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“Bad Parents,” “Codependents,” and Other Stigmatizing Myths About Substance Use Disorder in the Family

  • Carrie Wilkens
  • Jeffrey Foote
Chapter

Abstract

Stigma associated with substance use disorder (SUD) is well documented but less well described for family members of those struggling. Through a variety of mechanisms, including closeness, unusualness, and blame, family is implicated through stigma by association. This is especially true for parents as there is an assumption of poor parenting and poor “family values” by both those outside the family and parents themselves, resulting in poorer mental and physical health outcomes for families, as well as social isolation and a lack of help seeking. There is also the presence of specific stigmatizing language associated with families, including labels such as “codependent” and “enabling,” which further isolate families. Broader dissemination of evidence-based family approaches such as Community Reinforcement Approach and Family Training (CRAFT) could help shift stigmatizing understanding and attitudes, as could the development of peer-to-peer coaching utilizing evidence-based strategies.

Keywords

Evidence-based Stigma Codependent Enabling CRAFT Family therapy 

References

  1. 1.
    Angermeyer MC, Matschinger H, Corrigan PW. Familiarity with mental illness and social distance from people with schizophrenia and major depression. Schizophr Res. 2004;69(2):175–82.PubMedCrossRefGoogle Scholar
  2. 2.
    Barry C, McGinty EE, Pescosolido BA, et al. Stigma, discrimination, treatment effectiveness, and policy. 2004. https://doiorg/101176/appips201400140.
  3. 3.
    Beattie M. Codependent no more. Center City: Hazelden; 1992.Google Scholar
  4. 4.
    Burk JP, Sher KJ. Labeling the child of an alcoholic. J Studies Alcohol. 1990;51(2):156–63.CrossRefGoogle Scholar
  5. 5.
    Carson AE. Prisoners in 2016 Washington, DC. US Dept of justice Bureau of Justice Statistics, NCJ251149, p 13. 2018. https://wwwbjsgov/indexcfm?.
  6. 6.
    Cermak TL. Diagnostic criteria for codependency. J Psychoactive Drugs. 1986;18(1):15–20.PubMedCrossRefGoogle Scholar
  7. 7.
    Cooper AE, Corrigan PW, Watson AC. Mental illness stigma and care seeking. J Nerv Ment Dis. 2003;191:339–41.Google Scholar
  8. 8.
    Copello A, Templeton L, Powell J. Adult family members and carers of dependent drug users. London: UK Drug Policy Commission; 2009.Google Scholar
  9. 9.
    Corrigan P. Mental health stigma as social attribution. Clin Psych-Sci and Practice. 2000;7:48–67.Google Scholar
  10. 10.
    Corrigan P, Miller F. Shame, blame, and contamination. J of Mental Health. 2004;13(6):537–48.Google Scholar
  11. 11.
    Corrigan PW, River LP, Lundin RK, et al. Predictors of participation in campaigns against mental illness stigma. J Nerv Ment Dis. 1999;187(6):378–80.CrossRefGoogle Scholar
  12. 12.
    Corrigan P, Watson A. The paradox of self-stigma and mental illness. Clin Psych-Science and Practice. 2002;9:35–53.Google Scholar
  13. 13.
    Corrigan P, Watson A, Miller F. Blame, shame, and contamination. J Fam Psych. 2006;20(2):239–46.Google Scholar
  14. 14.
    Daley DC, Raskin M. Relapse prevention and treatment effectiveness studies. In: Daley D, Raskin M, editors. Treating the chemically dependent and their families. Newbury Park, CA: Sage; 1991. p. 128–71.Google Scholar
  15. 15.
    Dawson DA, Grant BF. Family history of alcoholism and gender. J Stud Alc. 1998;59:97–106.CrossRefGoogle Scholar
