天美传媒

Carrie Wilkens, Ph.D.

Helping families assist substance-abusing relatives is a focus of several Adelphi faculty members and alumni.

鈥淲ith young people, you have to involve the family,鈥� says alumna Carrie Wilkens, Ph.D. 鈥�00, co-founder and clinical director of the (CMC), a Manhattan- and White Plains, New York-based private practice that specializes in the treatment of substance use and compulsive behaviors. 鈥淭he parents have the leverage and need to reinforce the behavior they want to see and set limits around the behavior they鈥檙e trying to discourage.鈥�

Dr. Wilkens has written a new book with her colleagues designed to teach family members how to influence change in their loved ones with addiction problems. (Scribner, 2014) explains techniques from an approach to addiction treatment called Community Reinforcement and Family Training (CRAFT). CRAFT鈥攄eveloped by two University of New Mexico professors as an alternative for families to the strategy of detachment espoused by Alcoholics Anonymous and the strategy of confrontation encouraged by the Johnson Institute鈥攊s the model CMC psychologists use when working with families.

鈥淭he conversation has to change,鈥� Dr. Wilkens says. 鈥淧arents get the message that the only thing you can do if your loved one is using substances is distance yourself or confront them. It鈥檚 the only thing you see on TV.鈥� She continues: 鈥淐onfrontation works on TV. You yell at someone on TV, and we鈥檙e riveted; you yell at someone in treatment, they drop out. There are mountains of research that show confrontation is the least effective strategy we can use.鈥�

Dr. Wilkens explains what goes wrong when family members confront their substance-abusing relative: 鈥淲hen they talk to their loved one, they鈥檒l come at them with lots of emotion and wanting to challenge them and tell them how strongly they feel, hoping they鈥檙e going to get some sort of reaction out of them, and what they get is defensiveness. The substance user ends up defending their position, and the conversation goes nowhere.鈥�

A better approach, she says, is to keep your child talking by asking open-ended questions. 鈥淏ecause once your kid starts talking, there鈥檚 a ton of information there you can use to be helpful to them,鈥� she says. 鈥淛ust because you鈥檙e letting your kid tell you, 鈥楾his is why I want to smoke pot,鈥� doesn鈥檛 mean you鈥檙e somehow condoning pot. You鈥檙e actually just having a conversation about their feelings, and then you can take that and say, 鈥極.K., it sounds like you like to smoke pot because it helps you not feel so anxious around your friends. How can I help you do that in another way?鈥欌��

Errol Rodriguez, Ph.D.

In his private practice, Errol Rodriguez, Ph.D., assistant dean and director of the at the Derner Institute, counsels family members to consider all the ways they might knowingly or unknowingly enable their relative鈥檚 continued addiction. Often, family members attempt to help their relatives by stepping in to protect them from the natural consequences of substance abuse, he says鈥攚hether it鈥檚 dragging them out of bed so they aren鈥檛 punished for missing school or paying their rent after they get fired from their job because of their substance abuse.

鈥淎 dad will say, 鈥業 just paid my kid鈥檚 car note. I don鈥檛 want him to lose his car and wind up getting a bad credit score.鈥� And I鈥檒l say, 鈥榃hy not?鈥欌�� Dr. Rodriguez explains. 鈥溾�榃ell, I don鈥檛 want to see him mess up his future,鈥� dad says. But he鈥檚 messing up his present. If you pay for his car, and he doesn鈥檛 feel the impetus to stay clean, to go to work and make the money to pay for his car, what have you accomplished? And what will he do with the money you鈥檝e just freed up for him?鈥�

Dr. Rodriguez to help them look at their own contributions to their loved one鈥檚 problem and agree on strategies to push the relative towards the choice to get sober.

鈥淭he hypothesis is the less you enable and the more you reward non-use, the more you move this person toward making a decision to continue non-use or, at the very least, reduce the amount of their using because it鈥檚 not netting them any positives,鈥� he says. 鈥淗opefully that loss will get their attention and make them a little more humble, they may be able to hear the message that their struggle is causing their family and friends to struggle, and that there鈥檚 a way out.鈥