Efficacy of Family Therapy for Drug Abuse: Promising but Not Definitive

Abstract

Drug abuse is an enormous public health problem with consequences not only for individuals using drugs but also for families, communities, and society. Moreover, research evidence and clinical experience agree that drug abuse is one of the more dificult problems to treat. Despite considerable research on the connection between family factors and drug use, and the existence of family therapy models for drug abuse, comparatively few controlled eficacy studies have been conducted. This article presents a critical review of controlled treatment outcome research in the area of family therapy for drug abuse in both adults and adolescents. A number of studies from different clinical research groups demonstrate that different versions of family intervention can engage and retain drug users and their families in treatment, signijicantly reduce drug use and other related problem behaviors, and enhance particular domains ofprosocialfunctioning. Moreover, a smaller number of comparative eficacy studies have shown family therapy to be more effective than nonfamily therapies. Family therapy of adolescent drug abuse is more developed at present than family therapy of adult drug abuse. Although the results of the reviewed studies are promising, a blanket confirmation of family therapy's eficacy for drug abuse cannot be made at this time because of the relatively small number of studies and the noted methodological limitations of the studies published to date. Nonetheless, substantial progress in this clinical research area has occurred, and i f research and funding support continue or can expand, significant breakthroughs in the treatment of drug abuse with family-based treatments are possible.

Adolescent and parent therapeutic alliances as predictors of dropout in multidimensional family therapy.

“…With respect to MDFT, research has demonstrated the particular superiority of MDFT over usual community-based treatment in terms of treatment retention and completion rates (Liddle & Dakof, 1995). In an early intervention study, 96% of youths in MDFT completed treatment (120 days) compared with 78% in group therapy (Liddle & Dakof, 2002).…”

Adolescent and Parent Alliance and Treatment Outcome in Multidimensional Family Therapy.

“…Second, there is substantial empirical support for family-based intervention models with this population (Alexander, HoltzworthMunroe, & Jameson, 1994;G. S. Diamond & Josephson, in press;Liddle & Dakof, 1995;Stanton & Shadish, 1997). Third, the fact that family-based models involve multiple participants and, consequently, require the development and maintenance of multiple alliances (i.e., adolescent-therapist, parent-therapist) raises important clinical questions regarding the unique role of each alliance in the therapy process, as well as the interactive effect between the alliances.…”

What Works with Children and Adolescents?

“…Liddle and Dakof (1995) and Waldron (1996) in literature reviews of a series of controlled clinical trials, concluded that family-based therapy (which includes both family therapy and multisystemic therapy) is more effective than other treatments in engaging and retaining adolescents in therapy and also in the reduction of drug use. From their meta-analysis of controlled family-based treatment outcome studies Stanton and Shadish Evidenced based practice in family therapy 12 (1997) concluded that family-based therapy is more effective in reducing drug abuse than individual therapy; peer group therapy; and family psychoeducation.…”