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Family Therapy for Substance Use Disorders and Addiction Recovery

Last Updated: February 28, 2024

Editorial Policy | Research Policy

Addiction can be detrimental to the family of an addict. Unhealthy coping mechanisms and boundaries can complicate recovery for the person and their family.

Addiction does not happen in a bubble. The impact and consequences of addictive behaviors affect everyone around them, especially family members. Addiction can take an emotional toll on the family members, and they can develop unhealthy coping mechanisms or boundaries. Family programs offer tailored support to help the families of someone with a substance use disorder, so they can best help their loved one. \

Addiction as a Family Disease

Addiction can wreak havoc on the family of someone suffering from substance use disorder. Family is the first form of attachment someone develops and is their primary source of love and safety in childhood. These relationships play a big part in how someone will ultimately recover from their substance use disorder, but they are also impacted by their loved one’s addiction. 

Addiction can affect families in a lot of different ways. Some families try to hide that there is a problem. Others will financially compensate for the person with an addiction or may be financially affected if their family member steals from them to fund their addiction. Families try to find ways to cope with the addiction and often don’t have the tools to do that in a healthy way.

Signs Your Loved One Is Struggling With Substance Abuse

It can be difficult to tell if your loved one may be suffering from substance abuse, but there are some signs you can look for to determine if there is a potential issue. These can include:

  • Risky or dangerous behavior
  • A decline in performance at school or a job
  • Legal troubles
  • Changes in appetite
  • Changes in physical appearance
  • Changes in sleep patterns
  • Bloodshot eyes or dilated pupils
  • Withdrawing from regular activities
  • Being secretive 
  • Mood swings
  • Aggression
  • Anxiety or depression

Family Roles in Addiction

When someone has an addiction, their family members tend to take on one of six roles that help them cope with the addictive behaviors. This usually happens without the family realizing it.

The Addict

The addict is the main focus of the family. They become the main concern of everyone else in the family, who spends a lot of time trying to hide, fix or ignore the person’s behaviors. This person’s addiction causes everyone else to take on roles to cope with their behavior. 

The Caretaker

The caretaker is also usually the enabler of the family, or the person who makes excuses for the person with an addiction and subconsciously is helping them continue their destructive behaviors. The caretaker spends a lot of time and effort hiding that there is an issue and will do anything they can for the addicted person to avoid conflict or repercussions. 

The Hero

The hero often shares a lot of the same qualities as the caretaker, such as trying to distract everyone from the addictive behavior by overachieving and making the family look good on the outside. The hero can often feel a lot of pressure to be perfect and becomes emotionally exhausted. 

The Scapegoat

The scapegoat is also known as the problem child. They tend to act out and take attention away from the person with a substance use disorder. The scapegoat has a lot of hostility towards the other members of the family and the addicted person. 

The Mascot

The mascot, or comedian of the family, tries to make home life less tense. The mascot often feels helpless to do anything and uses humor to make the others feel better. The mascot is often very busy and does not like slowing down and becomes sad or depressed when they do. 

The Lost Child

The lost child is the family member who stays in the background. The lost child avoids everyone else so they can avoid the conflict and chaos of the addiction. They essentially disappear in the family as everyone else takes on the other roles to cope with the addiction. 

Codependency and Enabling Behavior

Codependency is when people in a relationship or family are unable to function without one another. They become overly involved in each others’ lives and are unable to act independently. Codependency also tends to have one person that is more timid and has trouble making decisions while the other is more domineering and controlling. 

Enabling is when someone’s actions or decisions support the behaviors of someone with an addiction. This makes it easier for the person to not accept or take responsibility for their actions because there are no repercussions. Some examples of enabling are:

  • Denial
  • Engaging in addictive behaviors with them
  • Minimizing
  • Justifying their behavior

These types of relationships are unhealthy long term and can cause stress among both people. Enabling and codependency can also interfere with the person getting the addiction treatment they need. 

How To Help a Family Member With Addiction

If someone you love is struggling with addiction, there are a few things that you can do to help them. It is important to take care of yourself before working to help someone with an addiction. Prioritizing your own mental and physical health will help you support your loved one in their recovery.

It is also important to understand that addiction is a disease, and recovery has many ups and downs. To best support your loved one in their recovery, you can ask them what they would like your help with. That may be making or attending appointments or going to support groups for family members. It’s crucial to be helpful to your loved one but not to take on their recovery as your responsibility. If your family member is suffering from addiction, The Recovery Village Atlanta is a great place to get support for yourself and loved ones. 

Family Program Features

There are many ways that families can help their loved one when they are looking to start or need addiction treatment. Many treatment centers like The Recovery Village Atlanta offer family programs so that they can be involved in addiction treatment and provide support during and after their stay. 

Intervention Planning and Support

Sometimes, a family member with addiction is not ready or willing to seek treatment and needs a push for their loved ones. It can be hard when a family has developed unhealthy coping mechanisms such as codependency or taking on roles that only further enable addictive behaviors. An intervention can help someone see the damage they have caused to their families and be the inspiration they need to enter treatment. 

Family Therapy

Family therapy is a type of psychotherapy that helps family members work through issues and resolve conflicts. This can be a very helpful tool when someone in a family has an addiction and there is a lot of tension and stress caused by their behavior. Family therapy is a safe space for everyone to communicate and create healthier coping mechanisms and relationships over time. 

Relapse Prevention Planning

Relapse prevention planning is a crucial part of addiction treatment and aftercare planning. It can help someone identify their main triggers and situations that may cause them to relapse. A relapse prevention plan is a written document shared with their support system and is used to help prevent a relapse and manage any that occur.

Safe Space for Families and Loved Ones

Family programs can be a place for the families and loved ones of a person with an addiction to feel safe and understood. Many times, being in a family where someone is suffering from addiction can feel very isolating and hopeless. Participating in family programs can help everyone feel like they aren’t alone. 

Strategies for Coping and Setting Healthy Boundaries 

Family programs can help the families of an addict create healthier boundaries and improve communication and coping skills. After participating in various roles to cope with addictive behaviors, a family might not know how to have boundaries with their loved one or how to say no to requests that are not healthy. It is also important for families to work on rebuilding trust with their addicted loved one so they can move forward in this person’s recovery. 

Additional Resources

Outside of treatment centers, other types of support are available for families of addicts. Support groups such as Nar-Anon and Al-Anon are meant for the families of those addicted to drugs and alcohol. These are meant to be a supportive and educational group for people struggling with their family members’ addiction. 

Family Programs at The Recovery Village Atlanta

The Recovery Village Atlanta is a full-service facility that offers a full range of care right in the heart of Atlanta. Levels of care covered at this facility include residential, partial hospitalization, medical detox and dual diagnosis care. This also includes programs specifically for patients’ families. 
The Recovery Village Atlanta is an accredited facility with licensed medical and mental health professionals trained to help treat addiction and those affected by it. If your loved one is suffering from addiction and needs treatment, contact the admissions team at The Recovery Village Atlanta today for more information on substance abuse treatment and family programs.


TN Department of Mental Health & Substance Abuse Services. “Warning Signs of Drug Abuse.” 2022. Accessed June 16, 2022.

Lander, L. “The impact of substance use disorders on[…] theory to practice.” Social work in public health, 2013. Accessed June 16, 2022. Alvernia University. “Coping With Addiction: 6 Dysfunctional Family Roles.” 2022. Accessed June 16, 2022.

James Madison University. “Codependency.” 2022. Accessed June 17, 2022.

University of Pennsylvania Health System. “Enabling Behaviors.” 2003. Accessed June 17, 2022.