Addiction treatment programs and their clinicians must not miss opportunities to enhance their patients’ chances for success by engaging patients’ family members in an open and honest way.
But to do so, programs and counselors must overcome individual and institutional barriers ranging from subtle sabotage by family members to systems of care that don’t reimburse for recovery support services such as recovery coaching.
Treatment and recovery communities are beginning to put actions behind the long-stated rhetoric about addiction being a family disease.
Parallels with the patient
Many of the same concepts that work in clinical care for the patient can and should be applied to family members. However, often the family’s readiness to change isn’t on a parallel track with the patient’s.
Most people try to avoid change. Sabotage of a person’s recovery by family members is usually not done intentionally but can be extremely damaging. A patient might make changes through the treatment and aftercare processes but then return to a family that is pulling in the opposite direction, especially when others in the family are active substance users.
The importance of educating families in order to clarify lingering misconceptions and stigma about their loved one’s illness should be emphasized. But the speed of the treatment system’s response remains critically important as well, as services must be available at the moment families overcome their ambivalence and pursue treatment for their loved one.
Besides the challenges clinicians face in maximizing the presence of family supports in their patients’ lives, programs also must deal with institutional barriers that greatly restrict payment for family support services. While some states have enacted billing codes for recovery coaching services, many have not.
In order to serve patients and their families to the fullest extent, treatment and recovery programs need to expand their vision to include critical areas such as vocational services, even though these can be difficult to finance as well.
The strong federal confidentiality protections for substance use treatment information also pose a barrier, in that they often block families from receiving accurate information about a loved one’s status in treatment. Imagine how a family member would feel if, after making the difficult decision to help a loved one into treatment, he or she was told upon checking on the patient that the program couldn’t confirm or deny the patient’s presence at the facility.