Minds at Peace

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How do you confront a family member with an addiction?

Mark Levine

How do you confront a family member with an addiction? Ultimatum? It’s a question I get almost everyday.

One out of two Americans admit to have a family member or friend with an addiction. One out of two. 

I asked a primary care physician friend of mine how he counsels patients when they tell them about a loved one with an addiction problem.  He threw up his hands and said, “Al-Anon?”.

For many that is the only option they know. Al-anon is a 12 step program that advocates family members “detach with love.” While Al-Anon has offered emotional support to countless people, the science shows that family members are in a unique position to help, i.e. to “engage with love.”

Another option that has gained notoriety is the ultimatum.  Or to it put in terms from the book The Anatomy of Peace, you can go to war with your loved one.  Think about how you feel when someone gives you an ultimatum?  Immediately your defenses flare as you prepare for battle. Your family member reacts the same way. You might get what you want from your loved one in the short term, but in the long run resentment builds, triggering a never ending cycle of emotional war.

Research has shown that family members can play a role in change.  CRAFT - Community Reinforcement and Family Training is an evidenced based approach that has been clinically proven to help families of substance abusers.

CRAFT has two main goals: 1) to teach family members skills to take care of themselves; 2) teach family members skills to help their loved one change.

So what does the research show?  

  • 66% of people using substances who had been resistant to treatment agreed to go to treatment (typically after family members had around five CRAFT sessions of training), compared to 30% for Intervention and 9% for Al-Anon.  I recently spoke with someone who does Intervention for a living.  He said, “They should come to you first!”

  • The majority of participant family members reported being happier, less depressed and with less family conflict whether or not their loved one engaged in treatment.

  • The effectiveness of CRAFT was not relegated to one particular group.  It was found to be effective across substance types, relationship types and ethnicities. 

CRAFT works because it understands that people don’t use substance in a vacuum.  Relationships play a major role in using, cutting down and quitting.  The CRAFT approach treats the problem as a deficit of skills rather than a disease of codependence.

Invitation to Change (ITC) is an updated version of CRAFT.  It takes all of the communication skills building of CRAFT and adds to it by teaching family members Motivational Interviewing and Acceptance and Commitment Therapy skills.  I have a video summarizing CRAFT communication skills on the homepage of my website mindsatpeace.net

Addiction is a family disease. But when only the substance user gets treatment and not the spouse, divorce rates are higher.  ITC understands the spouse and parents require coaching as well and offers a roadmap that combines science with kindness.

Some of the main points I focus on with family members are: all behaviors make sense (they do to your loved even if they don’t to you), ambivalence is normal, one size does not fit all, self-awareness and self-acceptance, self-compassion, and communication and behavioral skills.  And I constantly stress the importance of practicing these skills which sometimes involves role-playing in the office.

The whole point is to build collaboration within a family in order to communicate better instead of colluding in misinterpretation.

Here’s some helpful resources.

For specific coaching in helping a client, family member or friend email me or call 513-666-1413. I offer a free 15 phone conversation as well as a money back guarantee on the first coaching session. If you feel like you got nothing out of the first session, it’s free. This is hard enough. I want to make it a little easier.