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A Very Revealing Process.

I am in the process of refining family coaching / facilitator certification and it is a very revealing process.

The journey toward a true systems orientation is only beginning.

It’s really troubling how much the family has been ignored, historically, by payers and by extension providers.

The Disease Model

The disease model creates an interesting dynamic. By definition the “disease” is housed within the individual.

Naturally, this results in an over-emphasis on fixing the individual with substance use disorder.

Detachment, tough love, enabling, are all concepts that separate the person with SUD from the family.

These have been guiding principles of “family recovery” over the decades.

There are also some very practical issues that contribute to the emphasis on the individual over the family.

The “Identified Patient”

It is impossible for everyone with a SUD to have a marriage and family therapist assigned to them. In addition, many marriage and family therapists will not engage with a family if the SUD is active.

Make no mistake the family system must be addressed.

You can’t ignore that fact anymore then you can ignore gravity.

It must be addressed even if the “identified patient” is “stable”.

New Dynamics

The new dynamics of the family need to be explored.

The family will sometimes subconsciously sabotage recovery if they aren’t involved in their own process of change. The default behaviors will come back into play.

The new interpersonal patterns need to be worked out. New communication patterns need to be explored.

There is a very serious scale issue.


In a perfect world all families would be engaged in comprehensive family work.

That’s not going to happen.

The next best thing would be engagement in family coaching and family recovery facilitation. Scaling this service so that all families can be touched is the goal.

It’s a very ambitious goal.

It a Big Hairy Audacious Goal. A BHAG….

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