Social Work 5523: Substance Abuse Intervention Report, Spring 2020

This report delves into the critical issue of substance abuse within families, emphasizing its detrimental effects on children and overall family functioning. It defines substance abuse, explores its prevalence, and outlines its impact on family relationships, child development, and mental health, particularly within the Hispanic community in the United States. The report examines various intervention approaches, including Solution-Focused Brief Therapy, Ecologically Based Family Therapy, and Functional Family Therapy (FFT). FFT is chosen as the primary intervention toolbox, highlighting its ability to address maladaptive behaviors and improve communication within the family, ultimately aiming to reduce the social, personal, and economic consequences of substance abuse. The report underscores the importance of family support and collaborative interventions in mitigating the effects of substance abuse and fostering healthier family dynamics.

Running head: SUBSTANCE ABUSE INTERVENTION
Substance Abuse Intervention for Family and Children
Name of the student:
Name of the university:
Author Note:

1SUBSTANCE ABUSE INTERVENTION
Substance Abuse Intervention for Family and Children
Section I
Definition and Description of issue
Substance abuse in the family leads to huge family conflicts and create dysfunctional
family behavioral patterns. This create a mental effect on the children and the overall family
value system gets destroyed with violence and a toxic environment which is harmful for the
child development. According to (Reiter, 2014) the family as a whole a big part in shaping as
well as intervening with the substance abuse risking the protection and resilience of the
children in the family. The person who is found to abusing the substance is termed as
identified patient in the family. The family system in which the person is the substance
misuse victims affect not only the child and the spouse with whom the person being married
is living but also to others like spouse’s family, neighbors and other community members.
This disrupts the family relationships. Most of the substance misuse victims are found to be
married and suffering work depression, family burden, financial burden and psychological
stress. The paper deals with the discussion of culturally adapted intervention of family and
children relationships in the terms of the problem faced by them for having substance abuse
of a family member. The area of problem which are highly experienced by children and
families is the substance abuse which can be from the family member –father, mother or any
close family member impacting the healthy relationship bond among the family members.
Prevalence of the issue
As per Mattoo et.al, (2013) in paper “Family burden with substance dependence: a
study from India”; most of the families of alcoholics having the spouses as caregivers being
exposed to increased risk of stressful life occurrence and psychiatric disorders. The substance

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abuse in the family arise due to the financial burden. This create a disruption in the family
leisure and interaction with effect on physical and mental health of others. The substance
abuse at a massive scale impacts the overall functioning of family values, activities and the
daily routine. In terms of geographical region, like India where the joint family is a big notion
of value of togetherness; the substance abuse conditions among the males are prevalent.
While in terms of income group, the substance abuse is seen more in lower income groups
where the financial burden and the domestic violence rate increases.
According to (Naidoo, 2019) in the study conducted “Family functioning in families
affected by substance abuse” , the poor family relationships along with the poor
communication occurring between the parents and children has been seen to contribute
towards the problem of adolescent drug behavior at an increased rate. The rate of substance
abuse has seen an upward trend with the primary level of school children who are habituated
in experimenting with all forms of harmful substances in the drug abuse like Marijuana,
Nyaope a certain type of heroin and alcohol. All these have an effect on the various aspects of
behavior and value systems of family functioning. In the terms of South Africa, the drug
usage among the most of the individuals has been limited to drugs like opiates, sedative and
cocaine which are form of illegal drugs. These types’ drugs can be found in way of simulants
and the hallucinogens to inject in the physical body. Certain family dimensions have been
considered to be affecting the physical as well as emotional health of family members staying
with the victim of substance abuse. In the perspective of South Africa, the culture in family is
an important aspect which rules the relationships of social classes. The elders in the family
act as the by default therapists who advise and suggest the solutions for the problems of abuse
and family violence situations.

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Effects of the issue
As per Suomi et.al, (2013) in the paper “Problem gambling and family violence:
family member reports of prevalence, family impacts and family coping”, most of the family
violence gets created by the problem of gambling. In this gambling, the parent or the head of
the family is driven by alcohol abuse where most of the time, the females are the victims of
domestic violence. This creates the family dysfunction and the conflict in the house and
affects the mental health of the children in the family. The gambling as a by-product of the
substance misuse promotes the child abuse as well as child violence in the family.
According to (Taplin, Saddichha & Krausz, 2014), in the paper “Family history of
alcohol and drug abuse, childhood trauma, and age of first drug injection”; the occurrence of
substance abuse disorder is related as per multiple studies due to history of past childhood
abuse. The childhood trauma makes the person seek substance misuse. The reports state that
more than 80% of the children face mental and physical negligence in the family where one
of the member is the victim of substance abuse. They lack their physical needs of getting
appropriate clothes, food and shelter. The increased stake of domestic violence leads to
nutritional negligence by parents in the family. This give rise to conflict between child and
parent, the improper allocation of family funds, harmful behavior patterns in family. The
child learns from the adults by seeing their behavior and taking them as role models, thus
performing the same acts when they will grow up. The family history of substance use states
that the child gets mentally affected from the dysfunctional abusive patterns in the family
environment cycle which harm their development. The family environment where the father
or mother being the primary substance misuse victims affect the children more than the uncle
or aunt being distant relatives as victims. The joint families where a past history of
grandfather or grandmother being resorted to substance misuse can create role model conflict

