches in controlled clinical trials ³:

(1) Source: Kaufman, E. (1994) Family therapy: Other drugs. In M. Galanter & H.D. Kleber (Eds.), Textbook of substance abuse treatment (pp. 331-348).
(2) Source: O’Farrell, T.J. (1993) A behavioral marital therapy couples group program for alcoholics and their spouses. In T.J. O’Farrell (Ed.), Treating alcohol problems (pp. 170-209).
(3) Source: Treatment Improvement Protocol (TIP) 34: Brief Interventions and Brief Therapies for Substance Abuse, Chapter 8 – Brief Family Therapy, pgs. 4 -13 (2004) Substance Abuse and Mental Health Services Administration (SAMHSA).

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1. Disease Model Family Therapy

1.a. family disease model – the prevailing model used in most family therapy for alcoholism and drug addiction. In the family disease model, family members of the substance abusing family member suffer from the disease of “codependency” ¹, ² (see above). Furthermore, most family therapy for alcoholism and drug addiction is provided by private residential addiction treatment program. While private residential treatment facilities are to be commended for providing help for families (unlike most government-funded programs), the exclusive use of the family disease model has been to the detriment of other equally effective, research-based family therapy modalities ³. The result is that families, in spite of their many complexities and unique needs, are often subject to a one-size-fits-all approach to therapy.

Interestingly, the family disease model is one of the few family therapy models that attempts to explain the cause of addiction. Most family therapies models only attempt to explain what sustains addiction in the family and what can be done to change it 4 and are, therefore, not considered incompatible with the family disease model.

(1) Source: Beattie, M. (1987) Co-Dependent No More.
(2) Source: Coudert, J. (1972) The Alcoholic in Your Life.
(3) Source: Steinglass, P. (1994) Family therapy: Alcohol. In M. Galanter & H.D. Kleber (Eds.), Textbook of Substance Abuse Treatment (pp. 315-329).
(4) Source: Family Solutions for Substance Abuse: Clinical and Counseling Approaches (2001) Eric E. McCollum, Terry S. Trepper, pg. 31.

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2. Operant Learning Family Therapy

2.a. community reinforcement approach (CRA) – developed by Sisson and Azrin ¹, and is designed primarily as a way for families to encourage their addicted family member to get help for his/her addiction. Family members are taught to see the link between their behavior and the alcoholic’s drinking behavior. So, for example, CRA encourages spouses to reward their substance abusing partner for initiating or maintaining abstinence and allowing their partners to experience the negative consequences if they engage in problematic alcohol or other drug use. The goal of CRA is to have the spouse engage in addiction treatment.

Suggested CRA sites:

The Community Reinforcement Approach – BHRM
The Community Reinforcement Approach – NIAAA

(1) Source: Sisson, R.W., & Azrin, N.H. (1993). Community reinforcement training for families: A method to get alcoholics into treatment. In T.J. O’Farrell (Ed.), Treating alcohol problems (pp. 34-53)

2.b. community reinforcement and family therapy (CRAFT) – a modification of the community reinforcement approach

Suggested CRAFT sites:

Robert J. Meyers, Ph.D.

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3. Cognitive-Behavioral Family Therapy

3.a. network therapy – a cognitive-behavioral approach to therapy that includes more than just the partner and family. Friends and extended family members such as cousins, grandparents, aunts, and uncles are also included in network therapy.

Suggested network therapy sites:

1. Network Therapy for Substance Abuse – Therapist’s Training Manual
2. Network Therapy: Using Family and Peer Support to Improve Your Treatment Outcome

3.b. behavioral marital therapy (BMT) – (also known as behavioral couples therapy) developed by Timothy O’Farrell, BMT views abstinence as a necessary first step before work with the addicted family member and his significant others can begin. Under the BMT model, both partners must accept abstinence as the preferred treatment goal ¹, including a written contract (known clinically as behavioral contracting). To ensure abstinence, disulfiram ² is ingested and witnessed as part the sobriety contract. BMT uses behavioral assignments to “increase positive feelings, shared activities and constructive communication[s]. ³” Relapse prevention is the final activity of BMT.
 
Suggested behavioral marital therapy sites:

Behavioral Couples Therapy for Alcoholism and Drub Abuse – Psychiatric Times
Behavioral Couples Therapy for Substance Abuse: Rationale, Methods, and Findings – NIDA

(1) Source: Margolis, Robert D. & Zweben, Joan E. (1998) Treating Patients with Alcohol and Other Drug Problems: An Integrated Approach, pg. 205.
(2) Note: disulfiram (also known by the brand name Antabuse) is a medication that causes an individual to become violently ill when combined when with alcohol.
(3) Source: Behavioral Couples Therapy for Alcoholism and Drug Abuse (April 1999) Timothy J. O’Farrell, Psychiatric Times, Vol XVI, Issue 4.

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4. Strategic/Interactional Family Therapy

4.a. strategic family therapy – uses paradox as a way to break engrained, dysfunctional behavioral patterns that exist in the family. Examples of paradoxical interventions include

  • Telling family members to continue problematic behavior
  • Suggesting to the family that they may not be ready to change
  • Redefining problematic behaviors in a positive light
  • Acknowledging the negative consequences the family might face if the substance abuse were to end

 

By suggesting to family members that they may want to continue their problematic behavior, the therapist can achieve the desired opposite effect when the family member instinctively resists the instructions.

Suggested brief strategic family therapy sites:

Brief Strategic Family Therapy for Adolescent Drug Abuse – NIDA
Model Programs – Brief Strategic Family Therapy – NREPP

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5. Intergenerational Family Therapies

5.a. Bowenian family therapy – is similar to structural family therapy (see below) in resolving detachment and enmeshment patterns but is provided in one-on-one therapy sessions rather than parent-child group therapy ¹.

Furthermore, Bowen emphasized the critical role that family members play both in maintaining addiction in the family and in efforts to alleviate the problem. Finally, Bowen believed that addiction is a symptom of family dysfunction rather than an individual’s distorted thoughts, feelings, and behaviours.

Suggested Bowenian family therapy sites:

Bowen Center for the Study of the Family

(1) Source: Bowen, M. (1974) Alcoholism as viewed through family systems theory and family psychology. Annals of the New YorkAcademy of Sciences 233:115-122.

