. Author manuscript; available in PMC: 2019 Jul 11.

Published in final edited form as: J Soc Work Pract Addict. 2018 Jul 11;18(3):231–248. doi: 10.1080/1533256X.2018.1488720

Table 5.

Themes From Those Attending Meeting for Families with Prior Treatment Experiences

Themes	Examples
1. Psychoeducation a. Relapse is a learning opportunity for the patient and family-time sober is not time lost, despite relapse b. Effects of substance use disorders on family members’ mental health and coping-common reactions	“My own therapist, when I told her that X had relapsed, she said you know, you can learn a lot from a relapse… this is an opportunity, maybe not that one would seek, but having happened, you can learn from it” “I think you need to stress that it (relapse) wasn’t a failure. You know, this is just part of the process”
c. Review of “where the family may have contributed to the current relapse”	“… to look where we went wrong in supporting the first time. That, did we contribute to this relapse, if we did something different, would it not have happened?” “What could we do the second time that we either neglected to do the first time, or did the first time and we shouldn’t have done”
d. Healthy limits and boundaries for family involvement- reminder that family has little control over whether or not the addict is successful; it’s up to the patient	“The difference between enabling and support, which is a very difficult line for us as family members to adhere to, and a lot of issues were just brought up with the conversation with my daughter” “One thing that I realized in these communications and support groups that we’ve been going to for many years now it seems, is we as parents… we have very little control. I mean we can write the checks, we can do a number of things, (but) we have very little control over this”
2. Aftercare Planning a. What is the patient’s recovery plan? Specific living situation, treatments, meetings, etc.- b. DO NOT create the discharge plan without consulting the family c. What is the family plan if the patient relapses? Specific response and recommendations d. Develop a clear set of agreements between the patient and the family- contingency planning	“Many more things were covered, not just where she would be going, but also because of her relapse history, what choices she should make differently this time” “…Finding empties in the barrel. What do you do when they are all of a sudden back doing the same thing again” “It seems to me it would be helpful for there to be a defined set of agreements between a person who’s been using and the family that’s been at the effect of that, so that there’s real clear communication about what the ground rules are, and whatever the point is of going forward”
3. Referral a. Long-term treatment options for current or future referral (in the event of relapse)	“I know when my wife went through…the 3^rd or 4^th detox in a very short amount of time… (I realized) she’s not going to be able to come home. The people need to understand that there are other treatment options that probably necessitate time away from family”
b. Family support groups, self-help, family counseling or case management services, individual therapy- depending on assessment of family situation	“…make sure the family is getting support it needs as far as the family support programs that are here because a relapse can be really discouraging”