A Family-Centered Approach to Treating Addiction

Addiction is a family disease. Few know that better than Michael Barnes, Ph.D., LAC, LPC. Throughout the past 35 years, Dr. Barnes has served as an addiction professional, program administrator, family therapist, and counselor educator. He has been the chief clinical officer at the Foundry Treatment Center in Steamboat Springs, Colorado for the last three years. Dr. Barnes speaks nationally on families, trauma, addiction, trauma-integrated addiction treatment, and compassion fatigue. His publications in books and scholarly journals have focused on secondary trauma and clinical work with traumatized family systems.

In a recent webinar for Harmony Foundation, Dr. Barnes discussed a family-centered clinical approach to treating families struggling with addiction. The ultimate goal of this model is to include the client in family services to create family healing and improve treatment outcomes.

“Families should not be shamed or blamed,” Barnes quoted from one of his recent publications. “They should be provided an opportunity to learn about addiction, trauma, mental health issues, and transgenerational issues. They should be helped to identify system patterns that serve to maintain the problem that they’re desperately trying to change.”

Barnes then presented a quote from the mother of a 37-year-old man with addiction and other mental health issues, illustrating the impact on families.

“My second son has mental health issues and is an addict. It has been very difficult for our family unit to understand where he is coming from, how this happened. I wonder if there will ever be light at the end of his dark tunnel.”

Despite the trauma the family members of the addicted person experience, many do not consider themselves traumatized. Barnes talked about families needing integrated treatment rather than just the identified patient with the addiction. 

Barnes has investigated how medical practitioners have looked at family adaptation to a chronic illness—not necessarily addiction—and found a five-stage model developed by psychiatrist professor John Rolland particularly useful. Rolland starts with a three-generation assessment that will inform health and illness belief systems. What the family experienced over generations dictates how they view illness and treatment options.

“And how the family views problems will inform the five Rs—rules, roles, routines, rituals, and relationships,” explained Barnes, the third stage of the Rolland model. “This, in turn, determines how the family works through life cycle stages. Every time a family member is unable to proceed through a life cycle stage, we begin to see a lot of resentment and conflict.” Finally, there is the individual development of family members.

In the case of addiction in the family, a strong element of trauma is added. Individual and family system trauma emerges at the core. “If we look at all the symptoms of addiction, the conflicts, and the negativity, we begin to see how that is going to impact every aspect of how this family is going to adjust to deal with the chronic illness,” Dr. Barnes said. “The way a family is organized will either promote change, growth, and openness or keep it stuck in the same place.”

Barnes found that unresolved life cycle stages—especially during teenage years—can have a tremendously pernicious effect, influencing long-term family relationships and individual development. Barnes emphasized the importance of getting younger family members to participate in the treatment process as they are frequently much more affected than they assume. 

When Barnes worked with the Center for Dependency, Addiction, and Rehabilitation (CeDAR) in Colorado, he conducted surveys with families and asked them about the sources of their trauma. He received answers that are all too familiar to addiction professionals: fear of overdose or suicide attempts of their loved one, medical emergencies, legal complications, victimization of loved one (rape, assault, etc.), dangerous and out-of-control behavior, but also shattered dreams: “they will never be who we thought they would be.” 

The last one is a grief and loss issue Dr. Barnes encounters quite frequently with family members suffering secondary and systemic trauma due to the substance misuse of a loved one. “In family programming, it is important to recognize that the family members may have the same post-traumatic stress symptoms—hypervigilance, anxiety, anger and fear, intrusive thoughts, nightmares, sleep disturbances, and feeling the need to control others—that the client has,” Barnes said, “and it’s important to educate them on those symptoms.” 

Harmony Foundation is one of the world’s longest-running and most successful addiction treatment centers. We offer a family engagement workshop to all families of current and former clients. It educates family members about the disease model of addiction and gives them a place to express themselves and begin the healing process.

If you or a loved one are struggling with alcohol or drug addiction or have questions about our programs, call us today at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.