Help Family Members With Addiction: 5 Stages of Change

So, you have a family member with an addiction problem, but you don’t know how to help them? Especially now, self-isolation and physical distancing is causing tensions to run high among family members who live together. This makes it even more difficult than usual to start a constructive conversation about a family member’s addiction.

This article will teach you effective ways of communicating constructively to help your loved one make progress towards recovery. The Five Stages of Change is a useful psychological model which describes the stages that people go through from unacknowledged addiction to stable recovery. Understanding the Five Stages of Change will help you recognize the current stage in which your loved one is, allowing you to help them in the ways that are most effective for that particular stage.

Addiction Hurts Families

In addition to the suffering experienced by individuals with addiction, their families often suffer as well. For example, spouses of people with addiction are more likely to experience psychological problems, including depression and anxiety.[1] Marriages often deteriorate and fall apart due to addiction—a 2013 study found that a partner’s addiction was the deciding factor in 12% of divorces.[2]

Addiction also makes it much harder to be a good parent. Children who have a parent with a substance use disorder often develop mental health disorders and cognitive deficits.[3] These children are also more likely to have behavioral and academic problems.[4] They’re also more likely to develop substance use disorders themselves.[5]

Self-Isolation and Physical Distancing Make Addiction Worse

Self-isolation and physical distancing are straining many people’s physical and mental health. Most people have been forced to give up their daily routines and activities that previously provided enjoyment and stability. This places an even greater burden on family members with addiction, who are facing unprecedented levels of fear, frustration, uncertainty, and loneliness.

Family bonds are also being tested. With all of the stress, fear, and uncertainty created by the coronavirus pandemic, compounded by self-isolation, household tensions are undoubtedly rising. This makes it particularly difficult for family members to support their loved ones appropriately, while trying to manage their own fears as well.

Speak With Compassion; Listen Without Judgment

When talking to a family member with addiction, what you say matters. Even more important, however, is the tone that you use. “Compassion” means doing your best to understand how your loved one feels. It means listening with empathy and not judging them in any way. Ensure that they feel heard and validate their struggle. Make sure they understand that you want them to get better because you love them and want what’s best for them.

Shame. Fear. Isolation. Regret. Helplessness. Pain. Hopelessness. These sorts of feelings fuel addiction. The antidote to these emotions is compassion, which involves helping your family member feel supported, connected, and loved. Furthermore, by expressing compassionate kindness, you will help your loved one develop self-compassion. And self-compassion is a powerful tool for working towards addiction recovery.[6]

The Five Stages of Change

Researchers have discovered five stages that people go through from unacknowledged addiction to stable recovery.[7] The nature of support that a person needs will depend on their current stage of change. The descriptions of the stages that follow will help you recognize which stage your loved one is in. Each stage description is followed by effective approaches for helping someone in that stage.

Stage 1: Precontemplation

In precontemplation, a person is not actively thinking about or wanting to change. Often, people in precontemplation are in denial. They don’t see their substance use as a problem. Your family member may also be unable or unwilling to see how their addiction negatively affects their loved ones.

Helping a family member in Precontemplation

Because change is not necessarily on your family member’s agenda, you want to gently encourage them to start becoming aware of the harm that their addiction is causing. In a non-judgmental way, help them gain awareness and consider the possible benefits of quitting or using less.

Possible topics you can explore with your loved one include the following.

  • Is it possible that they’re becoming increasingly dependent on their substance of choice?
  • What risks do they face if they continue to use?
  • What would their life be like if they stopped using or used less?

Sometimes, your loved one may deny that they have a problem, and you may notice that they’re becoming defensive. In such situations, you can bring down the intensity of the conversation by reminding your loved one that, ultimately, it’s their decision whether or not to change—no one else can make the decision for them.

Stage 2: Contemplation

In contemplation, a person starts to consider the idea of stopping or reducing their substance use. Gradually, your family member begins recognize the negative consequences of their addiction. However, people in contemplation are often ambivalent and uncertain regarding whether or not they want to change.

Helping a family member in Contemplation

Use open-ended questions to help your family member develop a better understanding of how their life would be different if they stopped using.

  • What are the pros and cons of continuing to use?
  • How would they benefit if they stopped using or used less?
  • What makes it difficult for them to stop using?
  • What would life be like if they were in recovery?

By helping your loved one understand and evaluate the costs of their substance use and the benefits of recovery, you can help them resolve their ambivalence and start taking their first steps towards change.

The contemplation stage is also a good time to remind your family member that you’re there for them and that you’ll support them throughout their recovery process. Knowing that they have your support can motivate them to make a decision and start preparing for change.

Stage 3: Preparation

In preparation, a person acknowledges that they have a problem. They know that they want to change. Your family member starts creating a plan for how they will overcome their addiction, which includes considering options for getting professional help.

Helping a family member in Preparation

Notice all the small changes that your family member is making—encourage them by expressing your appreciation and gratitude. Positive feedback will give your loved one motivation to maintain their momentum as progress towards recovery.[8]

You can also help your loved one create their recovery plan by working with them to answer the following questions.

