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SAMHSA News - November/December 2004, Volume 12, Number 6

Integrating Substance Abuse Treatment and Family Therapy

A new practical guide from SAMHSA offers advice on how substance abuse treatment counselors and family therapists can understand and incorporate each other's methods and theories.

Substance Abuse Treatment and Family Therapy, SAMHSA's Treatment Improvement Protocol 39 (TIP 39), addresses how substance abuse affects the entire family and how treatment providers can use family therapy principles to improve communications and interactions among family members. The TIP series is produced by SAMHSA's Center for Substance Abuse Treatment.

Although family therapy has a solid history within the mental health field, substance abuse treatment developed in isolation. Prior to the 1970s, many alcoholism counselors rejected the widely held view among mental health experts that alcohol abuse was a symptom of some underlying disorder rather than a primary disorder of its own account. Over the years, however, practitioners in both fields have developed an understanding of the synergy between the services provided by substance abuse treatment providers and family therapists.

TIP 39 presents models, techniques, and principles of family therapy, along with special attention to stages of motivation and to treatment and recovery. Discussion also focuses on clinical decision-making and training, supervision, cultural considerations, specific populations, funding, and science-based research. This TIP also identifies future directions for both research and clinical practice.

Six chapters are included in the publication. Chapter 1, Substance Abuse Treatment and Family Therapy, introduces the changing definition of "family," explores the evolution of the field of family therapy and the primary models of family therapy, presents concepts from the substance abuse treatment field, and discusses the effectiveness and cost benefits of family therapy.

Chapter 2, Impact of Substance Abuse on Families, describes social issues that coexist with substance abuse in families and offers recommendations for ways to address these issues.

Chapter 3, Approaches to Therapy, examines differences in family therapy and substance abuse treatment services. One section, directed at substance abuse treatment counselors, provides basic information about the models, approaches, and concepts in family therapy. Another section, for family therapists, provides basic information about theory, treatment modalities, and the role of 12-step programs in substance abuse treatment.

Chapter 4, Integrated Models for Treating Family Members, discusses conjoined treatment approaches as well as matching therapeutic techniques to recovery levels.

Chapter 5, Specific Populations, provides background information about substance abuse treatment for various populations, based on characteristics such as age, gender, race and ethnicity, sexual orientation, and the presence of physical or cognitive disabilities or co-occurring disorders. This chapter also describes applications to family therapy for each population.

Chapter 6, Policy and Program Issues, presents information for administrators and trainers about the importance of improving services to families and some policy implications to consider for effectively joining family therapy and substance abuse treatment. In addition, this final chapter discusses program planning models that provide a framework for including family therapy in substance abuse treatment.

Appendices to TIP 39 include resources, guidelines for assessing violence, a bibliography, a glossary, and lists of panelists and field reviewers involved in producing the TIP.

For a copy of TIP 39, Substance Abuse Treatment and Family Therapy, contact SAMHSA's National Clearinghouse for Alcohol and Drug Information at P.O. Box 2345, Rockville, MD 20847-2345. Telephone: 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889 (TDD). For an electronic version of this TIP, visit SAMHSA's Web site at

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