IN CONTRAST to the analysis presented thus far
concerning the functional value of addiction in
families,6T.'"• [".15"' 1" 54' v" a number of investigators have given
evidence that the family can also be important in the rehabilitation of the
addict. When family members are involved in the treatment process,
the system can be changed toward helping the abusing member overcome his addiction rather than
serving as a force that maintains it. To this point, Eldred and Washington42
found in interviews with 158 heroin addicts that the people who the patients thought would be most
helpful to them in their attempts to give up drugs were the members of their
families of origin or their in-laws; second and third choices were an opposite-sex
partner and the patient himself. A group of 462 heroin addicts
interviewed by MACRO Systems researchers91 reported that the family
was second only to treatment (70.9% vs. 79.6%) as the influence they perceived as most important in changing their lives. Finally, a
5-year follow-up study of narcotics addicts by Levy92 found that patients
who successfully over-came their drug habits
most often had family support.
Studies of the effectiveness of family treatment
have shown this to be a promising approach with alcoholism and many other symp-toms, and family therapies
for drug problems have been gaining
This chapter is an expansion and revision of a
paper by the first four authors entitled "Engaging 'Resistant' Families in
Treatment: I. Getting the Drug Addict to Recruit His Family Members'. and is reprinted
with permission from the International Journal of the Addictions, 1980, 15, 1069-1089. (1) Marcel Dekker, Inc. momentum in recent years. t" In fact, a
1976 national survey of 2012 drug programs by Coleman and Davis3"
indicated that 93% were providing some kind of family services for at least a portion of
their clients—in many cases, family therapy.
Consequently, if there is a validity to such efforts, it is important to be
able to induct family members into the treatment program. This chapter presents
tech-niques pertaining to the initial facet of this process, that is, dealing with the addict in recruiting his family.*
As noted in the literature review in Chapter 5,
authors who have dealt with this
matter have noted how difficult it can be to bring family members of compulsive drug abusers into treatment.
Most family members, especially
parents, generally refuse to become involved. This is particularly interesting
in view of the aforementioned evidence that the majority of drug addicts—especially those who use opiates—maintain close ties to their families of origin. If
they do not live with one or both parents they may reside nearby and be
in frequent contact (see Appendix A for a
review of these studies). Thus it becomes all the more important that methods for effectively
involving members of addicts'
families in the treatment process be developed.
The AFP research
design called for a Family Evaluation Session (see Appendix C), which included at least the addict, both his parents or parent surrogates (e.g., stepmother, mother's boyfriend), and any siblings living nearby. This session was required
before treatment could proceed.
(Although not included in the Family Evaluation Session, spouses of married
addicts were usually involved in the therapy
that followed it.) Obviously, this put considerable pressure on us to succeed
in our recruiting efforts. The general procedure was for the person responsible for inducting the family to
function as both drug counselor and
family therapist. In approximately 80% of the cases we were able to obtain
cooperation from the addict toward including his family, and in 88% of these we
were able to get the family—including
both parents
or parent surrogates—to physically appear
at the treatment site together. In other words, two-thirds of
the subset of families we were unable to recruit occurred because the addict
*it should be noted that the
primary emphasis of this chapter is upon young adult addicts. Adolescents may
also manifest resistance to family involvement, However, the way the therapist
handles the process may differ when encountering an adolescent versus a
young adult, Some pointers and strategies for getting adoles‑
cents to agree to having
their families become involved in therapy are presented in Chapter 13.
JOHN M. VAN DEUSEN/M. DUNCAN
STANTON/
SAMUEI. M. SCUTT/THOMAS C.
TODD/DAVID T. MOWATT
