Helping A Loved One Seek Drug or Alcohol Treatment
Family members and close friends of persons who abuse alcohol are in a difficult position- they are often negatively impacted by their loved one’s drinking, while also being in an optimal position to assist behavior change. That is, they can be very helpful in getting their loved when to seek substance abuse treatment, and support their attendance and participation in substance and treatment, while offering loving encouragement.
There is strong evidence that alcohol abuse has a negative impact upon those individuals who are closest to the user. They may experience violence, unpredictable behavior and mood swings, theft of property, verbal aggression, embarrassment, irritability, withdrawal, and damage to their household from the substance user
On the other hand, evidence shows that loved ones can be highly successful in motivating treatment-resistant clients to both enter alcohol treatment programs and reduce their substance use. How can concerned loved ones best help get their loved one’s into substance abuse treatment, and what variables determines if such attempts will be successful?
There is plenty of research investigating both how concerned loved ones are impacted by alcohol use, and how such persons can impact the treatment outcome of their alcohol abusing friends and family members. There is less research into what factors determine why such loved one’s do takes steps, and what steps are the most helpful.
Deciding to Help A Loved One Seek Substance Abuse Treatment
How and why do people decide to make a change? Why do some people who abuse drugs or alcohol choose to stop, or seek help, while others continue to struggle with addiction? Why, and when, do the loved ones of someone who abuses drugs or alcohol take their own steps to help their loved one enter treatment?
One way of conceptualizing how friends and family respond to their loved one’s drinking is by using Miller and Tonigan’s motivational model (developed from Prochaska and DiClemente’s Transtheoretical Model of Change).
According to this model, there are stages of motivation that family and close friends moved through when helping their loved one’s change their problematic use of drugs and alcohol. These stages are:
Ambivalence: uncertainty about whether a problem exists. Does my loved really have a problem? He/she doesn’t get drunk everyday. He/she only gets high sometimes.
Problem Recognition: recognizing that there is a problem. My husband/wife drinks too much, but treatment could be expensive. I don’t think their problem is that serious- we’ll get help if it gets worse. Maybe we should get help, but where do we turn?
Taking Steps: taking steps to fix the problem. We need to get your into treatment. Where should we go? What treatment is best? If you don’t reduce your use, there will be consequences for our relationship.
Perhaps you recognize yourself at one of these stages. Are you ambivalent about the issue, sometimes thinking there is a problem, and at other times uncertain if treatment is necessary? Do you recognize there is a problem, but haven’t yet taken steps (perhaps because you don’t know what to do)? Or, are you taking steps, seeking out substance abuse treatment options, or supporting your loved one in treatment?
How to Support Someone Struggling with Substance Abuse
Previous research (such as Love et atl., 1993) has identified fours ways that people tend to respond when a loved one is struggling with drug abuse or problematic drinking:
Supporting Sobriety: behaviors that positively reinforce sobriety, such as arranging non-drinking social outings, or spending time with loved one’s when they are not drinking.
Supporting Use: Even when they recognize a problem exists, some persons continue to support their loved one’s use.
Punishing Use: includes initiating arguments when the loved one is using, threatening them with consequences (e.g., “I’m going to leave you”) for continued use, and attempting to embarrass them by reminding them of their behavior while under the influence.
Withdrawing from Use: includes behavior such as leaving the house or refusing to be around their loved one when they are using drugs or alcohol.
What are the most effective ways to respond? Research suggests that substance users are most receptive to supportive and assertive coping styles. The includes:
Expressing concern rather than criticism
Maintaining hope that treatment will be successful
Defending the substance user against criticism
Supporting treatment efforts
Clearly stating your own opinions on the abuse you perceive
Setting firm limits
Encouraging regular discussing of the issue
What are ineffective ways of responding? Research suggests such the following methods are less successful:
Responding with intense emotion
Acting intolerant of your loves ones
Being overcritical for failed attempts at sobriety
Withdraw, avoidance, or passivity in the face of the issue
Being unsupportive or pessimistic about effects to maintain sobriety
Obviously, when persons DO NOT recognize their loved one’s drinking as problematic, they are more likely to support use. Without problem recognition, they are more likely to engage in behaviors that include drinking with the substance user, buying alcohol for the user, and telling the user that they are fun to be around while drinking.
When persons DO recognize problematic drinking AND ARE NOT ready to take steps to help their loved ones, tend to respond by withdrawing from use.
When persons DO recognize problematic drinking AND are ready to take steps to help their loved ones, what steps are they most like to take? In many cases, they respond by punishing use.
Supporting sobriety is more difficult, and requires more information to pull off. However, this is the approach more likely to be successful in leading to sobriety. It is unfortunate that supporting sobriety is underutilized, given that it is an indicator of treatment success.
If you’re ambivalent about whether you or a loved one has an issue with substances and could benefit from treatment, we can help with an assessment.
If you recognize that your loved one has a problem why drugs or alcohol which they don’t acknowledge, we can offer you guidance and support.
If you are ready to take steps and help your loved one by supporting their sobriety, we can offer substance abuse treatment, or support for you as you support your loved one.