Utilizing Multifamily Therapy Groups in the Treatment of Chemically Dependent Adults

In today's environment of limited time resources for the treatment of chemically dependent adults and the need for more economically advantageous treatment that is empirically proven effective, treatment providers might consider using multifamily therapy groups as opposed to individual family therapy sessions. Using multifamily therapy groups is one concept that has not been utilized much in the treatment of chemically dependent adults. However, it has been used for some time with chemically dependent adolescents. It has also been utilized in the treatment of other adult populations for other addictive behaviors. Utilizing multifamily therapy groups is more cost effective than individual family therapy sessions which are often limited or not offered at all become of cost. Individual family therapy session can require time resources that the facility or therapist does not have. Whereas, multifamily therapy groups can include a number of families and requires far less time resources. For example, an intensive outpatient program therapist engaged in the treatment of chemically dependent adults with a caseload of ten clients would require a time resource of 600 minutes to schedule a one hour session for each client's family. Utilizing a multifamily therapy group once a week for 90 minutes would only require a time resource of 90 minutes. Many treatment providers also recognize the need to engage the family in the recovery process in order to increase the rate of sustained recovery.

Some explanation of terms follows. In the modern American society the term family has taken on a much broader definition. The American family is no longer an adult male, an adult female and their biological children. Today's American family as seen in chemically dependent adults could include spouses, common-law spouses, stepparents, biological parents, homosexual or cohabiting adults and/or their parents. Therefore, for the purpose of this article the term family to participate in multifamily groups would mean spouse, significant other, common-law spouse, biological and stepparent, and biological parents. In other words any adults living with the chemically dependent client or who provides social or financial support to the chemically dependent client. The term chemically dependent refers to any chemical substance to which a person might become dependent (addicted) this includes: alcohol, prescription drugs, and/or illicit drugs. Multifamily therapy group refers to two or more families who meet for the purpose of being lead in a group therapy session by a trained therapist.

Because of limited time resource the treatment for chemically dependent adults has often been reduced to 90 hours followed by 90 minutes one a week for six months referred to as aftercare or continuing care. This treatment also includes just the individual who is chemically dependent. This is true even though research has shown that (1) the longer an individual remains in treatment the greater the chance of sustained recovery and (2) the involvement of the spouse, significant other, and/or parents in the treatment process increase the chances of sustained recovery. Many treatment providers lack the time resources to include even individual therapy sessions except in the most resistant cases. As an example an outpatient program with four full-time therapists and three interns who has a caseload of 40 clients would struggle to do 90 hours of group therapy and one hour individual therapy for each of these clients. Any attempt to also include one family session a week for these clients would be almost impossible. By utilizing multifamily therapy groups it would only take 6 hours a week as opposed the 40 hrs for individual family therapy sessions.

These groups could also be utilized for family education sessions as well. One of the factors involved in the treatment of chemical dependency from a family systems concept is that the family is often as ignorant about chemical dependency and its effect on the family system as the chemically dependent individual. Therefore education on various aspects of chemical dependency's effect on the family system could be presented to all families through this process.

Below is a possible schedule for a model multifamily therapy/education group to be utilized in the treatment of chemically dependent adults. This is a model in which the chemically dependent individual is in an intensive outpatient program that meets for three hours daily five days a week for a period of six weeks (90 hours). The multifamily groups are presented once a week for 90 minutes. During the 90 minutes the first 60 minutes is spent processing any family difficulties that have arisen with the family member(s) during the previous week. The chemically dependent individual(s) would have had an opportunity to process any difficulties they have experienced during the week, daily. The remaining 30 minutes could be utilized to educate the family members on some aspect of chemical dependency in the family system, i.e., poor family communications, family roles, codependency, enabling, detachment, dysfunctional families, process of chemical dependency, process of recovery, and adult children of alcoholics/addicts.

Reference Sources:

Boylin, W. M., Doucette, J., Jean, M. F. (1997). Multifamily Therapy in Substance Abuse Treatment with Women. American Journal of Family Therapy, v25n1, pp.39-47.

Garner, D. M., Vitousek, K. M., & Pike, K. M. (1997). Cognitive-behavioral therapy for Anorexia Nervosa. In D. M. Garner and P. E. Garfinkel (Eds.), Handbook of Treatment for Eating Disorders (pp.94-144). New York: The Guilford Press

McFarlane, W. R. (2002). Multifamily Groups in the Treatment of Severe Psychiatric Disorders. New York: The Guilford Press.

Springer, D. W., Orsborn, S. H. (Aug 2002). Families helping families: Implementing a multifamily therapy group with substance-abusing adolescents. Health & Social Work,v27,n3pp204-207.

Tantillo, M. (2003). Eating Disorders Multifamily Therapy Group: Capitalizing on the Healing Power of Relationships. Eating Disorders Today V.2,1. Gurze Books. On-line newsletter available on-line http://bulimia.com.