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Worried about a loved one’s substance use? You Can Help!

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Many people believe that if someone has an alcohol or other substance problem, there is really nothing that anyone else can do until the person with the problem is “ready” to make a change. Luckily, research and our clinical experience tells us otherwise. Relationships have a powerful affect on people when it comes to motivation. And this is true when it comes to making changes around the misuse of substances. One of the biggest reasons people cite for entering treatment is the influence and importance of their friends and family. It turns out that family members can be helpful by really educating themselves and trying to understand the problem in a constructive way. They can also model healthy behaviors themselves and use reinforcement strategies that support healthy change through their interactions, influence, and leverage.


So what can you do to increase a loved one’s motivation for change in the realm of substance use? Here are five concrete things you can do now to help:


First off,learn to take good care of yourself as a family member: helping yourself really helps! It’s tempting to put aside your own needs in the face of what may be very serious problems in a loved one. Is it really so important to go to the gym, get a decent night’s sleep, and eat enough healthy food when you’re worried your husband is out on a bender? Or your child keeps staying out past curfew and yelling at you when you try to set a limit?  The answer is yes, because although crises obviously need attention, much more often family members face a slow burn/chronic stress situation, which actually does not improve by throwing all other priorities out the window. And often what is taking the place of self-care is simply a lot of worrying, which also does not help solve the problem. In fact, being an effective helper takes a solid foundation both emotionally and physically. You can’t do it well if you’re depleted. Another often-overlooked piece is that helping yourself provides an excellent role model for your loved one!


Second, understand that substance use is motivated behavior, not crazy behavior. If you can understand “what’s in it for them,” you can better identify ways you might alter your environment and relationship to support the changes you want to see. The downsides of substance use may be so glaring to you that the upsides are all but eclipsed, but be assured that they exist. And cultivating a greater awareness of those upsides allows you to be a more empathic and constructive collaborator in the project of creating a healthy life.



Third, identify positive behaviors and respond to them positively. A negative swirl of attention and interactions is often present when substance abuse exists in a family. This is understandable, but if everything is negative all the time, the motivation to make difficult changes may feel pretty elusive. Positive responses to positive behaviors can be a beacon of hope and a reminder of the reasons to make healthier choices. A family life that’s full of primarily negative interactions obviously isn’t good for you either, so find the positives and attend to them for both of your sakes.



Fourth, figure out your limits and allow for natural consequences to occur. Sometimes family members extend themselves too far in trying to help and it can be a good idea to re-set boundaries. Assess your stress level and what it would take to have a shorter “to do” list. Consider what you are doing to support your loved one and whether some of these things might be more appropriately back on his/her plate. Also, let your loved one learn directly from the consequences that come from their use. The world is a terrific teacher and when behaviors result in negative consequences out there in the world, they are more likely to impact motivation for change and less likely to cause conflict in your relationship.


Finally, the most crucial skill… learn to communicate positively. And this will help in every area of your life, not just with your loved one. Especially when someone is likely to respond defensively or by shutting down (in shame, feeling misunderstood, etc.), techniques that help to decrease defensiveness can be extremely helpful. Learning to communicate in a positive way will help you be heard and will help your loved one feel understood and more motivated to change.  (


Learning to use the leverage and influence you have while paying genuine attention and care to your own needs can be a complicated endeavor but well worth the effort to influence positive change for your loved one and yourself.



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I am the Director of Family Services at the Center for Motivation and Change in NYC where we utilize evidence-based treatments for substance abusing clients and their families. I have worked in both therapeutic and research settings and have specialized training in Community Reinforcement and Family Training (CRAFT) which is an effective and unique treatment approach designed to help family members take care of themselves while also helping to motivate their substance abusing loved ones to be engaged in treatment.

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