5.b. contextual family therapy – has been applied in work with families affected by substance abuse ¹ where parents are “encouraged to deal with their childhood issues directly instead of acting them out through their own children ².”

(1) Source: Flores-Ortiz, Y., and Bernal, G. (1989) Contextual family therapy of addiction with Latinos. Journal of Psychotherapy and the Family 6(1-2):123-142.
(2) Source: Treatment Improvement Protocol (TIP) 34: Brief Interventions and Brief Therapies for Substance Abuse, Chapter 8 – Brief Family Therapy, pg. 8 (2004) Substance Abuse and Mental Health Services Administration (SAMHSA).

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6. Other Family Therapies

6.a. family systems model – based on systems theory which has as its premise that behaviors, such as problematic alcohol or drug use, is determined and maintained by the dynamics of interpersonal systems, primarily the family. In other words, systems theory views humans as social beings rather than psychological beings. This is in marked contrast to the prevailing theory that behavior is determined by an individual’s thoughts and feelings.

Furthermore, systems theory suggests that drugs and alcohol play a stabilizing, adaptive, or functional role when viewed from the broader perspective of the family system.

Systems theory is not particularly concerned with what causes addiction but, rather, with the factors contributing to the maintenance and persistence of such behaviors. Therefore, it is quite different from psychodynamic theories which believe alcoholism is a symptom of a more basic emotional or psychological problem. Furthermore, systems theory has a “here-now” focus rather than looking at past experiences for the source of the problem. In this way, systems theory is similar to behavioral theory and shares a number of short-term behavioral therapies in common such as role playing, modeling, and communication training.

Systems theory, although best known in its application to family therapy, can also be applied to other environments such as the work of employee assistance programming in the workplace (see the Workplace Substance Abuse section).

Source: Pearlman, Sheldon in Theories on Alcoholism (1988) C. Douglas Chaudron, D. Adrian Wilkinson, Alcoholism and Drug Addiction Research Foundation, Chapter 8 – Systems Theory and Alcoholism.

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6.b. structural family therapy – based on research by Salvadore Minuchin and his colleagues at the Philadelphia Child Guidance Clinic, structural family therapy explores the organization of families that result in:

  • Extreme disengagement and enmeshment of parents with their children ¹
  • Inappropriate coalitions between family members ²
  • Dysfunctional uses of power (e.g. “scapegoating”)

Structural family therapy encourages families to loosen rules and expectations that might be locking the addicted child into a dysfunctional role ³, 4.

(1) Source: Stanton, M.D., (1981) An integrated structural/strategic approach to family therapy. In A.S. Gurman & D.P. Kniskern (Eds.), Handbook of family therapy.
(2) Source: Minuchin, S. (1974) Families and family therapy.
(3) Source: (1981) Family Therapy Techniques.
(4) Source: (1977) The addict as savior: Heroin, death, and the family. Family Process 16:191-197.

6.c. multidimensional family therapy (MDFT) – integrates structural and strategic family therapy ¹,² to treat addiction in adolescents. Individual counselling sessions are designed to form a supportive relationship with the teen while family sessions help to change the way parents interact with the teen from an authoritarian hierarchy to a relationship based on open communication and mutual respect.

Suggested MDFT sites:

Model Programs – multidimensional family therapy – SAMHSA

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RESOURCES

I. PRINTED RESOURCES

General Reading on Family Addiction Help

Addict in the Family: Stories of Loss, Hope, and Recovery(2003) Beverly Conyers.

Addiction-Free: How to Help an Alcoholic or Addict Get Started on Recovery (2003) Gene Hawes

Alcohol, Drugs, and Family Healing: What Are You Going to Do About That? (2006) Barbara F.

Alcohol and the Family: A Comprehensive Bibliographycontains over 6,000 references in all languages on alcohol and the family. Grace M. Barnes, Diane K. Augustine.

Coping with Alcohol and Drug Problems: The Experiences of Family Members in Three Contrasting Cultures(2005) draws on the results of the cross-cultural study of alcohol and drug problems in the family, and places these results within the broader context of the international literature on the subject. Jim Orford, Guillermina Natera, Jazmin Mora, Alex Copellol, Marcela Tiburcio.

Drug Abuse, A Family’s Guide to Detection, Treatment and Education (1999) A. James Giannini

Drug Abuse Prevention Through Family Interventions(1998) focuses on family-based interventions as opposed to school-based interventions. Rebecca S. Ashery, Elizabeth B. Robertson, Karol L. Kumpfer (Eds.), National Institute on Drug Abuse (NIDA), Research Monograph 177. NIH Publication No. 99-4135.

Drug Addiction and Families (2007) Marina Barnard

Everything You Need to Know About Chemical Dependence: Vernon Johnson’s Complete Guide for Families (1998) is a self-help guide designed for easy reference for any family impacted by addiction. Vernon Johnson

Families Under the Influence: Changing Alcoholic Patterns (1990) Michael Elkin

Freeing Someone You Love From Alcohol and Other Drugs Ronald L. Rogers and Chandler Scott McMillin

Getting Them Sober: You Can Help (1998) Toby Rice Drews

Good News for the Chemically Dependent and Those Who Love Them (2004) Jeff VanVonderen

Guidebook for the Family with Alcohol Problems (1982) J. Burgin

It’s Not Okay to Be a Cannibal: How to Keep Addiction from Eating Your Family Alive (2006) Andrew T. Wainwright and Robert Poznanovich

Mum Can You Lend Me Twenty Quid: What Drugs Did to my Family (2007) Elizabeth Burton-Phillips

My Heart is a Stone That Bleeds (2002) Karl P Whitehead

My Mama’s Waltz: A Book for Daughters of Alcoholic Mothers (1998) Eleanor Agnew

No More Letting Go: The Spirituality of Taking Action Against Alcoholism and Drug Addiction (2006) Debra Jay

No Soft Landings: A Memoir (2001) David McCreery

Outwitting Your Alcoholic: Keep the Loving And Stop the Drinking (Idyll Arbor Personal Health (2005) Kenneth A. Lucas and Eric Newhouse

Parenting One Day at a Time: Using the Tools of Recovery to Become Better Parents and Raise Better Kids (1999) Alex J. Packer

Reclaim Your Family From Addiction: How Couples and Families Recover Love and Meaning (2000) explains how families and couples who have spent years building a life together can lose their cohesive identity and meaning in the wake of addiction. Craig Nakken

Recovery of Chemically Dependent Families (1991) Johnson Institute

Surviving Addiction: A Guide for Alcoholics, Drug Addicts, and Their Families(1988) Dennis C. Daley

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ADULT CHILDREN OF ALCOHOLICS

This section is for adults who grew up in a family with an addicted parent. For Children of Alcoholics information see below.

