Addiction treatment heavily focuses on helping the individual recover utilizing various therapeutic treatment options over the course of recovery, but they are not the only one impacted by substance abuse. Addiction is often referred to as a family disease because those closest to the person with the addiction are severely impacted by it as well. Their experiences and interactions with their loved one can significantly strain relationships and cause additional issues to develop in the family dynamic. For this reason, family therapy is crucial to the recovery process.

Substance abuse treatment focuses on addressing the thoughts, feelings, and behaviors of the person with the addiction. In family therapy, the experiences of loved ones in relation to the addiction are explored and dissected in order to start the healing process. Substance abuse becomes a significant component of family members’ interactions with one another. From enabling behaviors to increased conflict, problems develop within the family structure that must be addressed in order to mend relationships and support the person’s journey in recovery.

Family Dynamic & Structure

In many family structures, addiction brings about a dynamic that can feel policing in nature. The person with the addiction may be exhibiting in secretive behaviors, lying, and potentially engaging in dangerous/criminal behaviors to support their addiction. This causes family members to distrust their loved one and may result in behaviors such as snooping or following them in order to uncover what is happening. It is also not uncommon to find enabling behaviors develop in this dynamic. As family members begin to feel defeated or unable to enact change, they may simply just do what they can to reduce tension and avoid conflict altogether.

Regardless of what behaviors evolve as a result of substance abuse, many families deal with anger, resentment, anxiety, stress, and a plethora of other negative emotions that can make even the smallest interactions increasingly emotionally charged. Family therapy focuses on helping the family unit work through these difficult emotions by validating their experiences and working through repairing relationships through education and changing problematic behaviors. This means helping the family develop new, effective methods of communicating and interacting with one another.

Elements of Family Therapy

There are multiple components of family therapy work together to repair relationships and strengthen the family dynamic. These components are:


The first step in starting family therapy is assessing each family member’s level of engagement. Some family members may be more reluctant than others to participate in therapy. During this phase, a therapist will work with individual family members to help them engage in the process. For reluctant family members, it is important to help them understand the importance of their involvement, the significance of communicating their thoughts and feelings, and understanding that discussions may be painful or difficult to participate in. The therapist’s role is to help ensure everyone is heard and their concerns are addressed.

Additionally, if the person with the addiction is reluctant to engage with their family members, the therapist can help reframe their perspective to understand its importance. It is vital to the healing process that difficult conversations take place in order for everyone to feel understood and validated. The therapist creates a safe space for everyone to engage in discussion about what is working and what is not in order to enact change.


After exploring the various perspectives of family members, it is important to reframe the thoughts and feelings that are expressed. Addiction can cause a great deal of tension and stress to develop in relationships, making even the most benign interactions turn chaotic. Reframing helps family members take a step outside of their own view and consider the perspective of others. Rather than taking interactions and finding the negative in them, a therapist can help them uncover the underlying motives and feelings that fuel these situations.

Rather than viewing words and actions through an irrational, emotionally-charged lens, the therapist can help everyone consider what motivates thoughts and behaviors. Concern, worry, fear, and anxiety can drive negative interactions, causing a person to focus on the feelings they are left with rather than what causes it to happen in the first place. Considering that everyone responds to stress and negative emotions in different ways, these conversations can help family members better understand what informs their actions.

Behavioral Changes

As the family works through their experiences, they must also learn how to improve their future interactions with one another. Ending enabling behaviors through the development of new skills can help strengthen relationships and reduce tension.

Some of the components of relationships that must be addressed include communication skills, the creation of boundaries, and better methods of addressing emotions. This requires both the person with the addiction and their family members to negotiate and develop rules, limits, and boundaries together. It encourages the family to work together as a unit rather than enforcing a “me versus them” mentality that can drive problematic behaviors.


The structure of the family often shifts because of addiction. The roles of family members change, creating instability and disorder. This requires the family to explore their dynamics and address how they currently reinforce negative behaviors.

The therapist can help discuss specific situations and experiences that need to change. Using the previously mentioned components of therapy, the family must work on developing new ways of addressing difficult situations and the role of each person in them. This can help foster shifts in relationships that support the person in recovery and helps family members engage in a productive way. By practicing non-judgmental communication methods, engaging in difficult conversations, and seeking support when necessary, relationships can become more positive and conversations are made easier.

Relationships in Recovery from Addiction

Although substance abuse can dramatically impact the relationships within the family, family therapy can help enable recovery and ensure all family members feel supported, understood, and heard. Ultimately, family therapy enables the development of positive relationships that support sobriety. This helps the family become a source of support for their loved one and provides them with the tools to support themselves, and each other, throughout the process.

If you or someone you know is struggling with substance abuse or addiction, we are here to help. Give us a call at 888.855.6877 or send us a message below and one of our admissions counselors will do their best to get you the help you need.

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