Chapter 1 drug abuse treatment and family therapy – drug abuse treatment and family therapy – ncbi bookshelf
Safety and Suitability of Family Therapy
Only in rare situations is family therapy inadvisable. From time to time, it’ll
be inappropriate or counterproductive due to reasons such individuals as
pointed out above. Sometimes, though, family treatments are eliminated because of
issues of safety or legal constraints. Family or couples therapy shouldn’t
occur unless of course all participants possess a voice and everybody can raise
pertinent issues, even when a domineering member of the family doesn’t would like them
discussed. Family therapy may be used when there’s no proof of serious
domestic or intimate partner violence. Participating in family therapy without
first assessing carefully for violence may lead not just to poor treatment,
but additionally to some risk for elevated abuse.
A systems approach presumes that family people have roughly equal
contributions towards the process and also have equity when it comes to power and control.
This belief isn’t substantiated within the research on family violence. Hence,
family therapy only ought to be used when one member of the family isn’t being
terrorized by another. Resistance from the domineering member of the family could be
addressed and restructured beginning with allying with this particular member of the family after which
progressively and lightly questioning this individual (and everyone) about
the suitability from the domineering behavior (Szapocznik et al. 1988). (See also appendix C,
Guidelines for Assessing Violence.)
It’s the treatment provider’s responsibility to supply a safe, supportive
atmosphere for those participants in family therapy. Children benefit by
attending organizations particularly on their behalf you should produce a
safe atmosphere that they can discuss family violence, abuse, and
neglect. Usually, a means are available to incorporate the member of the family who
has switched to violence as a means of coping with problems. That individual is really a
vital area of the family and will also be pivotal to understand the character of
the household violence. For instance, Manley
(1995) distinguishes between common couple violence and
patriarchal terrorism. The previous is characterised by periodic violent
outbursts by spouse and isn’t prone to escalate. It is almost always an
intermittent reaction to conflict, as well as in therapy could be examined and
channeled into better expression. Patriarchal terrorism, however, is
systematic male violence with the aim of control. It might not be possible or
better to incorporate a chronically violent partner in the household therapy
process.
Child abuse or neglect is yet another serious thought. Children in violent
homes convey more physical, mental, and emotional health issues compared to
children in nonviolent homes. Kids of individuals with excessive drinking
disorders suffer more injuries and poisonings compared to children within the
general population. Studies have proven that whenever families exhibit each of
these behaviors—substance abuse and child maltreatment—the problems should be
treated concurrently to make sure a child’s safety. It ought to be noted that
the withdrawal felt by parents who cease using alcohol or drugs
presents specific risks. The results of withdrawal frequently result in a parent to
experience intense feelings, which could raise the probability of child
maltreatment. During this period, it’s particularly important that family
support sources be distributed around the household (Bavolek 1995), which children understand how to find
safe adults to assist. When a counselor suspects child abuse or neglect,
laws and regulations require immediate reporting to local government bodies. For more
information, see TIP 36, Drug Abuse Strategy to Persons With
Child Abuse and Neglect Issues (CSAT 2000b
).
Domestic violence is really a major problem among individuals with substance use
disorders, and it should be included in therapeutic factors. If, for
example, a restraining order prohibits spouses from seeing one another, the
treatment provider must work in this particular limitation, using therapeutic
configurations that make certain that the client who’s abusive isn’t inside a
session using the person she or he has been barred from seeing. Frequently when
there’s concomitant family violence, the offender is mandated to accomplish a
Batterer’s Intervention Program before taking part in any couple’s work.
Simultaneously, the victim/spouse is involved in safety planning and
sometimes treatment for own issues.
Just the most extreme anger contraindicates family therapy. Kaufman and Pattison (1981)
developed the idea of the necessity for abstinence before
sufficient trust could be created to combat the anger. Including all family
people in treatment and supplying them a forum for releasing their anger
might help to work toward that threshold. Redefining the issue as residing
inside the family in general might help transform the anger into motivation
for change. Consequently, this motivation may be used to restructure the family’s
interactions so the drug abuse is not supported. The
therapist’s capability to reframe suggested obstructions by family people is
frequently the way to guarantee an optimistic therapeutic direction.
It can be counselors and therapists to evaluate the opportunity of anger and
violence and also to construct therapy so it may be conducted without endangering
any family people. Due to the life‐and‐death nature of the
responsibility, the consensus panel includes guidelines for that screening
and management of people distracted by periodic family violence. These
recommendations, adapted from TIP 25, Drug Abuse Treatment and
Domestic Violence (CSAT
1997b
), are presented in appendix C.
However, the following tips aren’t an alternative to training counselors and
therapists must have training and supervision in handling family violence
cases.
