Transcript Substance Abuse and Intimate Relationships

Substance Abuse and Intimate
Relationships
Jennifer L. Baker, Psy.D.
Anne B. Summers, Ph.D.
Debbi Steinmann, M.A.
The Training for the
Healthy Marriage
and Family
Formation
curriculum was
created through
the cooperative
efforts of:
Training Instructor / Mentors
Melissa A. Gibson, M.S.
Kim Rozell, M.A.
Graduate Assistants
Brent Anderson, M.S.
Matthew Biller, M.A.
Cate Brandon, M.A
Dawn Clinard, M.A.
Jessie Clinton, M.S.
Tabitha Carlson, M.S.
Anup Jonathan
Tony Larson, B.A.
Nicole Mannis, M.A.
Robert Mindrup, M.S.S.W.
Colleen Quinn, Ph.D.
Amber Schafer, M.A.
Amanda Schroeder, B.S.
Recent Statistics on
Substance Abuse
• Substance abusers dramatically impact
the lives of the people around them.
• One out of ten individuals currently
struggle with substance abuse or
dependence.
• Two out of ten have been alcohol
dependent at some time during their
lives.
How many
are
affected?
• Substance abuse
negatively impacts not
only the drinker, but also
his/her partner and other
family members.
• Approximately one child
in every four (28.6%), in
the U.S., is exposed to
alcohol abuse or
dependence in the family.
• A third of Americans
report family problems
due to alcohol abuse.
The
Family
• Often the family system has
unintentionally evolved to
support the addiction.
• Each family member plays a
role that serves a specific
purpose.
• Each family member must
perform his or her role to
keep the family functioning.
Family Roles
• The dependent is the substance abuser.
• The enabler is the one closest to the
dependent.
• The enabler’s behavior, allows the
dependent person to continue drinking.
• Rescuing and caretaking behaviors
• Taking care of household chores, etc.
• Inner feelings – powerlessness, self-pity,
fear.
Family
Roles
• Family Hero: often the
oldest child, “high
achiever”
• Scapegoat: often the
second born child,
“troublemaker”
• Lost Child: Usually a
middle child, “loner”
• Mascot: often the
youngest child, “class
clown”
Summary of Family Roles
• Most people can identify with parts or
combinations of these roles.
• However, in an alcoholic or dysfunctional
family, these roles are usually fixed and
inflexible.
• Other types of family dysfunction,
addictions, or mental illness may produce
similar roles in the family.
• Increased level of stress.
• Higher incidence of
domestic violence.
Impact on
the Family
• Lack of trust, often due to
broken promises to cut
back or quit using the
substance.
• Anger and resentment
may begin to build.
Impact on
the Family
• When parents become
preoccupied with drugs,
or any other activity
which dominates and
monopolizes their time
and energy, children
suffer.
• Children often lack the
love, support, and care
that they so desperately
need.
• Chaotic and inconsistent
home environment.
Impact on
the Family
– Lack of routines.
– Kids never know what to
expect.
• Inadequate supervision
and monitoring.
• May be exposed to
violence.
• Increased risk of teenage
substance use.
Impact on Couples
Often leads to
unhappiness
within the
relationship.
Impact
on
Couples
Arguing
and
Fighting
More
substance
abuse
Increased
conflict
Assessment of
Relational Factors
• Examine the extent or seriousness of
substance use by each partner.
– Tell-tale signs
• Strengths and weaknesses of the couple
relationship.
– Empowering the couple
Couple Relationship
Assessment: The 7 C’s
•
•
•
•
•
•
Character Features
Cultural Factors
Contract
Commitment
Caring
Communication
• Conflict Resolution
How Do I Know If My
Partner or I Have a
Problem?
Assessment of
Substance Abuse
• Informal assessment
– Types of substances
– Quantities
– Frequencies of use
• Formal assessment
– CAGE
– UNCOPE
CAGE
HAVE YOU EVER…
• Thought you should Cut down
on drinking?
• Become Annoyed when people
criticize your drinking?
• Felt scared, bad, or Guilty about
your drinking?
• Taken an Eye-opener drink to
feel better in the morning?
• Consists of six questions.
UNCOPE
• Most appropriate for
identifying risk for abuse
or dependence when
neither is identified as the
presenting problem.
• Easy to administer and
score.
UNCOPE
U- “Have you continued to use alcohol or drugs longer than you
intended or have you spent more time drinking or using than
you intended?”
N- “Have you ever neglected some of your usual responsibilities
because of alcohol or drug use?”
C- “Have you ever wanted to cut down on using alcohol or drugs
but couldn’t?”
O- “Has your family, a friend, or anyone else ever told you they
objected to your alcohol or drug use?”
P- “Have you ever found yourself preoccupied with wanting to
use alcohol or drugs?
E- “Have you ever used alcohol or drugs to relieve emotional
discomfort, such as sadness, anger, or boredom?”
Goals for
Effective Treatment
• Eliminate abusive drinking and drug
use, and gain partner support to
reinforce sobriety.
• Alter partner interactions to promote a
family environment supporting
abstinence.
• Chemical dependency is
treatable.
There is
hope . . .
• Families can change
patterns of interaction.
• The process is difficult,
but help is available.
• Treatment for the
substance abuser and the
family is critical.
Websites
Partnership for a Drug-Free America:
http://www.drugfree.org/
American Council for Drug Education:
http://www.acde.org/
National Institute on Drug Abuse:
http://www.nida.nih.gov/
Phoenix House:
http://www.phoenixhouse.org
Substance Abuse and Mental Health Services Administration:
http://www.samhsa.gov
Questions