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Chapter Eight: Effects of Alcohol Problems on the Family. points for consideration. Alcoholism as family disease Early research Family system approach Children in the family children in the home adult children Facts versus beliefs. family: early research.

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Presentation Transcript
points for consideration
points for consideration
  • Alcoholism as family disease
  • Early research
  • Family system approach
  • Children in the family
      • children in the home
      • adult children
  • Facts versus beliefs
family early research
family: early research
  • Classic monograph 1954
    • Alcoholism and the Family by J Jackson
    • parallels work by EM Jellinek on natural history of alcoholism
    • survey of “AA Auxiliary” (Alanon)
  • Introduced view of alcoholism as “family disease”
alcoholism and the family
“Alcoholism and the Family”
  • Seminal study by Joan Jackson
  • Seen as defining family’s efforts to live with alcoholic
  • Six stages
jackson s 6 stages
Jackson’s 6 stages

1. Denial

  • both partners “explain away” problems

2. Attempts to eliminate problem

  • partner recognizes drinking is abnormal
  • partner tries to intervene
jackson s 6 stages cont
Jackson’s 6 stages (cont)

3. Disorganization and chaos

  • family structure has broken down
  • family goes from crisis to crisis

4. Reorganization despite problem

  • partner’s coping improves
  • energy not spent on having spouse shape up
jackson s 6 stages cont7
Jackson’s 6 stages (cont)

5. Efforts to escape

  • possible separation or divorce
  • live around the alcoholic

6. Family reorganization

  • new stability established
  • true whether treatment and abstinence or continued drinking
caveats on jackson paradigm
caveats on Jackson paradigm
  • A product of its era
  • Assumes husband is alcoholic
  • Now recognize differences depending on when alcoholism emerges
vernon johnson paradigm
Vernon Johnson paradigm
  • “Hitting bottom” then seen as needed to promote treatment
  • Family seen as able to prompt alcoholic’s entry into treatment
  • Draws upon family system theory
  • Assumes alcoholic has inadequate sense of events
johnson s view of family
Johnson’s view of family
  • Family members also affected
  • Co-dependency = dysfunctions from living with alcoholic
  • Enabling = behaviors that unwittingly allow continuation of drinking
family system approach
family system approach
  • Underlies much of thinking
  • Efforts by members to maintain equilibrium
  • Alcoholic family = escalating system
  • Common strategies of family members
    • keeping out of way
    • care-giving, counseling, efforts to control
    • resignation
family current thinking
family: current thinking
  • Differences between families
  • Characteristics of “alcoholic family” common to families under stress
  • Increased risk for family members
    • increase in health problems
    • increase in domestic violence
children of alcoholics
children of alcoholics
  • First gained attention in late 1980s
  • Early approaches not science-based
  • Children in the home
  • Also adult children of alcoholics
children of alcoholics cont
children of alcoholics (cont.)
  • Models describing children’s response
  • Two models
    • family hero, family mascot, lost child and scapegoat
    • responsible one, adjuster, placator
  • Not empirical support for views
children of alcoholics cont15
children of alcoholics (cont.)
  • Adult Children of Alcoholics
  • Roles from childhood carry into adult behavior

0 %

children of alcoholics cont16
children of alcoholics (cont.)

Current Understanding

  • Emphasis on resiliency
  • Emphasis on risk and protective factors
  • Major risk factor is genetic predisposition
  • Extended family can be a resource for child