FINDINGS WITH ADDICTS' FAMILIES

FINDINGS WITH ADDICTS' FAMILIES

If one accepts that the family can be an important focal point for intervention, it is obvious that family members must be brought to treatment. The task, however, is particularly difficult with addicts' families. They often abdicate responsibility for the IP's problem and place the blame entirely on external systems and agencies such as peers, schools, courts, the neighborhood, or the treatment pro-gram.44' '92.'7" '8" Most of those who have written on the subject have lamented the difficulty involved. SeldiM 3 4 has called it a -monumen-tally discouraging task,- Salmon and Salmon' r note that such attempts have met with "little success,- Vaglum's" states that making family contact and getting members' cooperation is the therapist's -greatest problem and challenge," and Davis37 identifies addicts' families as -among the most difficult of all psychotherapy patients to get into the office- (p. 198). Mason's98 experience in trying to get addicts' mothers involved in their sons' inpatient program proved "uneconomical,"time consuming,- and -disappointing,- and he observed that of 1000 eligible parents, only 30 or 40 would appear at monthly parent-staff meetings and almost none of these attended more than three times. Alexander and Dibb2 reported that with the majority of addicts' families they contacted for outpatient treatment, either the IP or one or both parents refused to participate (even though these were cases in which the IP either lived in the parents' home or visited twice a week or more). Kaufman and Kaufmann's describe a program in which only 25% of addicts' families were recruited for multiple family therapy. Entin and Schumannu tried to engage six families of drug-using adolescents in Bowenian family therapy; their paper is a retrospective analysis as to why, after a few exploratory contacts, they were unable to get any of them in. As part of a therapeutic com-munity, Ziegler-Driscoll's7 reported a success rate of approximately 71% in trying to get addicts' families in for a family research inter-view that preceeded family therapy: 48% of the total group with which attempts were made continued for at least one therapy session. Ziegler-Driscoll also observed that the percentage of Whites re-cruited was nearly twice as high as that for Blacks. The only exception to this trend is described by Fram and Hoffmanss for a large, private, mental health center. They do not give statistics, but note that families were -most interested in becoming involved with the treat-ment- and often -welcomed it with delight- (p. 610). They do note that ( I ) their patients' socioeconomic status (White, middle-class) and (2) the nature of their program dictate that their patients be considered an -unrepresentative sample.' of the addict population, especially since there was enough cohesiveness in these families to seek and find private care for the IP. In sum, then, the experience of those in the field indicates that, with the possible exception of highly selected samples, the difficulty in engaging addicts' families in treat-ment cannot be overestimated.