Printed Resources – Research on Adult Children of Alcoholics

Children of Substance Abusers: Overview of Research Findings (May 1999) Jeanette L. Johnson, Michelle Leff, Pediatrics Vol. 103 No. 5 Supplement May 1999, pp. 1085-1099.

Printed Resources – Family Addiction and Adult Children of Alcoholics

Adult Children of Alcoholics (1990) Janet Woititz

ACOA’s Guide to Raising Healthy Children(1988) William Brines and James Mastrich

Adult Children of Alcoholics Syndrome: A Step by Step Guide to Discovery and Recovery (1988) Wayne Kritsberg

Adult Children: The Secrets of Dysfunctional Families (1990) John C Friel

An Adult Child’ Guide to What’s Normal (1990) John C. and Linda D. Friel

Changing Course: Healing from Loss, Abandonment and Fear (2002) Claudia Black

Alcoholism, the Disease and the Benefits: The Highly Effective Recovering Adult-Child (2001) Linda Tague

Children of Addiction: Research, Health, and Public Policy Issues (2000) reports on larger social implications of children of addicted parents and how to structure future research, health care, and policies. Hiram E. Fitzgerald.

Children of Alcoholics: Critical Perspectives (1992) Michael Windle and John S. Searles

Children of Alcoholics: Selected Readings (1996) Claudia Black, Hoover Adger, Steven Wolin, and Stephanie Brown

Children of Alcoholics: Understanding the Effects of a Parent’s Drinking on Your Life and Finding Ways to Heal the Hurt (1998) David Stafford

Children of Alcoholism: Struggle for Self and Intimacy in Adult Life (1987) Barbara L. Wood

The Complete ACOA Sourcebook: Adult Children of Alcoholics at Home, at Work and in Love (2002) Janet Woititz

Coping with a Drug Abusing Parent (1995) Lawrence Clayton

Family Secrets: Life Stories of Adult Children of Alcoholics (1987) Rachel V.

Growing in the Shadow: Children of Alcoholics (1986) Robert J. Ackerman. Health Communications, Inc. Deerfield Beach, FL

The Healing Journey for Adult Children of Alcoholics (1990) Darly E. Quick

It Will Never Happen to Me: Growing Up With Addiction As Youngsters, Adolescents, Adults (2002) using stories, revealing explanations, and exercises, Black helps readers gain personal insights that lead to a happier life. Claudia Black

The Laundry List: The Adult Children of Alcoholics Experience (1990) Tony A and Dan Fitzgibbon

Let Go and Grow: Recovery for Adult Children of Alcoholics (1987) Robert J. Ackerman

Lifeskills for Adult Children (1990) Janet Woititz, Alan Garner

Living With a Parent Who Takes Drugs (1991) Judith S. Seixas

Loving an Adult Child of an Alcoholic (2007) Douglas and Deborah Bey

Missing Mummy: Living in the Shadow of an Alcoholic Parent (2006) E. Spiegler

My Mamas Waltz: A Book for Daughters of Alcoholic Mothers (1998) Eleanor Agnew

Old Patterns, New Truths: Beyond the Adult Child Syndrome (1988) Earnie Larsen

Once Upon a Time: Stories of Hope from Adult Children (1987) Amy E. Dean, Hazelden Educational Materials.

Perfect Daughters: Adult Daughters of Alcoholics (Revised Edition) (2002) Robert J. Ackerman

Playing It by Heart: Taking Care of Yourself No Matter What (1999) Melody Beattie

Portraits of My Life: Looking Back As an Adult Child of Alcoholism (2001) Maryann F. Lenzi

A Primer on Adult Children of Alcoholics (1989) Timmen L. Cemak

Recovery: A Guide for Adult Children of Alcoholics (1987) Herbert L. Gravitz and Julie D. Bowden

Repeat After Me (1995) Claudia Black

The Resilient Self: How Survivors of Troubled Families Rise Above Adversity (1993) Steven J. Wolin

Safe Passage: Recovery for Adult Children of Alcoholics (1991) Stephanie Brown

Same House, Different Homes: Why Adult Children of Alcoholics Are Not All the Same (1987) Robert J. Ackerman

Struggle for Intimacy (Adult Children of Alcoholics series) (1985) Janet Geringer Woititz

Sweet Mystery: A Southern Memoir of Family Alcoholism, Mental Illness, and Recovery (1997) Judith Hillman Paterson

Taming Your Turbulent Past: A Self-Help Guide for Adult Children of Alcoholics (1987) Gayle Rosellini and Mark Worden

A Time to Heal: The Road to Recovery for Adult Children of Alcoholics (1989) Timmen L. Cermak

Transformation for Life: Healing and Growth for Adult Children of Alcoholics and Others:(2005) Roland Petit

Twelve Steps for Adult Children (1989) Friends in Recovery

Unfinished Business: Helping Adult Children Resolve Their Past (1989) Charles Sell

You Drink, I Die… (2006) Daniel Meier.

Printed Resources – Spirituality and Adult Children of Alcoholics

Claiming Your Own Life: A Journey to Spirituality (2007) Christine A Adams

Printed Resources – Treatment for Adult Children of Alcoholics

Group Psychotherapy with Adult Children of Alcoholics: Treatment Techniques and Countertransference Considerations is for therapists and counselors who work with adult children of alcoholics. Marsha Vannicelli.