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in children. It is reported that maternal and paternal substance misuse is different. The
maternal substance misuse in terms of drug use can create mental trauma for the child but in
terms of alcohol use can create physical violence and neglect. However, the paternal
substance misuse in terms of drug and alcohol both give rise to physical torture, sexual abuse
and neglect.
As per (Matejevic, Jovanovic, & Lazarevic, 2014) in the paper “Functionality of
family relationships and parenting style in families of adolescents with substance abuse
problems” the family patterns are a crucial factor which determines the substance abuse
effects. The disengaged family routines with the rejected form of parenting style and often
pattern of overprotecting the child and restricting from certain activities create incomplete
family functioning systems. The substance abuse make the adolescents at a later stage
consume the observed family patterns and also indulge in the abusive practices. The
dominance over the children make the relationship with parents disturbed. The repots state
that a direct correlation lie in the functioning of family and parenting style with the substance
misuse. The family support is required to reduce the effects of substance abuse in the family.
The interventions should be focused more on the collaboration of family relationships
strengthening the bond and dependence on each other.
Population group chosen
The Hispanic family in United States is mainly chosen as the population of study
where the substance abuse in the family is very high and it affects the children and the other
family members of the victim.

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Common treatments for the issue
Intervention A
As per (Mullet, 2018) in his paper “Solution-Focused Brief Therapy for Families:
When a Loved One Struggles with Substance Abuse”, the substance abuse is not exactly an
individual issue: however the family members of individuals along with these diagnoses are
highly impacted by the victim who is suffering from the abuse as well. The negative effects
can be highly seen on whether the substance user has been in the family a parent, spouse, or
child. These effects can be seen through negative changes which are highly predictable in the
family’s routine, structure f daily activities, roles, rituals as per the culture, communication
with the family members, social encounters with friends, finances, and the gradual
development of domestic as well as the intimate partner bond related with violence. It has
been reported that there has been a slight increase in the overall substance use over the past 5
years. In 2013, it has been estimated that mostly 9.4% which on data quantification, estimated
that 24.6 million of Americans having 12 years of age and also older had been using drugs
which on getting compared to 8.3% of people in the year 2002 as per the report published by
National Institute on Drug Abuse, 2015.
Intervention B
Another study conducted by (Slesnick & Zhang, 2016) in the paper “Family systems
therapy for substance-using mothers and their 8-to 16-year-old children” states that 85% of
the women who are mothers with a not so high educational degree and 19% of women being
only married are reported to be victims of substance abuse in the family. These women
belong to 60% of families with a moderate range of family income falling at the range of
$15,000 or below. Majority of the mothers are reported to be suffered from physical and
mental abuse from the substance misuse. The parent and child stress with the mother and the
child disturbed relationship due to the substance abuse lead to less caring for the child and the

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barrier of communication between them. Due to which the Ecologically Based Family
Therapy (EBFT) has been used as a family session therapy to moderate the interaction
between the mother and the child through interrupting the problematic behaviors with good
communication and problem solving training enhancing the family bonds. Within the various
interrelated system, the dysfunctional behavior in the family due to substance abuse are
detected and mitigated.
Intervention C
According to (Weisman & Montgomery, 2019) in the paper ‘Functional Family
Therapy (FFT) for behavior disordered youth aged 10–18’ the Functional Family Therapy
(FFT) has been a short period of intervention been conducted for 30 hours duration. This kind
of intervention has been designed through recognition and identification of the malpractices
occurring in the family and the dysfunctional behavior patterns detected. The communication
channel in the family is studied with the victim of the substance misuse. The family members
negotiate effectively within themselves and clear rules are being set where the privileges and
the assigned responsibilities are moderated to enhance the relationship among the family
members. This intervention is a very traditional practice over 270 sites, the majority being
practiced in United States. The countries in which it have been mostly used are United
Kingdom, New Zealand and Belgium. This intervention is widely used due to its longevity,
however the reliability of the test is questionable as per the magnitude of the event. It mostly
take into account the family patterns and the children with age from 10 to below 18 years
who are affected in the family substance abuse.
Intervention toolbox selected
The intervention chosen is the FFT. Functional Family Therapy being the most widely
used traditional practice has been chosen as the intervention toolbox to study the
dysfunctional patters and relationships in the family where substance abuse persists. It is

