1、FAMILY INTERVENTION: ALCOHOLISM,By: Nancy D. Losinno, LCSW, CASAC BNL EAP Manager,Effects of alcoholism on the family,Development of alcoholism in 1 family member affects all the other members; The longer-lasting ” Rigid patterns of behavior for all, attempts to change can become thwarted until a cr
2、isis disrupts the norm-steady state-homeostasis. See the scales in background-alcoholic family is always in a delicate state of balance.,Parallel defenses & symptoms,Jellinek model: denial, projection, isolation, rationalization, personality change; A simultaneous process in the members of the famil
3、y; Social isolation leads to emotional isolation Fears, anxiety, Family members experience decline in their own health, may question their sanity, and suffer rages, frustrations & self-pity when situation does not change, as “promised.”,What is “Codependency?”,A dysfunctional pattern of living/probl
4、em solving developed by family rules in childhood; CODA have a greater tendency to love the unreliable, emotionally unavailable, needy, “wounded birds” who need “rehabilitation” CODA tries to provide Creation of the “emotional debt” phenomenon out of fear of abandonment.,Codependent Behaviors,Contro
5、lling Distrust Perfectionism Avoidance of feelings Fears of being engulfed (intimacy issues) Caretaking Hyper vigilance Stress-related physical illness,How did I get here?,Families of origin: what were the patterns/dynamics in yours? How did my family handle conflict, anger, love, etc.? Many people
6、are taught not to be assertive or to ask directly for needs to be met; How do I become more fulfilled & feel better about myself and the life I live?,The “Rules” of Codependency,Dont rock the boat. Its not okay to talk about problems. Keep your feelings to yourself. Be strong, good, right, perfect.
7、Do as I say, not as I do. The “best” communication is indirect. Dont be so selfish.,What is Enabling?,Enabler makes it easier for alcoholic to function; Spouses take over the financial May continue to be loving/giving in the face of physical/mental/emotional abuse Parents close their eyes to suspici
8、ous behavior, hand out generous allowances, write sick notes,Enablings Purpose,Remember the delicate balance! Enablers do it to meet their own needs, to restabilize the relationship, to lure the alcoholic back to them after alcohol has taken them away; Enabling is a poor-quality glue; Behind enablin
9、g is fear of abandonment Only allows disease to grow to more serious stage,The “Disease Concept”,The “Jellinek” model poses 5 types of alcoholism based on male drinking patterns; Is the most widely used model in treatment programs, with abstinence as the primary goal; Most Americans in AA would be c
10、lassified as “gamma” type; Sharply contrasts with growth of psychiatric treatment programs for alcoholics who cannot recover without aid of anti-depressant meds,How Do People Change? The “Prochaska Model”,Stage 1: PrecontemplationResisting change. Precontemplators rarely take responsibility for them
11、selves or their behavior, they do not like living with short & long term consequences. They may have tried & failed in the past, and believe that it will keep happening. Problem is how to become unstuck.,Stage 2: Contemplation Change is on the Horizon,Being aware of your problem with passivity Some
12、people can get stuck in Contemplation for many years.,Stage 3: Preparation Getting Ready to Change,Brings you to the edge of action; Takes you from the decisions you make in Contemplation to specific steps to solve the problem; Some may wish that admitting a problem will make it go away; some wait f
13、or a “magic moment;” others get stuck; Making a commitment during this stage makes success more likely (set a date, “go public,” have someone hold you accountable),Stage 4: Action Its Time to Get Moving,Action without preparation will last only temporarily; Cheap change will not last long, real chan
14、ge takes work The myth of the “magic bullet”, there are no simple solutions. Changing your thinking about your problem can result in a better, more productive outcome.,Stage 5: Maintenance Staying There,The myth of “just one” (drink, cigarette, piece of cake, etc.) Successful change is sustained ove
15、r a period of years In alcoholism treatment, it is called Building Up to Drink (BUD) syndrome or use HALT.,Intervention: What is it?,Dynamics within alcoholic family are inter-twined, and involve response from other members; By working with the most motivated family member, and changing the way they
16、 are responding to the alcoholism, intervention is made; Is in contrast to glamorous/confrontational type of intervention, often high-priced. If family has not yet changed how they respond to the drinkingintervention may prove unsuccessful.,Intervention: How is it done?,Any method that creates chang
17、e in the family member that is lasting, sincere, and reinforces positive behavior in the drinker can be part of intervention process; For family members: Al-Anon, private therapy, even efforts to improve self-esteem (weight loss, depression, etc.) EAP can be a valuable first step in the process of intervention; Remember, intervention is a process, not an event! After taking steps to intervene, no looking backward, no sideward glances to check if someone is noticing!,
