Theoretical-methodological rationales in caring for family members of people with alcohol use disorders

Carias, Antonio Richard; Granato, Tânia Mara Marques

doi:10.1590/1982-0275202340e200180

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Estudos de Psicologia (Campinas)

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Theoretical article – Health Psychology • Estud. psicol. (Campinas) 40 • 2023 • https://doi.org/10.1590/1982-0275202340e200180 copy

Theoretical-methodological rationales in caring for family members of people with alcohol use disorders

Racionalidades teórico-metodológicas no cuidado aos familiares de pessoas com transtornos por uso de álcool

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

The present study aims to understand the theoretical-methodological rationales which guide psychological care practices for family members of people with alcohol use disorders.

Method:

For this theoretical-reflective study we conducted a systematic search for literature review articles to learn about the modality of interventions, their theoretical-methodological frameworks and clinical or efficacy results. Afterwards, a complementary search for articles and book chapters was conducted to map and analyze the most used professional care practices and their theoretical assumptions.

Results:

We identified six theoretical-methodological rationales that guide the professional’s clinical reasoning in caring for family members, which are organized around key concepts about their emotional suffering: 1) family stress; 2) family dynamics; 3) behavioral repertoire deficit; 4) codependency; 5) inflexibility; 6) potential for psychological change.

Conclusion:

The identification of these rationales can aid professionals when planning their practices in a critical and informed manner.

Keywords:
Alcohol abuse; Family relation; Professional practices

Programa de Pós-Graduação em Psicologia, Pontifícia Universidade Católica de Campinas Núcleo de Editoração SBI - Campus II, Av. John Boyd Dunlop, s/n. Prédio de Odontologia, 13060-900 Campinas - São Paulo Brasil, Tel./Fax: +55 19 3343-7223 - Campinas - SP - Brazil
E-mail: psychologicalstudies@puc-campinas.edu.br

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[1] Correspondence to: T. M. M. GRANATO. E-mail: <granatotania@gmail.com>

Year	Country	References
2001	USA	Thomas, C., & Corcoran, J. (2001). Empirically based marital and Family intervention for alcohol abuse: a review. Research on Social Work Practice, 11(5), 549-575.
2005	United Kingdom	Copello, A. G., Velleman, R., & Templeton, L. (2005). Family interventions in the treatment of alcohol and drug problems. Drug and Alcohol Review, 24, 369-410.
2006	United Kingdom	Copello, A. G., Templeton, L., & Velleman, R. (2006). Family interventions for drug and alcohol misuse: is there a best practice? Current Opinion in Psychiatry, 19, 271-276.
2006	USA	Fernandez, A. C., Begley, E. A., & Marlatt, G. A. (2006). Family and peer interventions for adults: past approaches and futures directions. Psychology of Addictive Behaviors, 20(2), 207-213.
2010	United Kingdom	Templeton, L., Velleman, R., & Russell, C. (2010). Psychological interventions with families of alcohol misusers: a systematic review. Addiction Research & Theory, 18(6), 616-648.
2010	USA	Morgan, T. B., & Crane, D. R. (2010). Cost-effectiveness of Family-based substance abuse treatment. Journal of Marital and Family Therapy, 36(4), 486-498.
2012	USA	O´Farrell, T. J., & Clements, K. (2012). Review of outcome research on marital and Family therapy in treatment for alcoholism. Journal of Marital and Family Therapy, 38(1), 122-144.
2013	USA	Cox, R. B., Ketner, J. S., & Blow, A. J. (2013). Working with couples and substance abuse: recommendations for clinical practice. American Journal of Family Therapy, 41(2), 160-172.

Intervention name	Short description
Johnson Institute Intervention	A meeting or a surprise get-together is planned by the health professional to approach the person who is abusive or dependent on alcohol. Family members are encouraged to participate in the meeting and confront the family member who uses alcohol through letters, reports of experiences, and an ultimatum for the family member to seek treatment.
Unilateral Family Therapy	Spouses receive training on alcohol-dependent use, techniques for improving the marital relationship, techniques for managing anger, and strategies for the sexual-affective partner who abuses or depends on alcohol ingestion to seek treatment.
Community Reinforcement and Family Training	Family members receive training to change environmental contingencies that favor alcohol consumption. Family members are encouraged to seek pleasurable/reinforcing activities and to prepare an emergency plan in case of crisis or violence.
Motivational Interviewing	Promotion of dialogue to motivate changes in the family’s lifestyle. Focus on the potential and resilience of family members to elaborate ambivalence.
Behavioral Couples Therapy	Identify with the couple the environmental triggers or cues that facilitate alcohol consumption. Improve relapse prevention behaviors. Work on the quality of the marital relationship.
Structural Systemic Therapy	Identify family roles and patterns. Making these roles and patterns conscious through interpretation and experiential techniques.
5-Step Method	Five steps that must be followed by the health professional to embrace the family member’s anguish and help them to develop coping strategies and problem-solving skills.
Codependency Therapy	A set of therapies from different theoretical perspectives that aim to raise awareness or reduce codependent behaviors of family members.
Relaxation and Meditation	Set of relaxation and meditation techniques that aim to reduce the emotional suffering of family members.
Experience Sharing Groups	Groups in which family members share experiences and the health professional acts as a facilitator for communication between themselves.