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FAMILY ADDICTION

Printed Resources – Al-Anon and Family Addiction

Blueprint for Progress: Al-Anon’s Fourth Step Inventory (1987) Al-Anon

The Lois Wilson Story: When Love is Not Enough: The Authorized Biography of the Co-founder of Al-Anon (2005) William Borchert

Printed Resources – Behavioral Marital Therapy

Behavioral Couples Therapy for Alcoholism and Drug Abuse (2006) presents an empirically supported approach for treating people with substance abuse problems and their spouses. Timothy J. O’Farrell, William Fals-Stewart.

Printed Resources – Boundaries and Family Addiction

Addictive Relationships: Reclaiming Your Boundaries (1989) Joy Miller

Better Boundaries: Owning and Treasuring Your Life (1997) Jan Black, Greg Enns

Boundaries – Where You End And I Begin: How To Recognize And Set Healthy
Boundaries (1994) Anne Katherine

Boundaries and Relationships: Knowing, Protecting and Enjoying the Self (1993) Charles Whitfield

Boundaries in Marriage (1999) Henry Cloud and John Townsend

Boundaries in Marriage – Participant’s Guide (2002) Henry Cloud and John Townsend

Boundaries: When to say Yes, When to Say No, To Take Control of Your Life(1992) Henry Cloud and John Townsend

Where to Draw the Line: How to Set Healthy Boundaries Every Day (2000)
Anne Katherine

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CHILDREN OF ALCOHOLICS

These resources focus on young children and the impact of having a parent with an addiction. For adult children of alcoholics information see above.

Printed Resources – General Reading on Children of Alcoholics

For adult children of alcoholics see the Adult Children of Alcoholics section above.

Broken Bottles, Broken Dreams: Understanding and Helping the Children of Alcoholics (1982). Charles Deutsch. Teachers College Press, New York, NY

Kids’ Power: Healing Games for Children of Alcoholics (1989) Jerry Moe, Don Pohlman, and Peter Ways 

Understanding Addiction and Recovery Through a Childs Eyes: Hope, Help, and Healing for Families (2007) M.A. Moe

Printed Resources – Children of Alcoholics ages 2 – 11 with Addicted Parents

Alcohol: What It Is, What It Does (1979) Judith S. Seixas. Greenwillow Books, New York, NY

Dear Kids of Alcoholics (1988) Lindsey Hall and Cohn Leigh. Gurze Books, Carlsbad, CA

Don’t Hurt Me, Mama (1983) Muriel Stanek. Albert Whitmen, and Co., Niles, IL

Drugs, What They Are, What They Do (1987) Judith S. Seixas. Greenwillow Books, New York, NY

I Wish Daddy Didn’t Drink so Much (1988) is a story about Lisa, her alcoholic father, her long-suffering mother, and a helpful neighbour. Judith Vigna.

Mom and Me. Community Intervention(1989) Karol Crosbie. Minneapolis, MN

The Mouse, Monster and Me: Assertiveness for Young People (1977) Pat Palmer. Impact Publishers, San Luis Obispo, CA

My Big Sister Takes Drugs (1990) begins when the police bring home Paul’s sister Tina, who was found taking drugs in the park. Judith Vigna

My Mom Doesn’t Look Like an Alcoholic (1984) Mary Hammond and Lynnann Chestnut. Health Communications, Inc., Deerfield Beach, Fl

Pablito’s Secret/El Secreto de Pablito(1984) Ronaldo Figueroa. Health Communications, Inc., Deerfield Beach, FL

Sometimes My Mom Drinks Too Much (1980) Kevin Kenny and Helen Krull. Raintree Children’s Books, Milwaukee, WI

The Three Robots Learn about Drugs(1987) Art Fettig. Growth Unlimited, Inc., Battle Creek, MI

Welcome Home: A Child’s View of Alcoholism (1986) Judith A. Jance. Charles Franklin Press, Edmonds, WA

When a Family is in Trouble: Children can Cope with Grief from Drug and Alcohol Addiction (1993) invites children to draw to help them express thoughts and feelings to help cope with addiction in the family. Marge Heegaard


The following are books you can read to children or that they can read themselves:

Brown Bottle: A Fable for Children of All Ages(1983) presents an allegory of alcoholism in the illustrated story of Charlie the caterpillar who leaves the caterpillar kingdom to follow the glow of the brown bottle. Penny Jones, Center City, MN: Hazelden Foundation.

The Cat Who Drank Too Much. (1982) contains twenty captioned black and white photos that relate the story of a kitten that was obsessed with drinking, reflecting the behavior and feelings of many alcoholics. LeClair Bissell and Richard Watherwax. Bantam, CT: Bibulophile Press.

An Elephant in the Living Room, The Children’s Book. (1984) is a program designed to help children from seven years to early adolescence cope with the problems of living with a problem drinking or drug-abusing parent or sibling. The leader’s guide is primarily for adults working with children in groups. The children’s book uses a workbook format with line drawings. M.H. Typpo and J.M. Hastings Minneapolis, MN: Compcare Publications.

An Elephant In The Living Room – Leader’s Guide: A Leader’s Guide For Helping Children Of Alcoholics (1994) Marion H. Typpo. Ph.D.

Getting a Life of Your Own: A Kids Guide to Undersanding & Coping with Family Alcoholism(1995) is for elementary- and middle-school-aged students who are coping with alcoholism in their family. Kim Frank, Susan J. Smith-Rex.

Have You Ever Been A Child?: (Hints for Helping When Life Seems Complicated) (1993) is for parents and teachers to use with children, and older children to use on their own. Simple illustrations with hope-filled messages give inspiration to children of all ages. Leslie Gebhart. Palm Springs, CA: Trineheart Publishers.

My Dad Loves Me, My Dad has a Disease. (1979) is a workbook designed to help young children learn about themselves, their feelings, and the disease of alcoholism in their families through art therapy. Children between the ages of six and fourteen share what it is like for them to live in an alcoholic family. Claudia Black. Denver, CO: M.A C. Printing.

Something’s Wrong in My House. (1988) talks about domestic violence and alcoholism and how it affects children. Acknowledges the universal feelings of fear, anger, and hopelessness, and looks for ways to cope. Katherine Leiner. New York: Franklin Watts.

Think of Wind: (1996) is a simply stated story about how alcoholism impacts families. An excellent resource for teachers and parents to use with young Children, and older children to read on their own. Catherine Mercury. One Big Press, Rochester, NY.

