Family therapy is a form of psychological intervention that works with the family as a whole, not just with one person. In addiction it has a special role: it helps relatives understand the problem, change the dynamics that unintentionally keep substance use going and look after themselves. And it can begin even if the person with the addiction does not yet want treatment.
Family therapy for addiction: why it matters
An addiction does not only affect the person who uses. Over time, it seeps into everyday life at home: arguments, mistrust, silences, money problems, fear. What is more, it is usually relatives who are the first to notice changes in behaviour or excessive use, and they are often the ones who seek advice even before the person affected does.
That is why, in the addiction services of the Fundación Salud y Comunidad (FSC), work with families is central from the start. In many cases the family is seen first. If you are worried about whether what you are seeing is an addiction, see how addiction is detected.
Two goals: helping the person and caring for the family
Making it easier for the person to seek treatment
Some common responses, such as covering for them, giving them money, avoiding conflict at all costs or, on the contrary, arguing non-stop, can end up perpetuating substance use without anyone intending it. Therapy helps the family break these dynamics and create a context in which it is easier for the person to decide to ask for help.
Caring for relatives
Living with an addiction for a long time is exhausting. Many relatives feel guilt, exhaustion or confusion. That is why the work also aims to ease guilt and review one’s own mistakes, so that the family can tackle the problem from different roles and learn to manage the emotional burden better.
What family therapy works on
- Limits: which behaviours are acceptable and which are not, and how to maintain them.
- How to react when there is substance use, without getting caught in spirals of reproach.
- Reviewing mistakes and getting family members on the same page.
- How to handle challenging behaviour.
- What stance to take when the person refuses to start treatment, so that they come to ask for help themselves.
How to help a relative with an addiction
While you look for professional support, these general guidelines may help:
- Get informed. Understanding what an addiction is helps you not to take everything personally. You can start with what addiction is.
- Talk at calm moments, not when the person has been using. Describe specific facts and how they affect you.
- Avoid shielding them from the consequences: making excuses for them, lying for them or paying their debts usually prolongs the problem.
- Set limits and stick to them, ideally agreed by everyone.
- Don’t carry everything yourself. Ask for support for yourself, even if the person does not want treatment.
- If there is danger, act: if there is violence, suicidal thoughts or an overdose or poisoning, call 112, the European emergency number.
What the FSC family support programme involves
The programme offers two complementary formats:
- Psychotherapeutic support: a psychologist specialising in substance dependence guides and accompanies the family in consultation sessions.
- Families group: a monthly therapy group attended only by relatives. Sharing the experience with other families in the same situation brings relief and practical ideas.
The family also plays a role in other programmes, such as the programme for teenagers, and can come to the free first appointment even if the person affected does not want to come.
When to ask for help
If life at home revolves around someone’s substance use, if you feel you have already tried everything or if you notice your own health is suffering, it is a good time to seek advice. Call +34 93 424 04 00 (guidance is free of charge) to ask for guidance as a relative.
Frequently asked questions
Can I have family therapy if my relative does not want treatment?
Yes. In many cases the family is seen first, precisely to help them change dynamics and make it easier for the person to end up asking for treatment.
What can relatives of a person with an addiction do to help?
Get informed, talk at calm moments, set clear limits and stick to them, and not shield the person from the consequences of their substance use. It is also important for the family to seek support for themselves.
How often does the families group meet?
In the FSC family support programme, the families group meets once a month and only relatives take part.
Is it the family’s fault that someone has an addiction?
No. Addictions have many different causes. What can happen is that some family responses unintentionally keep the problem going, and that is something that can be worked on in therapy.
Who leads the family therapy?
A psychologist specialising in substance dependence, who guides the family and accompanies them throughout the process.