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directed towards changing the maladaptive behaviors in the family and reduce the social,
personal and economic effects which the substance abuse bring in the family through
financial problem, violence and mental trauma in children. This intervention approach
focuses on the change of communication with regards to emotions and the deep
understanding of actions. The theories of cognitive behavior, emotional and social behavior
are collaborated in this approach. It is a short term 90 days comprehensive program where the
therapy includes visits in the home, school or any other environment where the victim and the
family of the victim spends most of the time. There are supposedly 12 visits and each visit
record the interactions and the history records of the behavioral pattern change. The therapist
here does not focus only on the specific number of family people who are directly affected by
the victim. It takes into account all the member of the family who are both directly and
indirectly affected in the process.
The intervention consists of 5 stages.
Stage 1 – Engagement
In this stage, the therapist try to build a good relation and network with the family
members of the victim of the substance abuse. All the family members are contacted and the
information are gathered regarding their connection with the victim.
Stage 2- Motivation
In this stage, the therapy identify the negative behaviors as reported by the family
members and try to modify the negative situations and behavior predicted to positive
outcomes. The blaming and the accusations in the relationships are shifted to a nurturing
perspective of building care and support in the family.
Stage 3 – Relational Assessment

8SUBSTANCE ABUSE INTERVENTION
In this stage, the relational problems getting faced in the toxic environment of the
house gets redirected into the positive behavior modulation. The individual problems are
heard and consulted with the group problems faced as a whole. The relations in the family
together are assessed and family bond is given more priority.
Stage 4 – Behavior change
In this stage, the inter family relationships are nurtured through role playing, conflict
resolution, relation building games and the counselling sessions with family members to
replace the negative behaviors with positive behaviors. The risk factors are replaced also with
the protective factors with the victim. The relational behaviors with the victim are moderated
with care.
Step 5- Generalization
In this stage, the behavior which are changed in the family is now extended to the
community, the school environment and the small groups in which the each member of the
family interacts with. The social settings here are focused to bring the change in overall
family relationship development towards a positive change.
Section II
Cultural Competent Practice 1
As per Cano et.al, (2018) in the research article ‘Alcohol use severity among adult
hispanic immigrants: Examining the roles of family cohesion, social support, and gender’ the
Hispanic families are widely known for heavy drinking and increased use of alcohol
consumption, especially the non-ethnic groups. There are developmental disorders in the
immigrant Hispanic families in terms of alcohol consumption and drug abuse. In such
families the gender and the family cohesion play a big role. Mainly the men are privileged to

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drink and consume drugs, the women are not much allowed. The family cohesion has an
indirect influence in the sense that family support can reduce the increased risk of substance
abuse in the family.
Cultural Competent Practice 2
As per Caballero et.al, (2017) in the paper ‘Adverse childhood experiences among
Hispanic children in immigrant families versus US-native families’ the Hispanic immigrant
children mostly come from the single parent structured family with high incidence of poverty
and low income households. The families go through disturbed environments with violence
and divorce between parents. The children get mentally affected with the alcohol abuse and
the mental pressure more arising from such toxic environment with low maternal health, less
educational opportunities and the hardships in their life than the US native Hispanics. The
native Hispanic adults with good economic opportunities and high income indulge in more
alcohol consumption and drug dealing.
Cultural Competence Practice 3
In the paper ‘Advances in Substance Abuse Prevention Practice and Science for
Hispanic/Latinos’, according to (Cervantes & Koutantos, 2020) the US Census Bureau Data,
the Hispanics are the youngest racial group with millennial more in population. There are
many immigrants who do not speak English language. In the immigrant population, the
children often face the forced family separation which make them adopt to drug abuse. Also,
in the family there are risk factors where the parental figures are high alcohol consumers/
resorting to violence and the children see their parents getting arrested. There are many health
related factors with degrading immune system and health diseases found in the children due
to negligence in the family separation and single parent family. The minority groups thus,
have these disrupted family systems with the post migration trauma in the children. The
family system is eroded with toxic cultural values and shift in the land. The family members

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are not that united. However, in the native Hispanic family system there is traditional
interdependence culture where the family values are very important and cooperation with
loyalty over family members matter. The skills to be incorporated within the immigrant
Hispanic families is the family cooperation, spiritual skills and the traditional values which
will bind them.