Wishes and Worries: A Story to Help Children Understand a Parent Who Drinks Too Much(2005) is written for children from 5 to 10 years old. An interactive resource for parents, extended family, teachers, and addiction/mental health professionals. Ben Hodson, Centre for Addiction and Mental Health.

Printed Resources – Children of Alcoholics ages 12 to Young Adulthood with Addicted Parent(s)

Alateen-Hope for Children of Alcoholics (2003) Al-Anon Family Groups. Virginia Beach, VA

Hope for Young People with Alcoholic Parents (1981) Ann M. Balcerzak. Hazelden Educational Materials, Center City, MN, 1981.

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If You Think Your Parent Drinks Too Much, Here’s Something You Should Think About (1992) from the Children of Alcoholics Foundation, New York, NY

Different Like Me: A Book for Teens Who Worry about their Parents’ Use of Alcohol/Drugs (1987) Evelyn Leite and Pamela Espeland. Johnson Institute, Minneapolis, MN

The Bluest Eye (1972) Toni Morrison. Pocket Books, Simon and Schuster, Inc., New York, NY

Coping with an Alcoholic Parent (1985) Kay Marie Porterfield. The Rosen Publishing Group, New York, NY

Familiar Strangers (1984) Kay Marie Porterfield. Hazelden Foundation, Center City, MN

Living with a Parent Who Drinks Too Much (1979) Judith Seixas. Greenwillow Books, New York, NY

Potato Chips for Breakfast (1986) Cynthia G. Scales. Quotidian Press, Rockaway, NJ

The Secret Everyone Knows(1981) Cathleen Brooks

A Share of Freedom (1994) June Rae Wood.

A Teenager’s Guide to Living with an Alcoholic Parent (1984) Edith Lynn Hornick-Beer. Hazelden Educational Materials, Center City, MN

Vulture: A Modern Allegory in the Art of Putting Oneself Down (1977). Sidney Simon. Argus Communications, Niles, IL,

When Your Parent Drinks Too Much: A Book for Teenagers (1985) Facts on File. Eric Ryerson. New York, NY

Youth and the Alcoholic Family (2003) Al-Anon Family Groups. Virginia Beach, VA

Printed Resources – Christianity and Family Addiction

Loving the Addict, Hating the Addiction: for Christian Families Coping with Drug Addiction (2003) Kecia C Sims

Printed Resources – Cocaine and Family Addiction

Cocaine Solutions: Help for Cocaine Abusers and Their Families (Addiction Treatment Series) (1990) Jennifer Rice-Licare, Katharine Delaney-McLoughlin

My Brother Bill: How Cocaine Killed my Brother (2007) Clare Campbell

For more information on cocaine see the Cocaine section.

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CODEPENDENCY

Printed Resources – General Information on Codependency

Addicted to the Addict: From Codependency to Recovery (1987) Kenneth G. Reiner

Adult Children, Adult Choices: Outgrowing Codependency (1992) Mary Ramey

Alcoholism and Codependency (1991) Alexander C. De Jong

Belonging: Bonds of Healing and Recovery (1992) Dennis Linn, Sheila Fabricant Linn, and Matthew Linn

Beyond Codependency and getting better all the time (1989) Melody Beattie

Breaking Free: A Recovery Workbook for Facing Codependence (1989) Pia Mellody and Andrea Wells Miller

Broken Toys Broken Dreams: Understanding and Healing Codependency, Compulsive Behaviors and Family (1990) Terry Kellogg

The Caring Persons Illness: Codependency/the Affected Family Disease (1990) Daniel T. Budenz

Challenging Codependency: Feminist Critiques (1995) Marguerite Babcock and Christine McKay

Claiming Your Self Esteem: A Guide Out of Codependency, Addiction, and Other Useless Habits (1990) Carolyn M. Ball

Close Enough to Care: Helping a Friend or Relative Conquer Codependency (Rapha Recovery Book) (1991) Pat Springle

Co-dependence: Healing the Human Condition (1991) Charles L. Whitfield

Co-dependence: Misunderstood – Mistreated (1992) Anne Wilson Schaef

Codependency Breaking Free From Entangled Relationships (1991) Lyman; Scales, Marty Coleman

Codependency: Breaking free of entangled relationships (Serendipity support group series) (1991) Richard Peace

Codependency: Breaking Free from the Hurt and Manipulation of Dysfunctional Relationships (1990) Pat Springle and Susan Joiner

Codependency Communication Skills Training (1998) Richard Cavasina

Codependency Confusion: Developing Healthy Relationship (Recovery Discovery) (1992) Randy Reynolds and David Lynn

Codependency: Emerging from the Eclipse! (1989)

Codependency: How to Break Free and Live Your Own Life (1999) David Stafford and Liz Hodgkinson

Codependency: Powerloss Soulloss (1994) Dorothy May

Codependency: A Second Hand Life (#5450b) (1985) Stephanie Abbott

Codependency to Self-Discovery (1985) Barrie L. Konicov

Codependency, Sexuality and Depression (1990) William E. Thornton

Codependency: Small group leader’s guide (1990) Pat Springle

Codependency Sucks (1999) Linda Meyerholz

Codependency in the Workplace: A Guide for Employee Assistance and Human Resource Professionals (1992) Seth Allcorn

Codependent No More: Beyond Codependency(2001) Melody Beattie

Codependent No More Handbook: Exercises for Learning to Stop Controlling Others and Start Caring for Yourself (Codependent No More Series) (2007) Melody Beattie

Codependent No More: How to Stop Controlling Others and Start Caring for Yourself (1992) Melody Beattie

Codependents’ Guide to the Twelve Steps (1992) Melody Beattie

Coping With Codependency (1997) Kay Marie Porterfield

Desperate to Be Needed: Freeing the Family from Chemical Codependency (Lifelines for Recovery) (1990) Janet Ohlemacher

Disentangle: When You’ve Lost Your Self in Someone Else (2004) is about finding our “self” when we have lost it to someone else. Nancy L. Johnston.

