When a loved one goes to rehab, you may feel both relieved and anxious. If a person you’re close to is enrolled, you have probably had many years of sleepless nights worrying about their safety, trying to conceal their actions from others, and waiting for the next crisis to appear. Helping someone get through treatment and recovery is a delicate task that requires you to continue being involved with a loved one’s life while also stepping back from the supportive role you have played in the past.
Addiction Affects the Whole Family
Substance abuse does not affect only the user. Partners, parents, children, and siblings also suffer from stress, instability, and financial burdens. Some family members describe living on high alert, never sure what mood or situation they’ll walk into.
Federal treatment guidance reflects this. SAMHSA’s (Substance Abuse and Mental Health Services Administration ) Treatment Improvement Protocol on substance use disorder treatment and family therapy includes a section on how substance misuse influences families, along with guidance on involving family members in counseling. In other words, the family is part of the picture, not a witness or bystander to it.
How Families Can Take Part in Treatment
Different programs include family members in the course of treatment. However, this may take different forms, including family counseling, education relating to addiction and recovery, and involvement in post-discharge planning. In some programs, family participation is optional, and the patient and treatment team agree on the level of involvement.
The type of treatment used matters too; involvement in a residential or inpatient program may be different from involvement in an outpatient program, where sessions may take another format or follow a different schedule. Instead of assuming that programs are similar at every facility, it would make sense to consult the family about the options available in the specifics of the program in question.
Calling ahead is often the simplest way to find out. A family weighing a Brooklyn drug rehab, for instance, might ask how family sessions are scheduled, what topics they cover, and how families are included in discharge planning. Those answers can tell you a lot about how a program views the people around the patient.
Location plays a practical role as well. A program within reach of home can make it easier for relatives to attend sessions in person, rather than crossing boroughs or traveling out of state after work. If in-person visits are hard to manage, it’s worth asking whether any family sessions can be joined by phone or video.
Useful questions to ask any program include:
- Are family counseling sessions offered, and how often?
- Will family members get time to talk about their own experience?
- How does the program prepare families for the weeks after discharge?
- What warning signs should we watch for once our loved one is home?
Supporting Without Enabling
This is where a lot of family members fail to move forward with their own lives. Enabling often begins with love, such as covering for a missed work shift, settling an overdue account, or even giving excuses to family. As time passes, such assistance may unintentionally create barriers to establishing solid boundaries and also lead to one person avoiding their duties as part of recovering from the sick mindset.
Context matters, though. Helping with rent, rides, or childcare isn’t automatically enabling, and “enabling” is a descriptive term rather than a diagnosis.
Support looks different. It means encouraging treatment, showing up for family sessions, and being honest about how the addiction has affected you. It also means letting your loved one carry responsibilities that belong to them, even when stepping in feels easier.
Family counseling is often helpful at resolving issues around family involvement in decision-making. The counseling professional will point out recurring patterns one might not notice as an insider. This helps the patient to accept responsibility for their own actions od live and sets appropriate boundaries for the family. This can be enabling for the patient.
Setting Boundaries That Protect Everyone
Boundaries aren’t punishments. They are clear statements about what you will and won’t do, and they tend to work best when they’re specific and rational. “I won’t lend money while you’re using” is easier to hold than a vague promise to stop helping.
A few principles can make boundaries easier to keep:
- State them when things are calm, not in the middle of an argument
- Focus on your own actions rather than trying to control theirs
- Follow through consistently, since mixed signals can undo the effort
- Expect some pushback, especially early on
At first, setting boundaries may feel uneasy, especially if you have been the one who has been putting out fires to help others for many years. However, just because it feels uncomfortable and unfamiliar does not mean you are doing something wrong.
You do not have to figure everything out by yourself. Provided your loved one consents, the treatment team may help in realizing how to communicate and provide the expectations during and after the treatment process. The programs have confidentiality rules when it comes to patients; thus, it may depend upon the consent issued by your loved one what your staff will be able to tell you.
