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Alcohol & Health
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Updated on May 25, 2023
6 min read

Family Addiction Counseling

What Is Family Therapy?

Family addiction counseling is also called family therapy or family counseling. It is designed to support the person in addiction recovery and improve family-relationship functioning.

Counseling options differ depending on who’s being treated and who’s involved. But, generally, this therapy treats the entire family, not just the person with an alcohol misuse problem.

Addiction can significantly affect the well-being of all family members. According to studies:1,2,3

  • Approximately 7.5 million children aged 17 or younger live with at least one parent with an alcohol use disorder.
  • One in 8 children under 18 live with at least one adult with a substance use disorder.
  • Parental substance use was behind 38.9% of children being removed from their homes in 2019.

Just as issues with family members can influence substance use, a supportive family environment can play an essential role in the addiction recovery process.

Can Family Therapy Treat Addiction?

People recovering from addiction who attend family counseling are more likely to:

  • Remain in treatment
  • Stop misusing alcohol and other substances
  • Stay sober
  • Seek help from mental health services

However, it’s essential to understand that while family therapy is often beneficial, it’s not for everyone. 

Some families might feel emotionally and psychologically drained after living with a loved one’s alcohol addiction for a long time. They may worry about the unknown or hesitate to share family problems with strangers.

It might be helpful to seek a family therapist to speak to each family member separately about any concerns. Those who want to participate in family addiction counseling can do so, while others can join if they feel ready.


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What Are Family Therapy Techniques?

There are four techniques and elements to family addiction counseling.

Family Engagement

Enhancing family involvement and investment in the therapy of someone struggling with alcoholism is key.

Family engagement interventions usually take place during the initial phase of treatment. However, investment and goal setting are continually revisited during family therapy.

Relational Reframing

Relational reframing consists of interventions designed to move away from individual ways of defining issues and generating solutions. It shifts toward an understanding focused on relationships.

These interventions also aim to remove irrational descriptions of family members’ behaviors. Instead, they work to understand motivations for behavior based on relationships.

Family Behavior Change

This element aims to shift the behavior of family members.

Family behavior change teaches solid new skills and encourages behavior changes that allow for improved family relationships. New behaviors and skills are positively reinforced and coached for the entire family. 

For example, new skills a family therapist might teach a family include:

  • Assertive communication skills
  • Enforcing limits
  • Negotiation of rules and boundaries
  • Expressing and discussing feelings more effectively

Family Restructuring 

This element aims to change the way a family system is governed. 

Family restructuring means shifting underlying: 

  • Beliefs
  • Premises
  • Family rules

For example, there may be a family trend that when someone is upset, they handle it alone. But a family therapist might help the family introduce new beliefs about the value of communicating with each other about difficult feelings.

There may be beliefs about the different roles two parents have in a family. Family therapies can help pinpoint a shared way that both parents can respond to their children.

Family members are encouraged to learn and understand their family dynamics and how they relate to problematic behavior. This can prompt shifts in attachment and emotional processes between family members.

Family Therapy for Alcoholism - Types & Benefits

Family counseling can take different forms in the addiction treatment process. It usually first involves the whole family meeting with a therapist.

However, sometimes only part of the family meets. Or, in some cases, each person might individually meet with a therapist.

Family therapy sessions usually last around an hour and can look different depending on each family’s needs. For example, one session might discuss each person’s feelings and concerns. Other family therapy sessions may involve teaching effective communication and improved listening to reduce misunderstandings.

The type of functional family therapy used for alcoholism depends on the family’s specific issues.

Types of Family Therapy for Alcoholism

Behavioral Couples Therapy (BCT)

Behavioral couples therapy (BCT) is intended for married or cohabiting couples where one person experiences alcoholism. BCT promotes and rewards abstinence from alcohol through a daily “recovery contract.”

This addiction recovery contract involves the person with alcoholism expressing their intent not to drink and the partner supporting their efforts to remain abstinent. 

This type of strategic family therapy can help:

  • Improve communication
  • Reduce stress
  • Maintain abstinence

Family Behavior Therapy (FBT)

Family behavior therapy (FBT) is successful with adults and adolescents with an alcohol use disorder. It’s a pick-and-choose-your-own therapy based on a selection of evidence-based treatment options. TBT teaches families skills to help them improve their home environment and family life.

FBT addresses how the behaviors of the person with alcoholism affect the family as a whole. It aims to change those behaviors with the involvement of the whole family.

Family Recovery Support Groups

Family recovery support groups are community-based group discussions that provide support and resources to families and the loved ones of those struggling with alcohol addiction.

These groups aim to help families cope with the challenges of having a loved one with alcoholism or drug addiction. They also provide a safe and supportive environment to share their feelings and experiences.

Benefits of Family Therapy for Alcoholism

Family addiction counseling provides many benefits, including:

  • Improved treatment retention
  • A better understanding of addiction and how it affects families 
  • Increased family support for the person in addiction recovery
  • Helping families realize the importance of taking responsibility for their emotional, physical, and spiritual well-being
  • An improved understanding of what to expect during treatment and addiction recovery
  • Enhanced awareness of the warning signs of relapse
  • Helping families make positive changes related to alcoholism, like their patterns of communication and behavior
  • Highlighting family strengths
  • Reduced risk of relapse

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How Family Affects Treatment and Recovery

Families can significantly help loved ones experiencing alcoholism. Family members initially recognize signs of alcohol addiction and can be the first to provide help and support.

When someone is seeking treatment, their family can provide support and a positive environment for ongoing recovery by:

  • Learning more about alcohol and drug addiction and what someone struggling with it is experiencing
  • Speaking to another family member about what they’re feeling and about any concerns or worries 
  • Accepting that the family member requires support, including professional substance use treatment and help from mental health services
  • Taking steps to recognize and shift enabling and co-dependent behaviors
  • Encouraging the family member to continue with ongoing substance use treatment
  • Avoiding alcohol or drugs and creating a safe, sober environment at home

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  • Family addiction counseling treats the whole family. It’s beneficial in addressing alcohol addiction and improving family relationships
  • Family engagement, relational reframing, family behavior change, and family restructuring are the four techniques and elements used in family addiction counseling
  • Behavioral couples therapy (BCT), family behavior therapy (FBT), and family recovery support groups are some forms of family therapy for alcoholism
  • Family addiction counseling provides many benefits, including improved substance use treatment retention and increased family support for the person recovering
  • Families can significantly help loved ones experiencing alcoholism by recognizing signs of addiction, providing support, and creating a safe, sober environment at home
Updated on May 25, 2023
6 sources cited
Updated on May 25, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Consequences for Families in the United States.” National Institute on Alcohol Abuse and Alcoholism (NIH), 2023.
  2. Report reveals that about 1 in 8 children lived with at least one parent who had a past year substance use disorder.” Substance Abuse and Mental Health Services Administration (SAMHSA), 2017.
  3. Child Welfare and Alcohol and Drug Use Statistics.” National Center on Substance Abuse and Child Welfare.
  4. Substance Use Disorder Treatment and Family Therapy.” Substance Abuse and Mental Health Services Administration, (Treatment Improvement Protocol (TIP) Series, No. 39.) Chapter 3—Family Counseling Approaches, 2020.
  5.  Lander et al. “The impact of substance use disorders on families and children: from theory to practice.”Social work in public health, 2013.
  6. Substance Abuse Treatment and Family Therapy.” Substance Abuse and Mental Health Services Administration, 2004.
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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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