  • What treatment options are available?
  • What are the benefits of getting professional help?
  • What are the challenges and risks of trying to get better without professional help?
  • What kind of professional treatment program would be best for them, residential or outpatient?
  • What are the relative advantages and disadvantages of in-person treatment versus online treatment.

Stage 4: Action

In Action, people are actively working towards recovery. People in this stage do things such as detoxing, abstaining, seeking recovery resources, and surrounding themselves with people who support their recovery—this includes attending aftercare groups. You’ll see your loved one starting to let go of the crutch that they previously used to cope with the emotional pain that underlies addiction.

Helping a family member in Action

During this exciting but challenging phase, continue reminding your loved one that you have their back and that you believe in them.

Self-efficacy is a person’s belief in their ability to successfully achieve their objectives. Research has consistently shown that people with high self-efficacy tend to experience fewer obstacles when working towards recovery.[9] You can help increase your loved one’s self-efficacy by supporting and encouraging them with each successful step they take, and each new step they attempt.

This stage involves hard work and discomfort for people going through it. Check in with your family member often to see how they’re doing. It’s not unusual for people in this stage to experience cravings, and it’s important for them to feel comfortable discussing these feelings with you when they arise. As mentioned above, uncomfortable emotions and cravings are likely to be more intense due conditions related to the coronavirus pandemic. Now more than ever, it’s important to be sensitive to signs that your loved one may be struggling and to do your best to offer them support and comfort.

Stage 5: Maintenance

In Maintenance, a person has successfully stopped using the substances to which they were addicted. If they had a behavioural addiction, they have stopped engaging in their problematic behaviours. Now, they focus on maintaining their recovery. They learn new, healthy behaviours which they try to perform consistently to create habits for a new, healthy life. A person in this stage should have a clearly defined aftercare plan to ensure consistent participation in aftercare. This could include individual counselling, support groups, or outpatient programs.

Helping a family member in Maintenance

Celebrate your loved one’s progress and congratulate them for all that they’ve accomplished—overcoming addiction might be the biggest challenge a person will ever face! Express your great respect and appreciate their efforts and achievements.

If they don’t already have one, now’s a good time to help your family member develop a relapse-prevention plan.

  • What strategies and tools can they use to maximize their chances of successfully maintaining long-term recovery?
  • One example of an effective tool is the Wagon app, a relapse-prevention plan on your phone—it gives you daily reminders to perform healthy activities, provides easy access to your most effective coping strategies, includes a journal to record the feelings and triggers that you experience each day, and tracks your progress towards recovery goals.
  • Create a list of people to whom they’d feel comfortable reaching out for help, if they ever felt that they were in danger of relapse.
  • Help them clearly define the steps that they would take for getting back into recovery if they ever did relapse.

Relapse Is a Learning Opportunity—Not a Failure

Addiction is a chronic condition which can cause brain adaptations that persist for a long time after a person stops using. Research suggests that between 40 and 60 percent of people treated for addiction will relapse and use substances again at some point after completing treatment.[10] How can you support your loved one if this happens?

Your family member should always take every possible precaution to minimize their chance of relapse. However, if your loved one ever does relapse—avoid judging them! Don’t view it as a failure and don’t be disappointed. Furthermore, help your loved one to frame their relapse as a learning opportunity, and not as a failure—this will help get them back into recovery faster. It’s critically important to avoid shaming them, since feeling shame is highly counterproductive when trying to get back into recovery.

Help your loved one understand how and why their relapse occurred, and use this knowledge to develop new relapse-prevention strategies so that their recovery will be more robust in the future.

  • What were their triggers?
  • How could they have managed the situation more effectively?
  • What can they do to avoid relapse when faced with similar situations in the future?
  • Design and write down new relapse-prevention strategies.

In addition to helping your loved one learn from their relapse, you also need to ensure that they stay accountable going forward.

  • Help them create a clearly defined plan for getting back into recovery.
  • Help them practice new relapse-prevention strategies and implement them in real-life situations.
  • Check in with them regularly to ensure that they’re following their plan and making steady progress towards getting back into recovery.

Most People With Addiction Need Professional Treatment

Overcoming addiction is a very challenging process and most people need professional help to achieve successful long-term recovery. Emphasize to your family member that getting help does not mean they’re weak or incompetent. Explaining the following points to your loved one can help persuade them that getting professional help is often the best choice.

  • Addiction is a chronic, complex condition that affects different people in different ways.
  • One-size-fits-all solutions are not very effective at producing lasting results.
  • Individualized treatment provided by experts is often required for life-changing outcomes.
  • Detox can be severely uncomfortable and, in some cases, withdrawal symptoms can be life threatening. Hence, medical supervision is very important for detox.
  • People with addiction often have undiagnosed concurrent mental health disorders and medical problems.[11] A comprehensive treatment program can address all these concerns at the same time, maximizing a person’s chances of achieving successful long-term recovery.