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Section III
Family and Child Intervention Toolbox
Synopsis
The Family Functional therapy incorporates the cognitive and clinical behavioral
models to change the negative behavioral patterns found in the children and the family
members suffering from the substance abuse. The skill based training which is imparted to
the family members and children involve anger management, improved parent monitoring
and supervision of children with group stress coping mechanisms. The focus is on
strengthening the culture, resources and the values of the family as a whole (Robbins, 2016).
It assess all the relations within the element of the family dyad.
Figure: Functional Family Therapy Model
Source: (Sexton, 2011 p. 3.15)
URL:https://www.semanticscholar.org/paper/Title-Putting-families-first%3A-An-evaluation-
of-in-Carr-Hartnett/6019ac6c1e626f8712fa35a8b014dac0abadccb7/figure/1

12SUBSTANCE ABUSE INTERVENTION
Settings and Duration
The therapy mostly conducted by the family therapists who are qualified with clinical
psychology, developmental psychology and has knowledge on the substance abusive
practices with the help of medical practioners. Each of the therapy is different and suited as
per the needs of the family chalked out before conducting the therapy sessions.
The timeline of the therapy takes up to more than 3 months with 8 to 13 family
functional; sessions with each family member. The family members are visited in the settings
of their home and sometimes in the clinical lab settings as necessary by the behavioral pattern
changes. The reaction and changes to the external stimulus are measured throughout the
sessions where the learning is evaluated and the changes in thoughts, actions and the values
are recorded.
Goals for the children
The therapist will set goals for the children throughout the session:
a. To cope up with the stress
b. More communication with the parents
c. Elimination of fear
d. Change in negative behavioral patterns
e. Exploration of ideas
f. Replacing toxic habits with healthy habits
Goals for the family
The therapist will also set goals for the family in the session:
a. The reduction of negative and toxic communication pattern to children

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b. Reduction in abusive languages in home
c. Monitoring the children in their work
d. Supporting children in exploration
e. Better relations with spouse
f. Caring and developing mindfulness in healthy activities
g. Elimination of substance purchases
Goals for the victim in the family
a. Reduce the risky behaviors attached with the substance consumption
b. Building relationship with people who do not consume alcohol or drugs
c. Employing healthy routines in life
d. Reducing the amount of consumption on each session
e. Substitution of the substance
f. Making the patient responsible for self

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Process of conducting the therapy
Phase 1 – Assessment
The assessment of the models and the cognitive theories to put in studying the
behavioral patterns are to be studied. The various cognitive behavioral theories which can be
used are the Erickson’s psychosocial theory which will help the children in the identity and
role confusion stage. The reinforcement theory can be used to teach the children through
positive reinforcement and negative reinforcement to react in the situations of substance
abuse. The information regarding the specialize drug or alcohol is to be collected, the various
symptoms shown on consuming it and the effects which it can produce on the victims as well
as indirect behavioral symptoms to be shown on others with direct touch to the person. The
substance abuse treatment facility organizations are to be contacted and made a report of the
conditions needed to satisfy to test the person and the medicines which can be prescribe din
the therapy. The drug authorities of the local state are to be communicated for the drugs and
the therapeutic treatment resources as additional medicines to be given.
Phase 2 – Planning
The number of family members with the issues and the problems of the victim in the
family suffering from substance abuse is to be planned. The number of sessions to be taken,
and the report structure as well as the resources required to monitor the members individually
are considered in the planning.
Phase 3 - Engagement
The main goals of this phase generally involve in enhancing he family members'
perceptions of the therapist responsiveness as well as the credibility. Therapists actually work
hard in order to demonstrate a most sincere desire in order to reach out to the children in the
family through listening, helping, respecting and creating a "match" to all the family

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members who in a way will bring the sensitive approach in terms of the individual, family
and cultural beliefs, as well as the values. The therapist's main focus is generally on creating
and gathering the immediate responsiveness from the family needs and in the side
maintaining the reports to assess the strength-based relational elements in their behavioral
patterns focus. In the engagement session, reaching out to the family members through
telephone and taking appointment then including proper dress, ethnic principles in
communication and carrying out a respectable attitude with the family members while
communicating.
Phase 4 – Treatment focused strategies
The treatment focused strategies to be used are:
Cognitive Behavioral Therapy – Group Therapy
In this therapy, the victim as well as the family members of the victim in the house
undergo various cognitive behavioral activities that help them to cope up with the stress. The
strategy is used to impact the cognitive functioning of the people in the family and regulate it
towards the positive thinking. The role playing is one of the cognitive behavioral therapy
where the child and one of the family member can take the role of the victim and portray the
activities that the victim perform with the child – be it violence or behaving rudely
(especially the negative behavior) is to be shown to the victim in front in order to modulate
the behavior. The other form of cognitive behavioral therapy includes art therapy and music
therapy which are used widely in the rehabilitation for the substance abuse patients.
However, this will be group art and music therapy. The family members will undergo
activities where the victim and the children and the spouse of the victim will draw to certain
themes as dictated by the therapist. One of the art therapy exercises include drawing the
portrait of oneself. This drawing tells a lot about how the person feels from inside. Another