Doormats and Control Freaks: How to Recognize, Heal or End Codependent Relationships (2005) Rebekah Lewis

Drugs and Codependency (Drug Abuse Prevention Library) (1999) Mary Price Lee and Richard S. Lee

Everything You Need to Know About Codependency (Need to Know Library) (1993) Al Septien

Facing Codependence: What It Is, Where It Comes from, How It Sabotages Our Lives (1989) Pia Mellody, Andrea Wells Miller, and J. Keith Miller

Family Intervention: Positive Action You Can Take to Help a Loved One – And Yourself – To Break the Cycle of Addiction and Codependency (1991) Frank L. Picard

Hooked on Life: How to Totally Recover from Addictions and Codependency (1989) Tim Timmons and Stephen Arterburn

I’m Not My Fault: The Why of Shame and Codependency (1990) Don Haury

Kids Who Carry Our Pain: Breaking the Cycle of Codependency for the Next Generation (Minrith-Moer Series) (1990) Robert Hemfelt and Paul Warren

The Language of Letting Go (Hazelden Meditation Series) (1990) Melody Beattie

Letting Go: A Moment to Reflect  (1989) Veronica Ray

Love Is a Choice: The Definitive Book on Letting Go of Unhealthy Relationships (2003) Robert Hemfelt, Frank Minirth, and Paul Meier

Playing It by Heart: Taking Care of Yourself No Matter What (1999) Melody Beattie

Rapha’s 12-Step Program for Overcoming Codependency (1990) Pat Springle

Recovering Love: Codependency to Corecovery (2001) J. Richard Cookerly

Setting Boundaries: A Moment To Reflect (A Moment to Reflect) (1989) Veronica Ray

The Seven Jewels of Codependency (2002) Robert F. Willard and Michael Gibertini

Some Sat in Darkness: Spiritual Recovery from Addiction and Codependency (1997) Declan Joyce, Brenda Leatherwood, Mike Leatherwood, and Joanne Randall

Stepping Stones To Recovery From Codependency: Experience The Miracle Of 12 Step Recovery (1994) Deb M.

The Too-Good Wife: Alcohol, Codependency, and the Politics of Nurturance in Postwar Japan (Ethnographic Studies in Subjectivity) (2005) Amy Borovoy

True Selves: Twelve-Step Recovery from Codependency (1991) Roseann Lloyd and Merle Fossum

Truth Will Set You Free: A Spiritual Program for People Recovering from Codependency and Life’s Losses (1991) Jack McGinnis and Barbara Shlemon

What’s Wrong With Me?: Breaking the Chain of Adolescent Codependency(1991) Lonny Owen

Women with Alcoholic Husbands: Ambivalence and the Trap of Codependency(1992) Ramona Marie Asher

Your Recovery Is in Your Hand: Codependency in Handwriting (2000) James Rindone

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Printed Resources – Christianity and Codependency

Can Christians Love Too Much?: Breaking the Cycle of Codependency (1990) Margaret J. Rinck

The Dysfunctional Church: Addiction and Codependency in the Family of Catholicism (1991) Michael H. Crosby

Freedom from Codependency: A Christian Response (1991) Philip St. Romain

From Bondage to Bonding: Escaping Codependency, Embracing Biblical Love (1991) Nancy Groom

God, Where Is Love?: Break Free from the Pain of Codependency (1993) Claire W.

Healing for Today Hope for Tomorrow/God’s Promises for Overcoming Codependency (New Perspectives) (1992) Gary Wilde

I Am: The God Who Heals: The Bridge from Codependency to Interdependency (2005) Kathleen Delia Rogers

Loving Yourself As Your Neighbor: A Recovery Guide for Christians Escaping Burnout and Codependency (1990) Carmen Renee Berry and Mark Lloyd Taylor

O Blessed Night!: Recovering from Addiction, Codependency, and Attachment Based on the Insights of St. John of the Cross and Pierre Teilhard De Char (1991) Francis Kelly Nemeck and Marie Theresa Coombs

Please Don’t Say You Need Me: Biblical Answers for Codependency (1989) Jan Silvious

Understanding & healing codependency with gospel principles (1992) John C Turpin

Untangling Relationships (A Christian Perspective on Codependency) (1993)

When People Are Big and God Is Small: Overcoming Peer Pressure, Codependency, and the Fear of Man (Resources for Changing Lives) (1997) Edward T. Welch

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Printed Resources – Opponents of Codependency

The Codependency Conspiracy: how to break the recovery habit and take charge of your life(1991) Stan J. Katz, S. & Aimee Liu

Codependent… What a Bore and Other Clinical Observations: Stop Struggling Under Pseudo-Psychology and Consider Suing The Idiots Mistreating You (2004) Rick Goodner

I’m Dysfunctional, You’re Dysfunctional (1992) Wendy Kaminer

Many Roads, One Journey: Moving Beyond the Twelve Steps (1992) Charlotte Davis Kasl

The Mismeasure of Women (1992) Carol Travis

Women with Alcoholic Husbands: Ambivalence and the Trap of Codependency(1992) breaks through popular notions about wives of alcoholics and presents a whole new understanding of denial, control, and other so-called symptoms of codependency.Ramona Marie.

Printed Resources – Grief, Loss and Family Addiction

Between Two Pages: Children of Substance (2003) Susan Hubenthal

I Am Your Disease: The Many Faces of Addiction (2006) Sheryl Letzgus McGinnis, Heiko Ganzer

Losing Jonathan (2003) Robert and Linda Waxler

When a Child Dies from Drugs: Practical Help for Parents in Bereavement (2004) Pat and Russ Wittberger

Printed Resources – Heroin and Family Addiction

One-Way Ticket: Our Son’s Addiction to Heroin (2007) Rita Lowenthal

For more information on heroin see the Heroin section.

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Printed Resources – Interventions and Family Addiction

Addiction-Free: How to Help an Alcoholic or Addict Get Started on Recovery (2003) is a complete up-to-date guide of who, what, where, and when you or someone you love can contact to get help for problems with alcohol or other drugs. Gene Hawes, Anderson Hawes.