When Your Family Member Won’t Talk About Their Addiction

Recovery requires courage. By discussing their difficulties with you and acknowledging that they have a problem, your loved one is making themselves very vulnerable. This can be incredibly scary, especially for people in the precontemplation or contemplation stages. What can you do about it?

Get support for yourself

If your family member’s addiction causes you distress, you can seek out a psychotherapist for support. Discussing your situation with a mental health professional can help you manage the powerlessness, frustration, and fear that you feel as a result of your family member’s addiction. You may also choose to proactively approach an addiction specialist who can provide further guidance on how to best help your family member and motivate them to start their recovery process.

Stage an intervention

An intervention involves sitting your family member down for a conversation with the rest of the family, about how the family member’s addiction is negatively affecting them and everyone else around them. This will inevitably involve difficult and emotionally intense conversations. Therefore, you should hire a professional interventionist who can guide the conversation and ensure that it’s as productive as possible.

It’s Their Recovery—but You Can Make a Big Difference

Remember that lasting change takes time. Also, no matter how strongly you feel about your family member’s addiction, you can’t force them to change. You can lead a horse to water—but only your loved one can make the decision to change. Nevertheless, you have enormous potential to positively influence their recovery process and help them succeed. One of the best approaches for helping a family member with addiction is recognizing their current stage of change, and helping them in the ways that are most effective for that stage.

We Can Help You

If you’d like to learn more about the addiction and mental health treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer a loved one, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Online Treatment and Support

If you’d like to learn more about our online treatment and support options, please call us at 1-800-387-6198 or visit onthewagon.ca.

References

[1] Dawson, D. A., Grant, B. F., Chou, S. P., & Stinson, F. S. (2007). The Impact of Partner Alcohol Problems on Women’s Physical and Mental Health. Journal of Studies on Alcohol and Drugs, 68(1), 66–75. Retrieved from https://psycnet.apa.org/record/2006-23097-009

[2] Scott, S. B., Rhoades, G. K., Stanley, S. M., Allen, E. S., & Markman, H. J. (2013). Reasons for divorce and recollections of premarital intervention: Implications for improving relationship education. Couple and Family Psychology: Research and Practice, 2(2), 131-145. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012696/

[3] Salo, S., & Flykt, M. (2013). The impact of parental addiction on child development. In N. E. Suchman, M. Pajulo, & L. C. Mayes (Eds.), Parenting and substance abuse: Developmental approaches to intervention (p. 195–210). Oxford University Press. Retrieved from https://psycnet.apa.org/record/2013-08934-010

[4] Peleg-Oren, N., & Teichman, M. (2006). Young Children of Parents with Substance Use Disorders (SUD): A Review of the Literature and Implications for Social Work Practice. Journal of Social Work Practice in the Addictions, 6(1-2), 49–61. Retrieved from https://www.tandfonline.com/doi/abs/10.1300/J160v06n01_03

[5] Biederman, J., Faraone, S. V., Monuteaux, M. C., & Feighner, J. A. (2000). Patterns of alcohol and drug use in adolescents can be predicted by parental substance use disorders. Pediatrics, 106(4), 792–797. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11015524

[6] Phelps, C. L., Paniagua, S. M., Willcockson, I. U., & Potter, J. S. (2018). The relationship between self-compassion and the risk for substance use disorder. Drug and Alcohol Dependence, 183, 78-81. Retrieved from https://self-compassion.org/wp-content/uploads/2018/05/Phelps2018.pdf

[7] Prochaska, J. O., Redding, C. A., & Evers, K. E. (2015). The transtheoretical model and stages of change. Health Behavior: Theory, Research, and Practice, 125-148. Retrieved from https://www.researchgate.net/profile/Daniel_Montano2/publication/233894824_Theory_of_reasoned_action_theory_of_planned_behavior_and_the_integrated_behavior_model/links/0a85e53b67d742bc29000000.pdf#page=164

[8] Kellogg, S. H., & Tatarsky, A. (2012). Re-envisioning addiction treatment: A six-point plan. Alcoholism Treatment Quarterly, 30(1), 109-128. Retrieved from https://www.tandfonline.com/doi/abs/10.1080/07347324.2012.635544

[9] Nikmanesh, Z., Baluchi, M. H., & Motlagh, A. A. P. (2017). The role of self-efficacy beliefs and social support on prediction of addiction relapse. International Journal of High Risk Behaviors and Addiction, 6(1). Retrieved from http://jhrba.com/articles/13118.html

[10] National Institute on Drug Abuse. (2014, July). Drugs, Brains, and Behavior: The Science of Addiction. Retrieved from https://safespace.org/drugs-brains-and-behavior-the-science-of-addiction/

[11] Sevelko, K., Bischof, G., Bischof, A., Besser, B., John, U., Meyer, C., & Rumpf, H. J. (2018). The role of self-esteem in Internet addiction within the context of comorbid mental disorders: Findings from a general population-based sample. Journal of Behavioral Addictions, 7(4), 976-984. Retrieved from https://akademiai.com/doi/abs/10.1556/2006.7.2018.130

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