Role reversals in families of substance misusers: a transgenerational phenomenon

FRANÇAIS :
Cinquante adultes en traitement de maintenance (méthadone) ont été vus avec leur épouse et/ou leur faille d'origine au cours d'une thérapie ayant pour objectif de renforcer et d'améliorer les relations familiales et sociales et de diminuer la consommation de drogues. Sur les 50, 42 avaient des parents eux-mêmes toxicomanes et 30 avait un "père absent", ce qui les avaient amené à devenir adulte trop tôt et à prendre trop de responsabilités. La thérapie familiale peut rétablir, restructurer les relations et redonner à chacun son rôle.
ENGLISH:
Fifty adult methadone maintained opiate misusers were seen with their spouse and/or family of origin in outpatient therapy as part of a Veterans Administration Research project supported by NIDA. Family treatment was offered in an attempt to improve and enhance family relationships/social supports and to aid in the decrease or cessation of drug use. In this study, 42 of the 50 patients had parents who were substance misusers. A recurrent problem of the "absent father" was identified across both generations studied. Thirty of the fifty opiate misusing men had absent fathers (usually due to alcohol or other drug misuse) and 27 out of 30 became absent fathers (also usually due to substance misuse) when they had children of their own. The absence of a father produced major developmental problems seen in these families. A structured clinical intervention is described using the three-generational family tree to bring out these relationship issues, followed by supportive family therapy to restructure wounded family relationships from the family of origin and to bring about appropriate role expectations in the marital families. (Extract from authors' abstract)