Substance Abuse and Intimate Relationships - The Murney Clinic at by fjzhangweiyun


									Substance Abuse and Intimate
                    Jennifer L. Baker, Psy.D.
                    Anne B. Summers, Ph.D.
                     Debbi Steinmann, M.A.
 The Training for   Training Instructor / Mentors
   the Healthy        Melissa A. Gibson, M.S.
                          Kim Rozell, M.A.
  Marriage and
                         Graduate Assistants
Family Formation        Brent Anderson, M.S.
                        Matthew Biller, M.A.
 curriculum was          Cate Brandon, M.A
 created through        Dawn Clinard, M.A.
                         Jessie Clinton, M.S.
 the cooperative        Tabitha Carlson, M.S.
                           Anup Jonathan
    efforts of:           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
• Two out of ten have been alcohol
  dependent at some time during their
            • Substance abuse
              negatively impacts not
              only the drinker, but also
              his/her partner and other
              family members.
How many    • Approximately one child
   are        in every four (28.6%), in
              the U.S., is exposed to
affected?     alcohol abuse or
              dependence in the family.
            • A third of Americans
              report family problems
              due to alcohol abuse.
         • Often the family system has
           unintentionally evolved to
           support the addiction.
 The     • Each family member plays a
           role that serves a specific
Family     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
• 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,
         • Family Hero: often the
           oldest child, “high
         • Scapegoat: often the
           second born child,
Family     “troublemaker”
Roles    • Lost Child: Usually a
           middle child, “loner”
         • Mascot: often the
           youngest child, “class
  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
• 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.
             • Lack of trust, often due to
Impact on      broken promises to cut
the Family     back or quit using the
             • Anger and resentment
               may begin to build.
Impact on    • When parents become
               preoccupied with drugs,
the Family     or any other activity
               which dominates and
               monopolizes their time
               and energy, children
             • Children often lack the
               love, support, and care
               that they so desperately
             • Chaotic and inconsistent
               home environment.
               – Lack of routines.
Impact on      – Kids never know what to
the Family       expect.
             • Inadequate supervision
               and monitoring.
             • May be exposed to
             • Increased risk of teenage
               substance use.
     Impact on Couples

Often leads to
  within the
Impact                Fighting
          More                   Increased
Couples   substance              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
  – 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
       Assessment of
      Substance Abuse

• Informal assessment
   – Types of substances
   – Quantities
   – Frequencies of use
• Formal assessment
   – CAGE
       • Thought you should Cut down
         on drinking?
       • Become Annoyed when people
         criticize your drinking?
CAGE   • Felt scared, bad, or Guilty about
         your drinking?
       • Taken an Eye-opener drink to
         feel better in the morning?
         • Consists of six questions.

         • Most appropriate for
           identifying risk for abuse
           or dependence when
UNCOPE     neither is identified as the
           presenting problem.

         • Easy to administer and
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
             • Chemical dependency is
             • Families can change
               patterns of interaction.
There is
             • The process is difficult,
hope . . .     but help is available.
             • Treatment for the
               substance abuser and the
               family is critical.

Partnership for a Drug-Free America:

American Council for Drug Education:

National Institute on Drug Abuse:

Phoenix House:

Substance Abuse and Mental Health Services Administration:

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