Families often are relegated to a peripheral role in traditional addiction treatment for a variety of reasons. However, families who incorporate recovery into their own lives, can maximize an individual’s chances of recovery, said Michael Barnes, PhD, LAC, LPC, chief clinical officer, Foundry Treatment Center Steamboat in Colorado.
On Thursday at the Cape Cod Symposium, Dr Barnes presented a session on how families can organize around a loved one’s addiction to improve outcomes. Recently, he spoke with Addiction Professional about the reasons that family programming isn’t sufficiently supported, the role of systemic motivational interviewing when working with families, and other best practices.
Editor’s note: This interview has been edited for length and clarity.
Addiction Professional: Why is family programming still often relegated to a peripheral role in traditional addiction treatment?
Michael Barnes: I think there are several reasons. The first is that as addiction treatment has moved more and more into a medical model, we have to have an identified patient who becomes the subject of treatment, and that the family becomes peripheral or secondary. In any medical environment, families are seen more as support and there for aftercare and those kinds of things.
I think the second reason is insurance. Insurance companies want to know if families are involved in treatment, but they’re not willing to pay for their involvement. They don’t see the family as part of the client and they certainly don’t pay for that. There are a growing number of programs around the country that are closing their family programs, or at least cutting them way back, because it’s just not financially feasible to do it. That’s one of the things that we’re trying to combat.
The third reason—and this is really interesting because I live in both worlds, with a PhD in marriage and family therapy, but working as an addiction counselor for 41 years–the 2 disciplines don’t understand each other very well. Addiction counselors have very little training in how family systems work. Many are in recovery themselves, and therefore tend to relate more to the struggle of the client than the family in many places. I’ve heard interventionists bring a client in and say, “I just brought you the healthiest member of this family,” and that they tend to see the family as the problem. Family systems thinkers can’t fathom why you would take a person out of the family to treat them for an issue, but very clearly the research does not say that if a family member gets sober, that then the family will get healthy. It says just the opposite: if the family can begin to incorporate recovery into their lives, they maximize the person’s chances of recovery significantly. This is something we have to get a handle on going forward, and we also need to be able to measure it way better than we’re currently measuring outcomes for family programming and all of that.