In some families, the addicted person can work like a disease carrier, bringing a condition into the home and changing the way the family members behave. The family members may not abuse alcohol or drugs, and they may not engage in any other impulsive behaviors like gambling, but they’re still impacted by addiction. They may become depressed when the alcoholic drinks. They may feel powerful when the drug user puts the needle down for a time. As the family members begin to define themselves in relation to the addict, they lose sight of their own personalities and goals. In short, they become addicts in their own right.
Family members might think they’re helping the addict with this behavior. They’re attempting to reward the addict for abstaining and punish the addict for giving in. But in reality, they’re creating patterns that can make it easier for the addict to continue with the addiction. The addict may feel spied on and watched, and may develop sneaky behaviors to hide the addiction. The family may be constantly on alert for these deceptions and prepared to engage in huge fights when the truth comes out. If the addict does step away from the addiction for a time, the family might continue with the suspicious behavior, encouraging the addict to submit to the addiction (“They already think I’m drinking. Why not have a drink?”). Both the family members and the addict put their mental and physical health at risk.
A systemic family model recognizes that true healing can only come when the addict gets treatment and the family learns to communicate in healthy, supportive ways. All members of the family must commit to change, and they all must have therapies to help them change.
When discussing intervention therapies, researchers often hone in on the person with the addiction. They might look at people who abuse alcohol, for example, and then outline how often alcoholics enter a treatment program when they’re subjected to one type of intervention versus another type of intervention. The systemic family model holds up quite well in this regard, with one study from Journals of Adolescent Research suggesting that family-based interventions significantly reduced drug use among adolescents.
Stopping analysis here does the systemic model a disservice, however. In the systemic model, the entire family is admitted for treatment. The addict may or may not receive treatment. The family members receive treatment no matter what. When the research options are opened up in this manner, the comparisons become slightly murky. Is success defined by recovery or by happiness of the other family members? More research is needed to fully answer that question, but one study performed in 2000 suggested that family interventions can reduce the incidence of separation, divorce and domestic violence. This might be decent proof that family interventions improve the health of the entire family unit, not just the health of the addict.
How It Works
A systemic family model of intervention turns a basic intervention on its head. As a refresher, these bullet points define a basic intervention:
Planning meetings are held in secret.
An intervention happens once.
The addict is confronted with behavior and encouraged to enter treatment.
When treatment begins, the family resumes with their daily tasks.
If the addict will not enter treatment, the family may choose to cut ties or impose other harsh consequences.
If a relapse occurs, the family performs another intervention.
Almost everything about a systemic family model of intervention is different from this list. For starters, there are no secret planning sessions. The family hires an intervention specialist, and that intervention specialist calls the addict to invite him or her to a series of meetings. The intervention specialist may discuss why the meetings are taking place and outline the family’s concerns in a very general manner, but the addict is not confronted by the family in any way.
The meetings take place between the interventionist, the family and the addict. In these meetings, they discuss the nature of addiction and how it impacts the physical and mental health of the addict. They may also discuss how communication styles should be modified to allow the addict and the family members to express themselves clearly. There may be up to five meetings like this, held on separate days. The family may or may not discuss the addict’s specific behavior. Instead, they may focus on addiction as a concept, with the goal of learning all they can about how addiction can be eradicated from the entire family.
In these meetings, the addict is encouraged to enter a treatment program. Most addiction specialists believe that inpatient addiction programs provide the best method for helping addicts overcome the chemical and physical addictions that drive their problems. But the family members are also encouraged to enter formal group therapy sessions such as Al-Anon or Alateen so they can learn how to adjust their own behavior and stick to their new goals. The entire family, including the addict, resolves to change and to participate in therapies to help them change. These therapies might continue for years, long after the intervention is complete.
Going It Alone
According to the founders of the systemic intervention movement, over 90 percent of addicts enter and complete a rehabilitation program when they’re subjected to a family intervention. However, there are times when an addict refuses to participate in any sort of treatment program. In many other forms of intervention, this can leave the family members in a tricky position. They can either follow through on their threats and exclude the addict from some or all of their lives, or they can simply pretend like the intervention never happened and go on as usual.
In a systemic family model, the family has many more options. They can:
Continue with the intervention meetings, and focus on learning new ways to work with the addict and improve their own mental health.
Stop the intervention meetings and head straight to group therapy sessions, and learn how to interact with the addict without letting the addiction drive the relationship.
Drop the systemic family model and move straight to a confrontation model such as the Johnson model, and force the addict to accept a change or leave the relationship.
Complete the intervention meetings and then enter private counseling to learn how to overcome codependency and become strong enough to leave the relationship.
The systemic family model truly does help more than just the addict, and it gives the family a large toolkit they can use to deal with their own problems. It must be noted, however, that this model does require the family to hire an intervention specialist. The interventions are more like group counseling sessions, and the family must have access to someone who can teach them how the addiction works and how it can be stopped. Families who would prefer to handle addiction problems alone without any outside staff may find this requirement to be a bit troublesome. Working within another intervention model might be more appropriate for these families, and they will have more control over what is said and how it is said. Additionally, the very nature of systemic family interventions is sporadic, and they allow the addict to take time away and think. Some addicts may participate in one session, grow angry about the message and refuse to participate in any later sessions. This is a risk families must be willing to take.