Dysfunctional Families: Prevention and Intervention

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Dysfunctional families and their prevention and intervention require closely coordinated, managed, and monitored long-term therapy, including continual support and periodic booster sessions.

In a word, it is the well-managed, intensive, closely-monitored, and comprehensive family-oriented programs that are likely to be the most effective and productive in helping high-risk and dysfunctional families raise children who refrain from alcohol or drug abuse.

The Dysfunctional Family:  A Definition

For purposes of clarity, we will define the term "dysfunctional family" as follows:  a dysfunctional family is a family in which misbehavior, conflict, or abuse by individual family members takes place on a continuing basis, leading other members of the family to enable, perpetuate, and reinforce such behaviors.  Frequently, children grow up in dysfunctional families with the belief that such behaviors and ways of interacting are "normal" mainly because they do not know any other "reality."

Family and Home Factors and Substance Abuse

Research has demonstrated that the dynamics of inter-related psychological, social, and familial factors play a major role in the initiation and continuation of substance abuse.

Research studies have shown that the following family-related antecedents are correlated to the beginning of substance abuse:

• high sensation-seeking
• sexual or physical abuse in childhood
• psychosocial development (such as conduct disorders)
• low academic performance
• low self-esteem
• high levels of stress and conflict
• economic instability
• neurotic traits
• psychological depression
• coercive behavior with family members
• poor family management (such as ineffective monitoring by the parents)
• antisocial behavior
• dysfunctional family behaviors and interactions
• juvenile delinquency
• genetic propensity toward substance abuse
• inadequate mother-infant bonding and nurturing
• parental use of drugs and alcohol
• relationships with peers who use drugs

Dysfunctional Families Prevention and Intervention: Family-Therapy

Some researchers have proposed a family interactional theory for explaining psychosocial aspects of adolescent substance abuse including vulnerability factors, family influences, and developmental factors.

What these researchers have found is that the risks of peer substance use and abuse were counterbalanced by protective factors such as strong parent-child attachment, maternal adjustment, and conventional child-rearing behaviors.

To be even more specific, researchers have discovered that when all members of a family live in a home environment that is characterized by open communication, understanding, and concern (that is, when the family is functional), the above mentioned family-related precursors of substance abuse can be reduced and early behavioral problems can be addressed and changed in a positive and beneficial manner. 

One final note.  When researchers talk about substance abuse and addiction in terms of genetic and environmental factors, it can be pointed out that a person's family is one of the most important environmental factors regarding many types of behavior, including drug and alcohol abuse and addiction.

Substance Abuse Prevention and Intervention

Interestingly, most of the substance abuse prevention and intervention research has been conducted on children who were between the ages of 10 and 17.  Current research, however, shows evidence that children at risk can be identified as early as preschool for preventative interventions.

Historically, substance abuse intervention and prevention programs centered on working with problem youths instead of with the entire family.  Such programs were based on rehabilitation and therapy approaches that focused on the youth who had the problem rather than the family. 

One of reasons for this perspective was practicality.  That is, not only are children typically more accessible than entire families, but they are also easier to work with than the entire family from an intervention or prevention perspective.

More recent substance abuse prevention and intervention programs, however, have been family-based rather than problem-person oriented.  Stated differently, many current researchers have found that their problem focus has become the family (which many times is dysfunctional) rather than simply the child identified with the substance abuse problem.   In fact, relatively recent substance abuse research demonstrates that effective family intervention needs to address the social skills, peer associations, and antisocial behavior of the troubled youth AND the parents' drug use and the parents' child monitoring skills and behavior.

The following represents additional reasons why child-focused therapeutic approaches, rather than family-based interventions, demonstrate a less favorable outcome:

• parents may be contributing to the vulnerability of their children
• the family may not be supportive of the child's treatment goals
• the family may be unaware of their impact on the child
• the family may engage in subtle forms of therapeutic sabotage in an attempt to regain the former family balance
• In a dysfunctional family, treating only the "problem child" is usually a fruitless endeavor

Family-Oriented Substance Abuse Interventions

A number of family-oriented interventions have been used to help prevent substance abuse.  These interventions include the following:

• family therapy
• in-home family crisis services
• family education programs
• family skills training programs
• family services
• family preservation programs

Family intervention programs differ in quality.  Taken as a collective, however, an evaluation of family-based interventions shows the effectiveness and viability of such approaches.

Concerning the above listed family-oriented intervention approaches, perhaps the "family skills training" is the most promising with high-risk, dysfunctional families.  With this form of intervention, all members of the family, including the "problem child," engage in structured activities designed by the therapist to change negative and damaging interaction patterns.  This kind of structured approach requires close therapeutic monitoring all through the training process.  Some of the kinds of training that can be employed in this form of intervention include the following:

• communication skills
• child management principles and parenting styles
• parent-child interactions
• affective skills
• family management skills
• effective monitoring skills

Dysfunctional Families: Prevention and Intervention:  Conclusion

A dysfunctional family is a family in which conflict, abuse, misbehavior by various family members takes place on a continuing basis, influencing other family members to perpetuate, enable, and reinforce such behaviors.  What about dysfunctional families: prevention and intervention?  According to substance abuse researchers, multi-problem, dysfunctional families with long-term problems are not likely to benefit from short-term or single-shot therapeutic approaches.  

To the contrary, dysfunctional families prevention and intervention need to be characterized by closely monitored, managed, and coordinated long-term therapy, including continual support and occasional booster sessions.  In short, it is the intensive, well-managed, closely-monitored, and comprehensive family-oriented therapy programs that are likely to be the most effective and productive in helping high-risk and dysfunctional families raise children who refrain from alcoholism or from drug or alcohol abuse.

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