Family Intervention: Ending the Cycle of Addiction and Codependency (1989) Frank L. Picard

Family Intervention in Substance Abuse: Current Best Practices (2008) Oliver J. Morgan

Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening (2003) Robert J Meyers and Brenda L Wolfe

Helping the Addict You Love: The New Effective Program for Getting the Addict into Treatment (2007) Laurence Westreich

Intervention: Confronting a Loved One Who Uses Drugs (2000) Craig Konieczko



Intervention: How to Help Someone Who Doesn’t Want Help (1986) Vernon E. Johnson

Love First: A New Approach to Intervention for Alcoholism and Drug Addiction (2000) Debra and Jeff Jay

Motivating Substance Abusers to Enter Treatment: Working with Family Members (2004) Jane Ellen Smith and Robert J. Meyers

When They Won’t Quit: A Call to Action for Families, Friends and Employers of Alcohol and Drug-Addicted People (2002) Bruce Cotter

For more information on interventions see the Family Intervention Help section.

Printed Resources – Judaism and Family Addiction

Recovery from Codependence: A Jewish Twelve Steps Guide to Healing Your Soul (Twelve Step Recovery) (1993) Kerry M. Olitzky

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Printed Resources – Marital Therapy for Addiction

See the Treatment for Partners or Family Members with an Addiction section above.

Printed Resources – Meditation Books

A Life of My Own: Meditations on Hope and Acceptance (1993) gently guide friends and family working programs like Al-Anon, Nar-Anon. Hazelden Publishing.

Printed Resources – Love and Family Addiction

In The Weather of the Heart: The Story of a Marriage Transformed by Addiction (2000) Valerie Monroe

Living With Drink: Women Who Live With Problem Drinkers (1998) Richard Velleman, Alex Copello, and Jenny Maslin

Loving an Alcoholic: Help and Hope for Significant Others (1985) is a guidebook for partners of alcoholics that emphasizes they are not alone in their problems. Offers practical advice for the partner. Jack Mumey.

Marriage On the Rocks: Learning to Live With Yourself and an Alcoholic (1986) helps the reader to recognize the dynamics of the alcoholic marriage, the effects on the spouse, and the damage done to the children. Help clients who are married to alcoholics develop their own separate recovery process. Janet Woititz

Resiilent Marriages: From Alcoholism and Adversity to Relationship Growth (2000) Karen J. Shirley

Struggle for Intimacy (1985) ( ) teaches clients the steps to developing healthy relationships and examines the factors that contribute to difficulties with intimacy, including chemical dependency, behavioral patterns, and growing up in a dysfunctional or alcoholic family system. Janet G. Woititz.



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Printed Resources – Mormonism and Family Addiction

On new wings: Mormon women rediscover personal agency and conquer codependency (1992) Gail Andersen Newbold

Printed Resources – Treatment for Partners or Family Members with an Addiction in the Family

Counseling Addicted Families: An Integrated Assessment and Treatment Model (2006) provides an integrated model for assessment and treatment. Gerald A. Juhnke, W. Bryce Hagedorn

Couple and Family Therapy of Addiction (1998) takes the reader down the parallel paths of addiction treatment and family therapy until they meet on the bridge of actual clinical practice. J.D. Levin

Family Solutions for Substance Abuse: Clinical and Counseling Approaches(2001) gives practical strategies to include families in treatment, discover their strengths, and help them to use those strengths to support competency. Eric E. McCollum, Terry S. Trepper.

Family Strategies: Practical Tools for Professionals Treating Families Impacted by Addiction(2006) presents strategies proven most effective in primary family systems therapy when addiction is either still active or the addicted person is in early recovery. Claudia Black.

The Family Therapy of Drug Abuse and Addiction (1982) M. Duncan Stanton, Thomas C. Todd.

Family Therapy of Drug and Alcohol Abuse(1979) Edward Kaufman and Pauline Kaufman.

Narrative Means to Sober End: Treating Addiction and its Aftermath(2002) proposes a narrative approach that bridges family therapy, psychodynamic therapy, and addictions. Jonathan Diamond, David C. Treadway.

The Responsibility Trap: A Blueprint for Treating the Alcoholic Family (1985) covers various various therapeutic approaches to use with families that have been impacted by addiction. Claudia Bepko, Jo Ann Krestan.

Removing the Roadblocks: Group Psychotherapy with Substance Abusers and Their Families(1992) is designed to help practitioners. Analyzes group therapy issues that arise in the three populations – substance abusers, adult children of alcoholics, and other family members. Marsha Vannicelli.

Substance Abuse and Family Therapy (1985) Edward Kaufman

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Printed Resources – Twelve Steps and Family Addiction

Family Recovery and Substance Abuse: A Twelve-Step Guide for Treatment (1998) Joseph Nowinski

For more information on the Twelve Steps see the 12 Step Support Groups section.

Printed Resources – Family Violence and Family Addiction

No Safe Haven: Children of Substance-Abusing Parents(January 1999) is a comprehensive analysis of the connection between substance abuse and child neglect. CASA Columbia.

Aggression, Family Violence, and Chemical Dependency (1990) analyzes the complex relationship between aggression, violence, and substance abuse. Ronald T. Potter-Efron, Patricia S. Potter-Efron (Eds.)

Elder Abuse and Alcohol(2006) examines relationships where there is an expectation of trust, which causes harm to an older person. Harmful and hazardous alcohol use have been identified as risk factors for elder abuse. World Health Organization (WHO).

II. ONLINE RESOURCES – ADDICTION HELP FOR FAMILIES & PARTNERS

Websites Specific to Family Addiction

National Association for Children of Alcoholics

Websites Specific to Family Addiction Self-Help Groups

Al-Anon Alateen
Adult Children of Alcoholics World Service Organization
Co-Dependents Anonymous
Families Anonymous
Parents Anonymous

Online Resources – General Information on Family Addiction

Addiction, Lies and Relationships talks about addiction as a disease of denial and also regret. Written by Floyd P. Garrett, MD.

The Addict’s Dilemmatalks about the prospect of the addict giving up his addictive behavior and the feelings it brings. These feelings include profound feelings of loss, deprivation and despair.

Excuses Alcoholics Make provides a long list of excuses that alcoholics often make as defense mechanisms. Written by Floyd P. Garret, M.D.

Family therapy approach to addiction (January 1988) United Nations Office on Drugs and Crime

What is Substance Abuse Treatment? A Guide for Families. (2004) Is created for family members of those dependent on alcohol or illicit drugs and answers questions often asked by families of people entering treatment. Center for Substance Abuse Treatment (CSAT), Publication BKD503.

