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FAMILY INTERVENTION: ALCOHOLISM

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FAMILY INTERVENTION: ALCOHOLISM By: Nancy D. Losinno, LCSW, CASAC BNL EAP Manager Effects of alcoholism on the family Development of alcoholism in 1 family member ... – PowerPoint PPT presentation

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Title: FAMILY INTERVENTION: ALCOHOLISM


1
FAMILY INTERVENTIONALCOHOLISM
  • By Nancy D. Losinno, LCSW, CASAC
  • BNL EAP Manager

2
Effects of alcoholism on the family
  • Development of alcoholism in 1 family member
    affects all the other members
  • The longer-lasting more subtle the process,
    the greater the acceptance of it as the norm
  • Rigid patterns of behavior for all, attempts to
    change can become thwarted until a crisis
    disrupts the norm-steady state-homeostasis.
  • See the scales in background-alcoholic family is
    always in a delicate state of balance.

3
Parallel defenses symptoms
  • Jellinek model denial, projection, isolation,
    rationalization, personality change
  • A simultaneous process in the members of the
    family
  • Social isolation leads to emotional isolation
  • Fears, anxiety, guilt parallel those of
    alcoholic
  • Family members experience decline in their own
    health, may question their sanity, and suffer
    rages, frustrations self-pity when situation
    does not change, as promised.

4
What is Codependency?
  • A dysfunctional pattern of living/problem solving
    developed by family rules in childhood
  • CODA have a greater tendency to love the
    unreliable, emotionally unavailable, needy,
    wounded birds who need rehabilitation
  • CODA tries to provide control every part of the
    relationship while denying their own needs,
    desires, dreams, setting themselves up for more
    unfulfillment
  • Creation of the emotional debt phenomenon out
    of fear of abandonment.

5
Codependent Behaviors
  • Controlling
  • Distrust
  • Perfectionism
  • Avoidance of feelings
  • Fears of being engulfed (intimacy issues)
  • Caretaking
  • Hyper vigilance
  • Stress-related physical illness

6
How did I get here?
  • Families of origin what were the
    patterns/dynamics in yours?
  • How did my family handle conflict, anger, love,
    etc.?
  • Many people are taught not to be assertive or to
    ask directly for needs to be met
  • How do I become more fulfilled feel better
    about myself and the life I live?

7
The Rules of Codependency
  • Dont rock the boat.
  • Its not okay to talk about problems.
  • Keep your feelings to yourself.
  • Be strong, good, right, perfect.
  • Do as I say, not as I do.
  • The best communication is indirect.
  • Dont be so selfish.

8
What is Enabling?
  • Enabler makes it easier for alcoholic to
    function
  • Spouses take over the financial home
    responsibilities
  • Spouses make allowances for forgive bad
    behavior
  • May continue to be loving/giving in the face of
    physical/mental/emotional abuse
  • Parents close their eyes to suspicious behavior,
    hand out generous allowances, write sick notes

9
Enablings Purpose
  • Remember the delicate balance!
  • Enablers do it to meet their own needs, to
    restabilize the relationship, to lure the
    alcoholic back to them after alcohol has taken
    them away
  • Enabling is a poor-quality glue
  • Behind enabling is fear of abandonment
  • Only allows disease to grow to more serious stage

10
The Disease Concept
  • The Jellinek model poses 5 types of alcoholism
    based on male drinking patterns
  • Is the most widely used model in treatment
    programs, with abstinence as the primary goal
  • Most Americans in AA would be classified as
    gamma type
  • Sharply contrasts with growth of psychiatric
    treatment programs for alcoholics who cannot
    recover without aid of anti-depressant meds

11
How Do People Change?The Prochaska Model
  • Stage 1 PrecontemplationResisting change.
    Precontemplators rarely take responsibility for
    themselves or their behavior, they do not like
    living with short long term consequences. They
    may have tried failed in the past, and believe
    that it will keep happening. Problem is how to
    become unstuck.

12
Stage 2 Contemplation Change is on the Horizon
  • Being aware of your problem with passivity
    depression
  • Struggling to understand causes cures
  • Seriously thinking about solving problem
  • Lets down defenses welcomes others into his
    life
  • Some people can get stuck in Contemplation for
    many years.

13
Stage 3 PreparationGetting Ready to Change
  • Brings you to the edge of action
  • Takes you from the decisions you make in
    Contemplation to specific steps to solve the
    problem
  • Some may wish that admitting a problem will make
    it go away some wait for a magic moment
    others get stuck
  • Making a commitment during this stage makes
    success more likely (set a date, go public,
    have someone hold you accountable)

14
Stage 4 ActionIts Time to Get Moving
  • Action without preparation will last only
    temporarily
  • Cheap change will not last long, real change
    takes work mental sweat
  • All change creates anxiety you need ways to
    deal with the anxiety of change
  • The myth of the magic bullet, there are no
    simple solutions.
  • Changing your thinking about your problem can
    result in a better, more productive outcome.

15
Stage 5 MaintenanceStaying There
  • The myth of just one (drink, cigarette, piece
    of cake, etc.)
  • Successful change is sustained over a period of
    years involves sweat effort
  • Must be aware of danger signs times, warning
    signals, areas of vulnerability
  • In alcoholism treatment, it is called Building Up
    to Drink (BUD) syndrome or use HALT.

16
Intervention What is it?
  • Dynamics within alcoholic family are
    inter-twined, and involve response from other
    members
  • By working with the most motivated family member,
    and changing the way they are responding to the
    alcoholism, intervention is made
  • Is in contrast to glamorous/confrontational type
    of intervention, often high-priced. If family has
    not yet changed how they respond to the
    drinkingintervention may prove unsuccessful.

17
Intervention How is it done?
  • Any method that creates change in the family
    member that is lasting, sincere, and reinforces
    positive behavior in the drinker can be part of
    intervention process
  • For family members Al-Anon, private therapy,
    even efforts to improve self-esteem (weight loss,
    depression, etc.)
  • EAP can be a valuable first step in the process
    of intervention
  • Remember, intervention is a process, not an
    event!
  • After taking steps to intervene, no looking
    backward, no sideward glances to check if someone
    is noticing!
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