An Overview of Marital and Family Treatments with Substance Abusing Populations

An Examination of Family-Involved Approaches to Alcoholism Treatment

“…Despite considerable empirical support for behavioral family treatment of alcoholism, it is important to acknowledge that these methods have not been proven to be superior to what has been termed the family systems approach in this article (Lipps, 1999;Thomas, 1989). For example, by citing longitudinal studies of family treatment in which follow-up periods are more than 1 year, Edwards and Steinglass (1995) pointed out that gains achieved in family therapy diminish substantially over time.…”

“…Over time, a fundamental transformation took place whereby the focus on the individual (referred to as the "identified patient") continued, but the family began to be seen as either being the cause of alcoholism or being involved in its maintenance (Thomas, 1989). This view of the individual as influenced by his or her family and larger context is implicit in sociological theory, which stresses the importance of cultural attitudes, suggesting that alcohol is sometimes used in families as a rite of passage (Lawson et al, 1983).…”

“…Many authors have regarded the active involvement of family members, especially spouses, as an important component of a comprehensive alcoholism treatment program (Edwards & Steinglass, 1995;Lipps, 1999;O'Farrell, 1993;Thomas, 1989). As a result, there have been several outcome studies conducted that compare individual treatment modalities to family interventions.…”

“…Indeed, even leaders in the field of behavioral interventions complain of a lack of administration guidelines and procedures (O'Farrell, cited in O'Conner, 2001). Notwithstanding, the fact that there is no agreed-on theory of alcoholism in the field of family therapy represents a critical limitation of this approach, and correspondingly, there is no consensus as to what constitutes family treatment (De Maio, 1989;Lawson et al, 1983;Leonard, 1990;Thomas, 1989;Trachtenburg, 1989). …”

“…Steinglass (1976) noted an interesting tendency: The application of family-involved approaches to the treatment of alcoholics and their families during the 1960s and 1970s was instituted to a greater extent by practitioners in the field of alcohol treatment than by marriage and family therapists. More recently, the use of marital and family therapy with alcoholic populations has flourished to become a mandatory component in many treatment programs (Thomas, 1989).…”