Communicating During Treatment
Talking during rehabilitation can be a heavy affair. While there may be many things you would like to say after many years of frustration, your loved one may not be in the best state of mind as they are recovering after detox and beginning therapy. However, it’s not necessary to clear the air in one go.
In the beginning, it’s a good idea to keep conversations short and sweet. Saying “I’m glad you are getting help” and/or “I’m happy to support you, although I have also been hurt” will allow you to both express your feelings in an honest way while avoiding the chances of confrontation. It is likely that serious discussions about trust and the past may be more productive in the context of a therapy session where a counselor will facilitate the conversation.
Remember to listen more than you talk during conversations. Your loved one may be learning to express feelings related to their past, and knowing that you are there for him might be a great comfort.
Caring for Your Own Mental Health
Family members often put their own needs last. After a long stretch of crisis, it’s common to feel anxious, depressed, numb, or just worn out, even once your loved one is in treatment. Some people notice the stress hitting harder once the immediate emergency has passed.
SAMHSA’s guidance for families coping with mental health and substance use disorders points family members to a section on taking care of themselves. Practical steps may include:
- Keeping regular sleep, meals, and some form of physical activity
- Leaning on friends or relatives who don’t need you to manage the crisis
- Joining a peer support group for families affected by addiction
- Seeing a mental health professional for yourself, not only for your loved one
In case of persistent feelings of depression, panic attacks, sleeping disorders, or just feeling you cannot manage the situation, it is best to consult a professional health worker like a psychotherapist, your family doctor, or even a psychiatrist. Taking care of yourself should not make you feel as if you are neglecting your loved one’s recovery.
When a Psychiatrist Can Help the Family
Addiction can coexist with other mental disorders both for the individual undergoing rehabilitation treatment and for his or her social circle. When a relative suffers from anxiety, depression, or insomnia, it is advisable to consult with either a therapist or a family doctor. If symptoms are complicated or do not improve, a mental health assessment can help find out whether the patient requires treatment for their mental health. Moreover, it is helpful to understand if depression or PTSD interferes with the normal functioning of the family after a relative completes the rehabilitation period.
Family or relationship psychotherapy can be especially useful when the loved one comes back home, especially if there has been a breach of trust between family members. Such sessions are aimed at the collaboration of family members instead of blaming somebody for the troubled situation.
Seeing a psychiatrist after discharge from rehab is often very helpful to avoid relapse and treat the underlying causes of the substance abuse. Established providers such as GABA Telepsychiatry operate in Brooklyn and they have a dedicated addiction psychiatrist.
Preparing for Life After Discharge
The end of a treatment program is a transition, not a finish line. Outpatient counseling programs, support groups, as well as medication may still be pursued by a loved one, while family members may experience difficulties in adjusting to life at home.
This stage of discharge is a good moment when a family can come in if their relative agrees with that step. While leaving the program, a family can ask the team what kind of follow-up care they will be provided with, by whom it will be arranged, and when it will start.
It is possible to find out how to cope with the problem of alcohol and prescription medications at home, and what kind of risks may arise from having a recovering person around.
Thus, having answers to these questions beforehand has a potential to make the first period easier and thus help someone to adjust to the new way of life smoothly. If someone has started using substances again, it is important to reach out to their treatment provider or any other specialist that can help them continue receiving necessary treatment.
You Don’t Have to Do This Alone
One of the most challenging situations families have to go through is helping their loved ones while they are receiving addiction treatment. The entire process of addiction treatment means supporting someone while protecting oneself too; although these two goals seem contradictory, nothing is further from the truth.
Stress reactions are not the same for everyone, and if the symptoms persist or become worse, it is advisable to seek help from a professional. Depending on the problems a family is facing, a family therapist, a primary care provider, or a psychiatrist may help them to cope with their stress. Thanks to telemedicine, Brooklyn families have an opportunity to connect with a provider licensed in the state of New York right from their homes instead of visiting a specialist’s office.
In case you or any member of your family is experiencing an emergency, it is advisable to call or text 988 to connect with the 988 Suicide & Crisis Lifeline; for any medical emergencies, the most reasonable decision is to call emergency services at 911.
