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Case Study: How the Family Affects Treatment Outcomes

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We know family involvement in the treatment process increases the probability of a client experiencing a successful outcome. We know this because addiction is a family disease, so naturally the family must be supported as well.

Today we discuss the case of a 25 year old female. This client presented for treatment for substance abuse disorder, anxiety, depression and post-traumatic stress disorder. This client admitted to several treatment centers prior to her admission at Destination Hope. She reported a deep self-hatred due to a near fatal accident involving a close family member for which she blamed herself. She also struggled with obsessive compulsive behaviors which impaired her ability to complete college and was the source of family conflict. While prescribed prescription drugs to manage the pain from the accident, she began abusing them. However, upon admission she denied being an addict and was closed to discussing her abuse of substances although admitted to the detox level of care.

The Therapeutic Process

The client was admitted to the detox level of care. The client reported motivation to get well but admitted she held very little hope for her recovery. As a result of client’s hopelessness, she began sabotaging her treatment process through non-compliance, angry outbursts directed towards staff and concluded she was deserving of the emotional pain she experienced. The therapist worked closely with the family, educating them on trauma, codependency, setting clear boundaries, addiction as a family disease and provided them with resources. The family was also supported and encouraged to do their own work by attending support groups and seeking individual therapy. As members of the family accepted clinical recommendations and began doing their own work, not only did the family dynamic begin to change, but the client became increasing motivated to engage with the treatment process. They accepted that her substance use and compulsive behaviors were both used to cope with her depression and trauma.

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The therapist utilized Motivational Interviewing, Cognitive Behavioral Therapy, Psychoeducation on the 12-step of Al-Anon and Alcoholics Anonymous and Narrative Therapy.

The Outcome

The client addressed her trauma, depression and substance abuse. This client now accepts she is an addict and actively works a twelve-step program and the obsessive-compulsive behaviors have not returned. She now uses medication management appropriately as recommended by the psychiatrist. While she has made great strides in forgiving herself and has significantly improved her self-image, this continues to be a work in progress. The client has increased her independence and she lived on her own for the first time at a local structured sober living which supported her recovery. Both the client and family recognized that returning to the family home would increase the risk of regression. The family is now able to communicate more openly and honestly about challenges and find solutions.

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