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Online Resources – Adult Children of Alcoholics

ACOA Awareness Center is a site of renowned ACOA specialist, Dr. Janet G. Woititz.

Children of Alcoholics (1997) includes concepts and issues in COA research, parenting influences on the development of alcohol abuse and dependence, the role of family influences in development and risk, the effects of prenatal alcohol exposure, a behavioral-genetic perspective on COAs, and physiological responses in sons of alcoholics. National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Selected References on Children of Alcoholics (September 2002) contains selected bibliographic references on children of alcoholics covering the period from the late 1800’s through September, 2002. National Association of Children of Alcoholics (NACOA).

Online Resources – Children Who Have Parents with Addiction

Alcohol and Drug Addiction Happens in the Best of Families (September 2005) discusses the problem of addiction in the context of the family and explains that all members are affected. Center for Substance Abuse Treatment (CSAT), publication no. PHD1112.

Children Living with Substance-Abusing or Substance-Dependent Parents (June 2003) surveyed children younger than 18 years of age who were living with one or both parents. The NSDUH Report.

A Family History of Alcoholism (February 2003) is information for teenagers who have a parent, grandparent, or other close relative with alcoholism. National Institute of Alcohol Abuse and Alcoholism (NIAAA). NIH Publication 03-5340.

It Feels So Bad (September 2005) is for young people who worry about their parents drinking too much or using drugs. This brochure offers answers to questions children have about their parents’ substance abuse. Publication PHD1111, National Institute on Drug Abuse (NIDA).

It’s Not Your Fault is for children worried about their parent who drinks too much or uses drugs. National Association for Children of Alcoholics (NACOA).

Resilient Children of Parents Affected by a Dependency (August 2005) highlight the characteristics and experiences that seem to support successful adaptation into society despite personal and socio-economic backgrounds and experiences as well as age-groups. Health Canada.

When a Parent Drinks Too Much: What Kids Want to Know (2005) is a brochure to help adults prepare for taking the first step in discussing alcohol problems with their child (or another child you care about). Centre for Addiction and Mental Health.

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Online Resources – Families or Partners Who Have Family Members with Addiction

What is Addiction Treatment? A Booklet for Families (2004) is a booklet that helps families of people entering treatment. DHHS Publication 07-4126. Substance Abuse and Mental Health Services Administration (SAMHSA).

Family Toolkit (2004) was designed to assist families in caring for a family member with a mental illness or substance use disorder by providing information and practical resources. The toolkit consists of 5 modules. BC Partners for Mental Health and Addictions Information.

Online Resources – Families or Partners Who Have a Family Member in Treatment

Contact Guidelines for Families (2006) is designed to help family members learn constructive ways to support their family member who is in treatment for their addiction. Sunshine Coast Health Center.

Online Resources – History of Family Therapy and Addiction

All in the Family: Addiction, Recovery, Advocacy explores the history of family perspectives on addiction and recovery through the published work of psychiatrists, psychologists, social workers, and addiction counsellors. William White, Bob Savage.

Online Resources – Inhalants and Family Addiction

Parents be aware: sniffing kills! (November 2005) warns parents of the dangers of inhalants and solvents, even for first-time users. Canadian Health Network, Public Health Agency of Canada.

For more information on inhalants see the Inhalants section.

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Online Resources – Marijuana and Family Addiction

Marijuana: Facts Parents Need to Know (August 2007) National Institute on Drug Abuse (NIDA). NIH Publication 07-4036

For more information on marijuana see the Marijuana section.

Online Resources – Partners Who Have Partners with Addiction

The Female Partner of the Recovering Male Alcoholic is a comparative review of 3 methods of family therapy, including a feminist perspective. Written by Pat Jones, MS, RN, CS

Getting Away With Addiction? reveals how an addict’s self-deception supports the continued operation of the addictive process. Written by Floyd P. Garrett, MD.

When Your Partner has a Drug or Alcohol Problem (December 2005) is a guide for gay and bisexual men. Seattle King County Public Health (*)

Worried Sick About His Drinking? Is an article that asserts that a non-alcoholic spouse who experiences prolonged exposure to alcohol addiction may be vulnerable to spousal alcohol syndrome. 

(*) Note: for more information see the Gay, Lesbian, Bisexual, and Transgender section in Special Populations.

Online Resources – Treatment for Couples and Family Members with an Addiction

Family Participation in Addiction Treatment – Part 1 – The Importance of Engagement(January 2008) recommends methods for counsellors to enhance their relationship with both the client and family members. Addiction Messenger, Northwest Frontier Addiction Technology Transfer Center, Volume 10, Issue 1.

Family Participation in Addiction Treatment – Part 2 – Levels of Involvement (February 2008) is designed for counsellors and recommends that levels of involvement with families be determined by family readiness and the counsellors experience and comfort with family members. Addiction Messenger, Northwest Frontier Addiction Technology Transfer Center, Volume 11, Issue 2.

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III. VIDEO RESOURCES

Video Resources – Educational Videos

Addiction and the Family: Healing and Recovery (March 2006) is designed for children of alcohol- and drug-addicted parents or guardians are profoundly affected by living with this experience. DVD252.

Disclaimer: the materials and information offered on this site are intended for educational purposes only and are not intended as a substitute for needed medical, psychological or psychiatric treatment or counseling. If you have any questions, consult with your health professional before using these materials.

Video Resources – Movies

Ordinary People (1980)
Starring: Donald Sutherland as Calvin Jarrett, Mary Tyler Moore as Beth Jarrett, Judd Hirsch as Dr. Tyrone C. Berger, Timothy Hutton as Conrad Jarrett.
Director: Robert Redford

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Reviews

Surprisingly enough, I’ve been having an absolute blast. I’ve been having a lot of fun and it’s nice to wake up in the morning with a clear mind and energy and just wanting to get out there and try new things. I’m enjoying getting out of bed. SCHC was very accommodating when it came to my passion (golf) and felt that it would be a huge part in my recovery. That was huge for me. It allowed me to want to try and now I’m excited for group and doing the hard work that I need to do in order to sober up.

- Mick

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