Academic journal article Forum on Public Policy: A Journal of the Oxford Round Table

Contemporary Family Systems Approach to Substance Abuse

Academic journal article Forum on Public Policy: A Journal of the Oxford Round Table

Contemporary Family Systems Approach to Substance Abuse

Article excerpt

Contemporary Family Systems Approach to Substance Abuse

This paper will address theoretical and clinical issues that challenge family therapists treating families dealing with substance abuse, specifically alcohol. A contemporary family systems approach to substance abuse seeks to understand how the relational patterns of family members are not only recursively shaped by the presence of a family member actively abusing substances, but also how the families' potential for growth and development throughout the family life cycle may be restricted.

Research has demonstrated the utility of examining family rituals as a reflection of family process (Bennett, Wolin & Reiss, 1988; Bente, Storm, Haughland, 2005; Dickstein, 2002; Fiese1992, 1993; Hawkins, 1997; Imber-Black & Roberts, 1992; Steinglass, Bennett, Wolin, & Reiss, 1987). Family rituals are the epicenter from which social, emotional, individual, and cultural meanings and values emerge. They function as an integral part of family life. Ritual behavior provides "a lens through which we can see our emotional connections to our parents, siblings, spouse, children, and dear friends. Rituals give us places to be playful, to explore the meaning of our lives, and to rework and rebuild family relationships" (Imber-Black & Roberts, 1992, p. 4). According to Bennett and her colleagues (1988), "A family ritual is a symbolic form of communication that, because of the satisfaction that family members experience through its repetition, is acted out in systemic way overtime. Through their special meaning and repetitive nature, rituals can contribute significantly to the establishment and preservation of a family's collective sense of itself.." (p. 825)

When families are organized in response to a substance abusing member, family rituals become embedded in multiple levels of distortion and accommodations. As a method of examining family relational processes and development, this paper will present a current review of literature that highlights the significance of parental drinking patterns in the context of family rituals, and the potential impact this has on the values, attitudes, and belief systems of young adults as they differentiate from their families of origin.

Empirically the study of substance abuse and its intergenerational process of transmission has progressed from a study of individual factors and perspectives that privilege psychosocial, genetics, and environmental domains (Bennett et al. 1988; Edwards & Steinglass, 1995; Ellis & Zucker, 1997; Fiese, 1993) to a more comprehensive approach which includes a multitude of family factors. Edwards & Steinglass (1995) report, "Early trends in treatment approaches were very much skewed toward a biomedical/behavioral treatment of the individual alcoholic during initial phases and group therapy during rehabilitation phase, again for the individual alcoholic." (p. 1). Substance abuse has historically been viewed as a problem that affects the individual with subsequent social and emotional costs to the family. Treatment has been primarily modeled on individual pathology, with or without the concurrent treatment of the family (Steinglass et al., 1987). Since 1960 treatment approaches to alcoholism have evolved and a greater number of clinicians are recommending treatment models that include a systemic perspective based on family systems models (Bente et al., 2007; Edwards & Steinglass, 1995; Fiese, 1993; Rollan, &Walsh, 2005; Steinglass, et al., 1987).

Steinglass et al. (1987) comment, "In recent years, a more empathetic view of families with alcoholic members has been emerging. Family oriented clinicians and researchers have drawn on the burgeoning interest in family systems theory ... Along with new family perspective, there is increased awareness of the multidimensional nature of the relationship between alcoholism and the family" (p. 8).

Steinglass et al. …

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