Safety and Suitability of Family Therapy
Only in rare situations is family therapy inadvisable. From time to time, it’ll
be inappropriate or counterproductive due to reasons such individuals as
pointed out above. Sometimes, though, family treatments are eliminated because of
issues of safety or legal constraints. Family or couples therapy shouldn’t
occur unless of course all participants possess a voice and everybody can raise
pertinent issues, even when a domineering member of the family doesn’t would like them
discussed. Family therapy may be used when there’s no proof of serious
domestic or intimate partner violence. Participating in family therapy without
first assessing carefully for violence may lead not just to poor treatment,
but additionally to some risk for elevated abuse.
A systems approach presumes that family people have roughly equal
contributions towards the process and also have equity when it comes to power and control.
This belief isn’t substantiated within the research on family violence. Hence,
family therapy only ought to be used when one member of the family isn’t being
terrorized by another. Resistance from the domineering member of the family could be
addressed and restructured beginning with allying with this particular member of the family after which
progressively and lightly questioning this individual (and everyone) about
the suitability from the domineering behavior (Szapocznik et al. 1988). (See also appendix C,
Guidelines for Assessing Violence.)
It’s the treatment provider’s responsibility to supply a safe, supportive
atmosphere for those participants in family therapy. Children benefit by
attending organizations particularly on their behalf you should produce a
safe atmosphere that they can discuss family violence, abuse, and
neglect. Usually, a means are available to incorporate the member of the family who
has switched to violence as a means of coping with problems. That individual is really a
vital area of the family and will also be pivotal to understand the character of
the household violence. For instance, Manley
(1995) distinguishes between common couple violence and
patriarchal terrorism. The previous is characterised by periodic violent
outbursts by spouse and isn’t prone to escalate. It is almost always an
intermittent reaction to conflict, as well as in therapy could be examined and
channeled into better expression. Patriarchal terrorism, however, is
systematic male violence with the aim of control. It might not be possible or
better to incorporate a chronically violent partner in the household therapy
process.
Child abuse or neglect is yet another serious thought. Children in violent
homes convey more physical, mental, and emotional health issues compared to
children in nonviolent homes. Kids of individuals with excessive drinking
disorders suffer more injuries and poisonings compared to children within the
general population. Studies have proven that whenever families exhibit each of
these behaviors—substance abuse and child maltreatment—the problems should be
treated concurrently to make sure a child’s safety. It ought to be noted that
the withdrawal felt by parents who cease using alcohol or drugs
presents specific risks. The results of withdrawal frequently result in a parent to
experience intense feelings, which could raise the probability of child
maltreatment. During this period, it’s particularly important that family
support sources be distributed around the household (Bavolek 1995), which children understand how to find
safe adults to assist. When a counselor suspects child abuse or neglect,
laws and regulations require immediate reporting to local government bodies. For more
information, see TIP 36, Drug Abuse Strategy to Persons With
Child Abuse and Neglect Issues (CSAT 2000b
).
Domestic violence is really a major problem among individuals with substance use
disorders, and it should be included in therapeutic factors. If, for
example, a restraining order prohibits spouses from seeing one another, the
treatment provider must work in this particular limitation, using therapeutic
configurations that make certain that the client who’s abusive isn’t inside a
session using the person she or he has been barred from seeing. Frequently when
there’s concomitant family violence, the offender is mandated to accomplish a
Batterer’s Intervention Program before taking part in any couple’s work.
Simultaneously, the victim/spouse is involved in safety planning and
sometimes treatment for own issues.
Just the most extreme anger contraindicates family therapy. Kaufman and Pattison (1981)
developed the idea of the necessity for abstinence before
sufficient trust could be created to combat the anger. Including all family
people in treatment and supplying them a forum for releasing their anger
might help to work toward that threshold. Redefining the issue as residing
inside the family in general might help transform the anger into motivation
for change. Consequently, this motivation may be used to restructure the family’s
interactions so the drug abuse is not supported. The
therapist’s capability to reframe suggested obstructions by family people is
frequently the way to guarantee an optimistic therapeutic direction.
It can be counselors and therapists to evaluate the opportunity of anger and
violence and also to construct therapy so it may be conducted without endangering
any family people. Due to the life‐and‐death nature of the
responsibility, the consensus panel includes guidelines for that screening
and management of people distracted by periodic family violence. These
recommendations, adapted from TIP 25, Drug Abuse Treatment and
Domestic Violence (CSAT
1997b
), are presented in appendix C.
However, the following tips aren’t an alternative to training counselors and
therapists must have training and supervision in handling family violence
cases.
If, throughout the screening interview, it might be obvious that the batterer is
endangering a customer or perhaps a child, the therapy provider should react to
this case before every other issue and, if required, suspend the remainder of
the screening interview before the safety from the client could be ensured. The
provider should refer the customer or child to some domestic violence program and
possibly to some shelter and legal services, and really should take necessary steps to
make sure the safety of affected children. Any outcry of anticipated danger
must be considered using the utmost significance and immediate safeguards
taken.
Resourse: https://ncbi.nlm.nih.gov/books/NBK64269/
