Session Two: Substance Use Problems

Partnering With Families Affected By Concurrent Disorders - Facilitators' Guide

Session Goals

• Provide an overview of substance use problems.
• Enhance concern and regard for people with substance use and other addiction problems.
• Help participants understand how substance use problems affect their families.
• Encourage identification of practical concerns and goals that participants have for their families.

Content Outline

• DSM criteria for substance-related disorders.
• What is the risk of becoming substance dependent?
• Why do people become substance dependent?
• Types of substances.

Activities

• 2-1: Identifying Substance Categories

Leaders’ Notes

The most important thing to remember when planning for this session is to link the educational material to participants’ real life situations. This is true of every group session, but it is especially important for this session (and Session 8: Medication). Information on drugs and medications and the interactions between the two can be overwhelming for family members already inundated with new information and consumed by worry and preoccupation. We learned this lesson the hard way when, after preparing a 75-slide PowerPoint presentation for this session on substance use problems, we only made it through two slides. We quickly realized that letting the group participants pave the way for the discussion by using their personal situations as a guide was a much more effective strategy. Information that is meaningful and personal is far more relevant and much easier to absorb.

Exploring reasons for substance use

Many family members have trouble understanding why their relatives continue to use substances despite obvious negative consequences. A Family Guide to Concurrent Disorders includes an activity that helps family members think about how their relatives might see the benefits and costs of substance use (see Session 7 - Activity 7-1: Exploring Ambivalence about Change). The activity is part of a discussion about motivation to change behaviour, but we have found it helpful to begin the benefit/cost discussion in Session 2, and then pick it up again in Session 7.

Ask the participants about problems that result from substance use or other behaviours such as gambling. Ask them to talk about their own family experience and write their responses on a flip chart. Examples participants have given include:

• lost jobs and income
• social rejection
• jail as a result of out-of-control behaviour
• hospitalization
• fear of loss (children, partner, family)
• embarrassment
• blackouts
• increased fear of psychiatric episodes.

Then ask the participants to suggest what people might see as benefits of using substances or engaging in other addictive behaviours, such as problem gambling. Examples participants have given include:

• excuses their behaviour
• makes them feel good, at ease, relaxed
• balanced him
• makes them think they are important
• makes them sound more intelligent
• helps them to stay awake, keep thoughts going
• needed for social acceptance, to deal with peer pressure
• helps reduce anxiety
• escape—making troubles go away.

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Partnering With Families Affected by Concurrent Disorders - Facilitators' Guide

• Overview
• Working with families
• Preparation
• Implementation
• Evaluation
• Session Outlines
  • Session 1: Introduction
  • Session 2: Substance use problems
  • Session 3: Mental health problems
  • Session 4: How concurrent disorders affect family life
  • Session 5: Self-care
  • Session 6: Stigma
  • Session 7: Navigating the treatment system
  • Session 8: Medication
  • Session 9: Relapse prevention
  • Session 10: Crisis and emergency
  • Session 11: Recovery
  • Session 12: Saying goodbye
• References
• Resources
• Appendix 1: An Overview of the Research
• Appendix 2: The Partnering With Families Affected by Concurrent Disorders Project

• Print