How Family Therapy for Addiction Can Help Your Teen

Family therapy can help a teen seek recovery by addressing relationship-based stresses in their life. This therapy helps set strong foundations for coping mechanisms and boundaries. Different types of family therapy for addiction exist and can take place in various settings.
In this article:

How Can Family Therapy Help Recovery?

Relationships with family members, friends, and significant others can contribute to teen substance use. Family therapy can be effective because it creates support structures that foster nurturing relationships between teenagers and their family members. It also address any stressors that lead to substance use in the first place. This enables the teen to have healthy relationships of all types and to seek healthy coping mechanisms.

Family Relationships

Lack of emotional support from family or significant familial conflict can be risk factors for teen substance use. If teens do not feel safe enough to share their emotions or troubles with their parents, they are likelier to use substances to cope with those difficulties. On the other hand, adolescents who have strong connections with their families are less likely to use drugs. A teen’s home environment can also greatly affect their likelihood of using substances, especially if alcohol or drugs are used in the home or readily available.1

Peer Relationships

Peer relationships can lead teens to use substances in a few different ways:1, 2, 3

  • Bullying—About 1 in 5 high school students report being bullied. Research shows that a teen is likelier to use substances if they are a target of bullying. They may engage in drug use to cope with the resulting emotional distress. This risk is higher if they do not have a home environment that encourages them to share their struggles or support them through those struggles.
  • Desire for acceptance—Teenagers have a strong desire to be accepted and included by their peers. If they interact with peers who use substances, they are at an increased risk of also using substances. This risk is amplified by weaker family bonds because a teen then often places greater emphasis on peer relationships. Thus, “just saying no” is not that simple for a teen.
  • Peer pressurePeer pressure is a significant factor in the decision-making process of a teen because of their desire to fit in with others. Moreover, if relationships with family members do not provide a healthy example or instill a strong set of morals for a teen, then peer pressure can have a greater effect. A teenager who has not learned to enforce their boundaries may want to say no but might not feel comfortable doing so.

Romantic Relationships

In addition to relationships with family members and friends, romantic relationships can pressure a teen to use drugs. Dating someone who is using substances increases exposure and normalization of alcohol or drug use, which increases the likelihood of a partner also using substances. Further, about 1 in 12 teens experience violence from a dating partner.4 A teen might use drugs to cope with the stress of romantic partner abuse in the same way they may use drugs to cope with bullying.

What is Family Therapy for Addiction?

Family therapy is based on what is called the family systems model. Individual therapy treats the teen as the client, but in family therapy, the entire family unit is considered the client. The theory is that interactions between all family members contribute to the problems and distress of one family member and vice versa.5

The family systems model is especially relevant to teenagers because of their unique developmental level. While they may have more independence than children, they still depend on adult caregivers to provide structure. At the same time, teens start to develop their own identities, values, boundaries, and communication styles.6

Therefore, the adults in their lives are role models and have more control over the environment in which teens continue to grow emotionally and interpersonally. Family therapy helps strengthen connections and enhance communication between them and their family.

Types of Family Based Therapy

There are different types of family based therapy. While each focuses on working with the teen’s family, techniques may vary depending on the individual therapist and the needs of the teen and their family.

Brief Strategic Family Therapy

In brief strategic family therapy (BSFT), the therapist works to establish a relationship with each individual in the family and observes how family members interact with each other. The therapist then works with the family to change negative patterns. This helps to foster healthy family relationships for the teen.7

Functional Family Therapy

Functional family therapy (FFT) works to improve communication, solve problems, address conflict, and provide parenting skills. These skills can help provide a teen with the structure they need.7

Multisystemic Therapy

Multisystemic therapy (MST) is particularly effective with teens who have severe substance use disorders (SUDs) and engage in delinquent or violent behavior.7

MST views the teen’s problems in the context of their peers and school in addition to their family. This can help the teen not only strengthen their relationship with family but also learn how to integrate school and healthy peer relationships into their lives.7

Multidimensional Family Therapy

Multidimensional family therapy (MDFT) collaborates with other systems of the teen, such as school or juvenile justice, in addition to their family system. Thus, therapy sessions can happen in a few different settings, such as the teen’s home, school, family court, or other locations in the community.7

MDFT can be effective in treating severe SUD. This form of therapy can also help a teen transition from a youth detention center back into the community.7

Family Behavior Therapy

Behavior therapy focuses on addressing negative thought patterns and actions. This, in turn, leads to more positive feelings and healthier behaviors.8

Family behavior therapy (FBT) addresses behavioral problems in addition to substance use. FBT therapy combines behavioral therapy and contingency management (CM). CM involves giving the adolescent prizes or rewards for reaching treatment goals and abstaining from drug and alcohol use. For the teen, this reinforces healthy decision-making.7

Treatment Settings Including Family Therapy

Family therapy for addiction can take place in several settings, including in a teen rehab center. This type of treatment can occur in combination with individual therapy or on its own, depending on the assessment and recommendations of a mental health professional.

