Why Does My Therapist Ask Me About My Family?

Although there are commonalities among people who suffer from addiction to drugs like amphetamine, just as there are commonalities among people with heart disease or cancer, it is important that treatment be individualized and based on each patient’s unique needs. In addiction treatment, therapists will seek to learn as much as possible about their patients and their life circumstances. Knowledge about both an individual’s family of origin and current family situation can help in tailoring a treatment plan.

Understanding a Patient’s Family of Origin

Family of origin is a term sometimes used to describe the family in which someone was raised.  Therapists may ask questions about parents, siblings and other immediate family members. Sometimes it is helpful to understand family dynamics across multiple generations. Therapists may work with their patients to draw family trees or genograms, which map relationships and patterns.

One reason that it is helpful to look at family history is that addiction to drugs like amphetamine has a genetic component. The National Institute on Drug Abuse reports that an estimated 40 to 60 percent of someone’s vulnerability to addiction may be related to genetic factors.[1] Sometimes, seeing a pattern of substance abuse illustrated in visual form, or even just discussing it, can help provide patients with an extra level of motivation to stay sober. It can help patients who are ambivalent or unsure about whether they are truly addicted to see their situation more clearly.

Family of origin issues are also important because children learn by example. When people grow up in a family where negative emotions are not dealt with in a healthy way, they may fail to develop good patterns themselves and can be more likely to turn to drugs or alcohol to cope with life’s challenges. They may also learn to associate drugs like amphetamine and alcohol with socializing or having a good time if they grow up watching parents connect them. Therapists who understand these dynamics can help patients work to identify and change associations and develop new skills for addressing negative emotions.

Researchers have determined a number of risk factors involved in the development of substance abuse. These include factors in the individual, peer, family, school and community domains. A government website notes the following family-related risks:[2]

  • Substance abuse by family members
  • Lack of time spent together
  • Low level of parental supervision and monitoring
  • Lack of clear rules and consequences regarding substance use
  • Parental acceptance of substance use
  • Inconsistent expectations and limits
  • Job loss
  • Conflict
  • Abuse

Understanding a Patient’s Current Family Situation

A patient’s current family situation is also important for a therapist to understand. Therapists may help their patients to both identify family stressors that may need to be addressed and family strengths that can be drawn on to help in the recovery process. Sometimes they will involve family members and incorporate family therapy in the treatment process.

The Substance Abuse and Mental Health Services Administration (SAMHSA) notes that families act as systems in which the actions of one affect the others.[3] Other family members adapt to the actions of the one with substance abuse issues and develop patterns and coping mechanisms in an attempt to maintain balance. Unfortunately, these adaptive mechanisms can sometimes turn into enabling behaviors which need to be addressed.

SAMHSA notes other aspects of a family system. They explain that families possess nonsummativity, meaning that the whole is more than simply the sum of its parts. They also have their own pattern of verbal and nonverbal communication. The adaptation of members to the actions of others can lead to circular causality in which the behaviors of one prompt changes in another, which leads to subsequent changes in the person who originally initiated an action.

SAMHSA notes that when people begin to understand how substance abuse treatment can affect an entire family’s functioning, they often have increased motivation to work at recovery. Therapists may address family issues for this reason. They may also seek to understand more about family dynamics because it may be in a patient’s best interest to detach from family members who abuse drugs like amphetamine or alcohol or who otherwise may impede a patient’s recovery efforts.

Are You Ready?

Are you ready to begin a recovery journey? If so, give us a call. Our toll-free helpline is available 24 hours a day and is staffed with caring and knowledgeable individuals who understand the issues and want to help you find healing. They can even check your insurance coverage for you if you wish at no cost or obligation. No matter your family history or current family situation, recovery is possible. Take the first step today.


[1] “Drugs, Brains, and Behavior: The Science of Addiction,” National Institute on Drug Abuse, July 2014, https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-abuse-addiction (February 24, 2016).

[2] “Risk and Protective Factors,” Massachusetts Executive Office of Health and Human Services, http://www.mass.gov/eohhs/gov/departments/dph/programs/substance-abuse/providers/prevention/risk-and-protective-factors.html#family (February 24, 2016).

[3] “Substance Abuse Treatment and Family Therapy,” Substance Abuse and Mental Health Services Administration, 2004, http://www.ncbi.nlm.nih.gov/books/NBK64269/ (February 24, 2016).