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Many individuals who engage in substance abuse and develop formal substance use disorders operate under the impression that their behavior affects only them; however, someone who has a substance use disorder does not have a circumscribed condition that affects them alone.
The individual’s behavior affects many others, most importantly members of their family and close friends.
The person with a substance use disorder actually resembles an individual with a communicable disease who brings certain aspects of their disorder into the home, affecting the way members of the family behave and function. Even if other family members do not use drugs or alcohol or have no other compulsive behaviors, they are still impacted by the actions of the individual with the substance use disorder.
For instance, family members may inadvertently attempt to punish or sanction the member with the substance use disorder when they believe the person has used alcohol and drugs, whereas they may inadvertently reinforce the person when they are sober. In some cases, family members may actually reinforce the dysfunctional substance abuse of the affected sub-unit. In family therapy, the members of the family are often referred to as sub-units, and the family consists of the entire unit.
Members of the family may perform these behaviors overtly or may not be aware of them. They may believe that they are actually helping the person, but the reality of the situation is not quite that simple. Family members may be constantly on alert for deception and engage in confrontational behaviors with the affected member; the affected member may feel punished and that they are singled out unfairly; and other family members draw the family’s attention to the person’s substance abuse to avoid other family conflicts.
The systemic model of family therapy recognizes that treatment for substance use disorders often involves the individual with the disorder getting specific individual treatment and the family getting treatment to learn to communicate in a healthier and more functional manner.
A substance use disorder intervention is an action by a group of concerned family members, friends, coworkers, etc., of an individual who has a suspected substance use disorder. The goal is to persuade the person to get treatment for their problem. The group will typically follow some formal plan of action that organizes the process and results in it being more efficient and more likely to reach its goal. In a basic intervention, the following occurs:
How the Systemic Family Model Works in an Intervention
According to scholarly sources, such as the book Family Systems/Family Therapy: Applications for Clinical Practice, the basic assumptions of Family Systems Therapy propose the following:
In the systemic family model of intervention, the following takes place:
Family Systems Therapy has a good body of empirical evidence to support its use. However, there is a paucity of research evidence regarding the effectiveness of these types of substance use disorder interventions in getting individuals into treatment and keeping them there.
A similar model of intervention that also includes the subject of the intervention in the planning stages as opposed to holding secret meetings is the ARISE model (A Relational Intervention Sequence for Engagement).
ARISE has some evidence to suggest that it is effective in certain instances.
A major drawback to using a formal substance use disorder intervention is that in many cases individuals plan the intervention but do not follow through with the actual event. Getting the subject involved from the beginning in the planning stages avoids this issue, as they are part of the process from the very beginning.