Inpatient Treatment

Inpatient treatment is a fit for a teen dealing with a severe SUD or a co-occurring mental health condition or significant medical condition. It can also be preferred for someone who does not have a supportive home environment or has frequent exposure to substances.

While in inpatient treatment, the adolescent will live full-time in a facility that is managed by healthcare professionals and strictly scheduled. Inpatient treatment includes participation in multiple services. These usually include individual therapy, group therapy, family therapy, and drug and alcohol education classes.9

Inpatient treatment includes a multidisciplinary team so that various services can be provided. The team consists of therapists, psychologists, social workers, psychiatrists, doctors, and nurses.9

Intensive Outpatient or Partial Hospitalization

Intensive outpatient treatment (IOP) or partial hospitalization programs (PHP) are very similar in intensity and level of care to inpatient treatment. However, a teenager would need to go to the treatment facility each day, which may be difficult if transportation isn’t readily available

These treatment programs often serve as step-down programs to help adolescents transition from inpatient to outpatient care.

IOP or PHP programs usually involve attendance three to five times per week for a few hours each time. Similar services and providers are available in these settings as those in inpatient treatment. Evening programs may also be available so that teens can attend school during the day.

Outpatient Treatment

Standard outpatient treatment often happen in a community mental health center or a therapist’s private practice.9

Outpatient treatment is appropriate for an adolescent with a milder SUD. Sessions typically occur once per week. Family therapists who work in private practice often have large enough offices for family therapy, or they have access to a larger room in their building.

Outpatient treatment is also common after a teen completes a more intensive program such as inpatient substance use treatment. Experts recommend participating in outpatient therapy for about one year after completing inpatient treatment. Engaging in outpatient therapy for an indefinite amount of time is also not uncommon.9

Outpatient therapy after inpatient treatment helps to maintain the progress made in inpatient treatment. It can also help to address ongoing concerns that might contribute to substance use. This setting can also help you continue to learn and strengthen coping and communication skills and work on relapse prevention.9

For teens with a more severe SUD, typically, clinicians also recommend attending a 12-step program such as Alcoholics Anonymous or Narcotics Anonymous while participating in professional treatment. Research has found that participation in these programs helps recovery and maintain abstinence.10

If your teen is struggling with substance use, they likely could benefit from family therapy for addiction. For assistance with locating treatment providers or programs, please call 800-662-4357 at any time for help from one of our specialists.

Resources

  1. Whitesell, M., Bachand, A., Peel, J., & Brown, M. (2013). Familial, social, and individual factors contributing to risk for adolescent substance use. Journal of Addiction, 2013.
  2. S. Department of Health and Human Services. (2021). What is bullying?
  3. Iwamoto, D. K., & Smiler, A. P. (2013). Alcohol makes you macho and helps you make friends: The role of masculine norms and peer pressure in adolescent boys’ and girls’ alcohol use. Substance Use and Misuse, 48(5), 371-378.
  4. Centers for Disease Control and Prevention. (2022). Fast facts: Preventing teen dating violence.
  5. Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social Work in Public Health, 28(3-4), 194-205.
  6. Gentina, E., Butori, R., & Heath, T. B. (2014). Unique but integrated: The role of individuation and assimilation processes in teen opinion leadership. Journal of Business Research, 67(2), 83-91.
  7. National Institutes of Health. (2014). Evidence-based approaches to treating adolescent substance use disorders: Family-based approaches.
  8. Regis College. (2021). What is behavior therapy, and why is it important?
  9. Substance Abuse and Mental Health Services Administration. (2014). What is substance abuse treatment? A booklet for families.
  10. Manning, V., Best, D., Faulkner, N., Titherington, E., Morinan, A., Keaney, F., Gossop, M., & Strang, J. (2012). Does active referral by a doctor or 12-step peer improve 12-step meeting attendance? Results from a pilot randomized control trial. Drug and Alcohol Dependence, 126(1-2), 131-137.

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