16SUBSTANCE ABUSE INTERVENTION
exercise includes drawing other’s portraits or a family picture using different art objects. The
family together engaging in these art activities make it fun which in a way entertain them and
shift the negative focus of the victim to the positive focus enhancing the family bond. The
music therapy in the form of singing as family in their cultural music or using various music
beats to dance together is performed for fun. The interaction through art and music and dance
bring the family values together.
Acceptance and Commitment therapy – Group Therapy
In this therapy, the victim is gone through the mediational therapy in order to connect
to the positive senses and commit to inner self for reducing such harmful activities of taking
the substance. The family members can be taught to practice the traditional spiritual culture
in the home and build a peaceful environment where the children learn from others how to
accept the good and healthy deeds and reject the negative deeds as well the consequences.
The family bond grows with mindfulness in their daily home activity tasks like the cleaning
of home, cooking and eating together with mindfulness. The assumption of certain
responsibilities in the home and committing moral deeds is the prime focus of the therapy to
reduce the toxic patterns from life.
Motivational Interviewing – Personal Therapy
In this therapy, the victim is personally interviewed and data is obtained regarding the cause
of the substance misuse. The choice of the substance, and the consequences of not leaving it
along with the side problems the person is facing due to which removing the bad habit is not
getting successful gets studied. The victim is interviewed in a very comfortable and personal
setting with one-to-one face conversation. The family members are also interviewed one by
one in this therapy where they share their stories of how the substance abuse is creating a
mental, physical and psychological effect on them. The children are interviewed with not so

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serious questions but comfortable questions are asked which they can answer without
hesitation. The main focus of this therapy to understand the condition of the family members
along with the victim and motivate them verbally through counseling as to how to cope with
the present scenario and make better modulations in the future.
Phase 5- Termination
The family members on completing the full sessions within the timeline are them
terminated on showing successful outcomes from the therapy. Until and unless the outcomes
are successful, the timeline gets extended to more 1 month.
Phase 6- Evaluation
The reports and the full sessions monitoring results are evaluated. The process does
not ends here. The evaluation and the monitoring are performed on monthly visits each 2
months consecutively to check upon the progress and the modulation of therapies.
Session IV
Summary
In this study, the chosen population is the Hispanic group of families be it both native
and immigrant in the USA. This kind of population sample is chosen as the Hispanic
population race is considered to be very different ethnic race. The immigrants are while less
drawn to substance misuse, on the other hand the native Hispanics are highly drawn to
alcohol and drug abuse. Out of all the interventions, the Functional Family Therapy is used as
the Hispanic population consider the family values and the traditions very much from their
ancestral tribal culture. This kind of therapy is much old and cost effective to execute. The
functional family therapy takes into consideration the change of negative values to positive
behavioral patterns through the interaction of each element in the family dyad through

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collaboration and interdependence. It is reported that substance abuse can reduce through
family cohesion.
References
Caballero, T. M., Johnson, S. B., Buchanan, C. R. M., & DeCamp, L. R. (2017). Adverse
childhood experiences among Hispanic children in immigrant families versus US-
native families. Pediatrics, 140(5), e20170297.
Cano, M. Á., Sánchez, M., Rojas, P., Ramírez-Ortiz, D., Polo, K. L., Romano, E., & De La
Rosa, M. (2018). Alcohol use severity among adult Hispanic immigrants: Examining
the roles of family cohesion, social support, and gender. Substance use & misuse,
53(4), 668-676.
Cervantes, R. C., & Koutantos, E. (2020). Advances in Substance Abuse Prevention Practice
and Science for Hispanic/Latinos. In Effective Prevention and Treatment of Substance
Use Disorders for Racial and Ethnic Minorities. IntechOpen.
Matejevic, M., Jovanovic, D., & Lazarevic, V. (2014). Functionality of family relationships
and parenting style in families of adolescents with substance abuse problems.
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Mattoo, S. K., Nebhinani, N., Kumar, B. A., Basu, D., & Kulhara, P. (2013). Family burden
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Naidoo, A. (2019). Family functioning in families affected by substance abuse (Doctoral
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