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DRINK & DRUGS NEWS :: Q&AYou ask the questions - you answer the questions. Please keep your answers coming, and feel free to email a new question. Thanks to this issue's respondents for their contributions. Question:I have a client who's now doing really well in treatment. He's
reached the stage when he really needs to reconnect with and have
support from his family. The problem is, his family are less than
keen to come in, saying they have 'heard it all before'. Has anyone
got ideas on how I can persuade them to give him another chance?
[Colin, Manchester] Your replies...Dear Colin Your dilemma highlights the need for a family support element in all drug treatment services, something that Adfam campaigns strongly for as a vital component in assisting the maintenance of recovery from drug or alcohol addiction. I am a former drugs worker and currently a family counsellor in the addiction field so I really identify with you wanting to help your client reconnect with his family and your struggle with their resistance to this idea. It sounds like this family may have felt genuinely let down, and disappointed at similar moments in the past when your client has said he is doing well in recovery. Their capacity to trust could have hit a real low. It may only be salvageable through careful and gradual support rather than an effort on your part to 'persuade' them to get involved again. You could try empathising with their despair and resignation about the future and their fears of further disappointment and pain. You could also try some motivational interventions such as 'It seems that you don't feel your relative is ever going to make real changes?' These kind of open, non-judgmental statements may encourage them to share more about the events that have led to their lack of willingness to engage with your client today. By reflecting back their statements, they may realise that they do still have some faith in the possibility of his recovery. From there you can explore the 'unfinished business' that they still need to resolve. It also affords the opportunity to explore what it might be like to have contact again while also acknowledging the real risk of lapse or relapse in the future. If the family is to engage fully in a dialogue with you, they will need to trust that what they tell you is confidential and that you are acting as a mediator rather than an advocate for your client. Ask the family what they need in order to consider reconnecting with their relative. You can then talk to him about what he can do to demonstrate more clearly that he intends to maintain the changes he has made. By mediating in this way a negotiated outcome might become possible. If the family does decide to make direct contact with the client or participate in his treatment, it is important they feel it is their choice and that it happens in a way that they feel comfortable with. If their contact is driven by a sense of guilt or coercion, it is more likely to breed further resentment rather than benefit your client. Along the way there may be a real pull for you between the client's interests and those of the family. I have found it helpful to talk to a supervisor or manager about how to manage these kinds of dilemmas. I also wonder if your client might like to explore what is driving his need to reconnect so quickly with his family members? Often this journey after treatment is far longer and more painful than one would wish and this reality could be acknowledged and addressed as part of his work with you. He may never get the kind of support he most craves from his family. Perhaps he needs to consider how he will cope without a satisfying reconnection rather than allowing this unmet need to grow into a potential trigger for a lapse or relapse. Often clients emerge from treatment with a new or heightened awareness of their family history and the dynamics of their relationships. The family meanwhile may still feel as they did prior to treatment - despondent, angry or scared. They may also find the change in their relative unsettling if it challenges the pattern of behaviour that the family has grown used to. It is a huge task for the client to navigate these dynamics. The more they are enabled by you to reflect on what is happening for them, weigh up the possible outcomes and support themselves, the more likely his family is to reconnect with him at their own freewill and build genuinely supportive relationships. Emily Holt, Counsellor, Adfam
Dear Colin The solution to the problem of the parents not wanting to come into treatment with their son may be difficult because of feeling let down. But they need to help him by telling him they will never give up on him, and hopefully he will stay on the right track. If they give up, he is sure to go back to his isolated world of drugs. Good luck with your help. Julie, by email
Colin Well done, the connection you have made with your client is evident and I too have come across similar problems in respect of family members who are unwilling or unable to move forward with the client, for fear of rejection and turmoil again. One solution I have found to be successful in the past was to turn the tables round and invite the family to attend, not on the basis of how it could be of value to the client, but how you are interested in their feelings, thoughts, fears etc. In this way they may feel valued for their opinion, even if it initially does not appear to be the one your client is seeking. Surely it is not about giving the client another chance, but the other way round - all too often we focus on our clients' needs and are blind to those around them. The family members often experience the same pain and confusion as the clients, but this can be exacerbated when all their previous efforts are thrown back in their faces (their perception). Let them know that you value and welcome their input; negative input has a way of turning situations around when people are able to be open and honest and the counselling process should allow this to happen naturally. It sounds like all members of the family are needing help and assistance and I am sure you will find a way. Good luck. Katie Macdonald, Alcohol Counselling Inverness
Dear Colin I don't know if you can persuade them to give him another chance - they may be 'at that stage' where they don't want to know. Their reaction might be reasonable in the circumstances. The way to encourage them could be for him to get on with his treatment and his life showing them that he is staying clean. In time they may come round, they may not. If they do or don't, is he relying on their support for him to continue with his recovery - and is that wise? Regards Simon Bull, Manager, Vita Nova
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