When an adolescent or young adult enters residential or outpatient addiction treatment, they usually don't come alone. Most are part of an extended family. Parents, siblings, and even grandparents may be struggling with the chaotic behaviors and negative outcomes of living with an addicted family member. "We know that addiction is a disease that affects the whole family, so providing family programming services is needed to bring hope, healing, and restoration to families," said Dr. Tim Portinga, senior clinician/clinical supervisor at Hazelden's adolescent and young adult services in Plymouth, Minnesota. How does a family begin the recovery process? Even though a young person completes treatment and begins to experience recovery, it doesn't mean that the residual effects of the addiction within the family just disappear. Addiction encompasses all aspects of the individual's life—from social development and communication skills to behaviors and actions to relationships within the family, school, and community. Addiction's ripple effect may have far-reaching and even devastating consequences. In response to addiction, it is typical for parents to experience fairly polarized reactions—they may be struggling with a sense of guilt or a feeling of being personally responsible for the actions of their child. Or, they may be angry or resentful at the devastation that has resulted because of the addictive behaviors. Effective addiction treatment programs provide resources and tools to equip parents and siblings with the skills they need to improve family systems and start their own recovery. Changing destructive patterns of behavior. One of the classic patterns in co-dependent relationships is the underlying fear of confronting the truth about the substance abuse. For chemically dependent individuals, the goal is to avoid any conversations about their use; to achieve this, they may use tactics such as anger, threats, or violent behavior. Through repeated encounters, parents are "trained" to avoid confrontation and not talk about the problem. According to Dr. Portinga, when parents and siblings start receiving family services, either through a formal family program or family therapy, one of their first discoveries is that they are not alone. In a family program, they are surrounded by other families who are going through similar experiences and are now ready to figure out next steps. For some family members, this may be the first time that they have been around people who understand what it's been like to live with addiction in the household. And it's often an incredible relief to be able to talk about the issue in a safe, open, and nonjudgmental environment. What should you expect from a family program? The core of family programming is focused on education—enhancing understanding about the disease of addiction as well as how it impacts the patient and the rest of the family. Family members learn that while they cannot control the addiction in their loved one, they can control their reactions to it. They learn to define what healthy boundaries are and how to set effective limits. They learn about the importance of continuing care for their family member in order to firmly establish the patterns needed for lifelong recovery. And they learn how to find supportive networks for themselves, so they can begin to cultivate a healthier family dynamic. Successful family programs also involve all members of the immediate family to thoroughly address the family system. Most siblings have been impacted, on some level, by the addiction of their sister or brother. They are surely aware that their parents are struggling, and as a result, this may cause them to be worried or confused. Or they may be resentful as the family resources of energy, time, and money are being consumed by the "problem" child while their own issues are dismissed or overlooked. While some siblings may be too young to participate in the program sessions, it is a vital option for preteen, teenage, or older siblings. Integrated family programs provide resources for helping siblings gain a new understanding of the dynamics of addiction. What are some options for ongoing support? Encouraging participation in parent support groups, family therapy, and Al-Anon or Alateen meetings are commonly recommended support services for families in the early stages of recovery. Parent support groups are typically facilitated by a licensed addiction or mental health professional and provide a forum for parents to share with each other about the ongoing recovery process. Family therapy offers more individualized support for addressing a family's specific clinical needs. Al-Anon and Alateen meetings are free and provide that essential component of fellowship with others on the recovery journey. There are also social media recovery support sites where parents can access a secure portal and communicate with each other.