Rehab 4 Addiction

The Sequential Family Addictions model is an approach to treating addiction.

Unlike other methods, this model acknowledges how family, meaning individual members, attachments and relationships, as well as overall dynamics, impacts the person with the addiction. It was created by Juhnke and Hagedorn in 2006.

This structure of treatment places ownership and responsibility into the hands of every person involved. It recognises that communication and interaction in the present as well as events from the past all impact a person’s outcomes.

Counsellors utilise various therapies, counselling, and interventions that have proven to be successful in treating addiction.

These include:

  • Cognitive Behavioural Therapy (CBT)
  • Family systems theory
  • Motivational interviewing
  • Solution-focused counselling

The Sequential Family Addictions Model is structured in 7 stages. Most stages are essential, but where positive change is being demonstrated by the family, there is one that is optional.

A family might opt out of this stage where relationships have improved and substance use is being managed effectively or stopped.  

The Seven Stages of the Sequential Family Addictions Model

Stage 1

The Seven Stages of the Sequential Family Addictions Model

In order for change to occur, people must want to change. For families where addictions exist, this doesn’t simply mean the person who is addicted.

In every family, each member exhibits behaviours that might be viewed as positive or negative by the others.

Some people may have no idea just how much their speech and behaviours impact the rest of the family. Many unhealthy communication styles can develop.

Every person has to be willing to put in time and energy to self-reflect honestly on their own role in affecting others.

Stage 1 uses motivational interviewing to support the family to become ready for change. Motivational interviewing addresses ambivalent feelings people might have about substance use or how people feel in general. 

It reinforces the positive and works to strengthen the belief that change is needed and now is the time.

How long does it last? 1 – 2 sessions. 

Stage 2

Life without addiction

It’s helpful for families to be able to imagine how they might be different.

After years of unhealthy functioning where there is a lot of emotional strain, this can be difficult for some people. 

Therefore, the counsellor supports the family to construct a picture of how life would look for them if the addiction didn’t exist.

This is done by using solution-focused methods. All the family members take part.

Families consider all angles; from relationships to housing arrangements, personal goals and shared dreams.

How long does it last? 3 – 7 sessions.

Stage 3

Cognitive Behavioural Therapy

This stage is where cognitive behavioural therapy really comes into its own.

This is an evidence-based therapy which means that it’s proven to successfully treat people who have addictions. CBT is also an excellent therapeutic approach in terms of treating particular mental health problems, such as anxiety and depression.

The therapist will guide the family in how to identify how their thoughts trigger behaviours.

The family will be given techniques so they’re able to start changing thought patterns. In turn, they’re able to begin changing how they behave and tackling unhealthy habits.

This is especially helpful for everyone involved because addictive thoughts don’t just come from the person who is addicted. They can be perpetuated by the entire family.

How long does it last? 3 – 11 sessions.

Stage 4

Family Support

Stage 4 focuses on improved communication, interaction, and dynamics within the family.

The counsellor uses the family system theory to guide the family. They learn to reformulate how they function as a whole.

Together, each member of the family reflects on their communication style, the impacts this has, and how they can implement healthier communication styles.

There is a focus on what is known as the “basics system”. This is the system by which a family is governed.

Stage 4 aims to implement a healthy and robust system where the family functions in a positive way: one where dysfunctional and harmful speech and behaviours that fed the cycle of substance use no longer exists.

How long does it last? 5 – 10 sessions.

Stage 5

Individual

Bowenian theory demonstrates that if there is too much “togetherness” in a family, it prevents members from developing as individuals. On the other hand, too much individuality can create emotional distance within families.

In stage 5, the counsellor supports family members to differentiate. People unable to do this find it difficult to separate their thoughts from their feelings. They usually define how they think and feel by looking at other members of the family and seeing how they are. 

This means that how the person thinks and feels is heavily influenced by the dysfunctional system that the family has had in place for years and has likely been carried down through generations.

The family will also consider how addiction (not purely substance addiction) carries through generations. 

Differentiation enables each person to start separating themselves from the family and understand their own responses.

This is a stage that provides enlightenment and understanding for the whole family.

How long does it last? 5 – 10 sessions.

Stage 6

Childhood Trauma

In terms of addiction, experts recognise that it can develop from a place of trauma. Many people with addictions will have experienced damaging and/or traumatic events in their childhood. 

Some practitioners acknowledge that raising issues from the past isn’t always beneficial. This situation is assessed on an individual basis and is why this stage is optional.

During the sessions, some family members will revisit their childhood and their lived experiences. The goal of this is to develop healthy emotional responses to uncomfortable and distressing feelings and memories that they hold.

The therapist aims to support the person towards inner peace in relation to old trauma.

Stage 7

Together

There are some families who reach stage 7 and find that the addiction/s is still present. This does not mean that the model has failed to work.

People will still have gained many positive techniques to use within the family and will have begun to practice deep and healthy self-reflection.

A family in this situation will then be guided by a therapist using psychodynamic object relations principles. This focuses on how family members need contact with each other and to form emotionally beneficial relationships.

How long does it last? This is a long-term approach with at least 15 sessions.

boris

Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.