Eating Disorder Pro

What Are the Most Common Problems Facing the Family of a Drug-Abusing Adolescent?

The makeup and dynamics of the family are discussed in terms of the adolescent’s symptoms and the family’s problems.

The Family Profile of a Drug-Abusing Adolescent

Research shows that many adolescent behavior problems have common causes and that families, in particular, play a large role in those problems in many cases (Szapocznik and Coatsworth 1999). Some of the family problems that have been identified as linked to adolescent problem behaviors include:

* Parental drug use or other antisocial behavior

* Parental under- or over-involvement with the adolescent

* Parental over- or under-control of the adolescent

* Poor quality of parent-adolescent communication

* Lack of clear rules and consequences for adolescent behavior

* Inconsistent application of rules and consequences for adolescent behavior

* Inadequate monitoring and management of the adolescent’s activities with peers

* Lack of adult supervision of the adolescent’s activities with peers

* Poor adolescent bonding to family

* Poor family cohesiveness

Some adolescents may have families who had these problems before they began using drugs (Szapocznik and Coatsworth 1999). Other families may have developed problems in response to the adolescent’s problem behaviors (Santisteban et al. in press).

Because family problems are an integral part of the profile of drugabusing adolescents and have been linked to the initiation and maintenance of adolescent drug use, it is necessary to improve conditions in the youth’s most lasting and influential environment: the family. BSFT targets all of the family problems listed on page 3.

The Behavioral Profile of a Drug-Abusing Adolescent

Adolescents who need drug abuse treatment usually exhibit a variety of externalizing behavior problems. These may include:

* School truancy

* Delinquency

* Associating with antisocial peers

* Conduct problems at home and/or school

* Violent or aggressive behavior

* Oppositional behavior

* Risky sexual behavior

Negativity in the Family

Families of drug-abusing adolescents exhibit high degrees of negativity (Robbins et al. 1998). Very often, this negativity takes the form of family members blaming each other for both the adolescent’s and the family’s problems. Examples might include a parent who refers to her drug-abusing son as “no good” or “a lost cause.” Parents or parent figures may blame each other for what they perceive as a failure in raising the child. For example, one parent may accuse the other of having been a “bad example,” or for not “being there” when the youngster needed him or her. The adolescent, in turn, may speak about the parent accused of setting a bad example with disrespect and resentment. The communication among family members is contaminated with anger, bitterness, and animosity. To the BSFT counselor, these signs of emotional or affective distress indicate that the work of changing dysfunctional behaviors must start with changing the negative tone of the family members’ emotions and the negative content of their interactions. Research shows that when family negativity is reduced early in treatment, families are more likely to remain in therapy (Robbins et al. 1998).

What Is Not the Focus of Brief Strategic Family Therapy?

BSFT has not been tested with adult addicts. For this reason, BSFT is not considered a treatment for adult addiction. Instead, when a parent is found to be using drugs, a counselor needs to decide the severity of the parent’s drug problem. A parent who is moderately involved with drugs can be helped as part of his or her adolescent’s BSFT treatment. However, if a parent is drug dependent, the BSFT counselor should work to engage the parent in drug abuse treatment. If the parent is unwilling to get drug abuse treatment, the BSFT counselor should work to protect and disengage the adolescent from the drug dependent parent. This is done by creating an interpersonal wall or boundary that separates the adolescent and non-drug-using family members from the drug dependent parent(s). This process is discussed in Chapter 4 in the section on “Working With Boundaries and Alliances,” beginning on page 36.