  16. 16.
    Eaton K, Ohan J, Stritzke W, et al. Failing to meet the good parent ideal. J Child Fam Stud. 2016;25(10):3109–23.CrossRefGoogle Scholar
  17. 17.
    Felitti V, Anda R, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Amer J Prev Med. 1998;14(4):245–58.CrossRefGoogle Scholar
  18. 18.
    Foote J, Wilkens C, Kosanke N, Higgs S. Beyond addiction. New York: Scribner; 2014.Google Scholar
  19. 19.
    Francis A. Stigma in an era of medicalisation and anxious parenting. Soc of Health & Illness. 2012;34(6):927.CrossRefGoogle Scholar
  20. 20.
    Gerson R, Davidson L, Booty A, et al. Families’ experience with seeking treatment for recent-onset psychosis. Psychiatr Serv. 2009;60(6):812–6.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Girma E, Moller-Leimkuhler AM, Muller N, et al. Public stigma against family members of people with mental illness. BMC Int Health & Human Rights. 2014;14:2.CrossRefGoogle Scholar
  22. 22.
    Goffman E. Stigma. New York: Simon & Schuster; 1963.Google Scholar
  23. 23.
    Haskell R, Graham K, Bernards S, et al. Service user and family member perspectives on services for mental health, substance use/addiction, and violence. Int J Mental Health. 2016;10:9.CrossRefGoogle Scholar
  24. 24.
    Johnson V. Intervention. Minneapolis: Johnson Institute Books; 1986.Google Scholar
  25. 25.
    Kirby KC, Marlowe DB, Festinger DS, et al. Community reinforcement training for family and significant others of drug abusers. Drug Alcohol Depend. 1999;56:85–96.PubMedCrossRefGoogle Scholar
  26. 26.
    Kulik C, Bainbridge J, Cregan C. Known by the Company we Keep: Stigma-by-Association Effects in the Workplace. Acad Manag Rev. 2008;33(1):216–30.CrossRefGoogle Scholar
  27. 27.
    Larson J, Corrigan P. The stigma of families with mental illness. Academic Psych. 2008;32(2):87–91.CrossRefGoogle Scholar
  28. 28.
    Laslett AM, Mugavin J, Jiang H, et al. The hidden harm: Alcohol’s impact on children and families. Canberra: Foundation for Alcohol Research and Education; 2015.Google Scholar
  29. 29.
    Lefley H. Family burden and family stigma in major mental illness. Am Psychol. 1989;44(3):556–60.PubMedCrossRefGoogle Scholar
  30. 30.
    Ligon J. Families and significant other. NAADAC News. 2005;15(4):8.Google Scholar
  31. 31.
    Lipari RN, Van Horn S. Children living with parents who have a substance use disorder. The CBHSQ Report: August 24, 2017. Center for Behavioral Health Statistics and Quality. Rockville: Substance Abuse and Mental Health Services Administration; 2017.Google Scholar
  32. 32.
    Link BG, Phelan JC. Conceptualizing stigma. Annual Rev Soc. 2001;27:363–85.CrossRefGoogle Scholar
  33. 33.
    Marlowe D, Merikle E, Kirby K, et al. Multidimensional assessment of perceived treatment-entry pressures among substance abusers. Psych Addict Behav. 2001;15(2):97–108.CrossRefGoogle Scholar
  34. 34.
    McCann TV, Lubman D. Stigma experience of families supporting an adult member with substance misuse. Int J Mental Health. 2018;27:693–701.CrossRefGoogle Scholar
  35. 35.
    McCann TV, Lubman D, Boardman G, Flood M. Affected family members’ experience of, and coping with, aggression and violence within the context of problematic substance use. BioMed Central J Psychiatry. 2017;17:209.CrossRefGoogle Scholar
  36. 36.
    Meyers R, Wolfe B. Get your loved one sober. Center City, MN: Hazelden; 2004.Google Scholar
  37. 37.
    Meyers R, Miller W, Hill D, Tonigan S. Community reinforcement and family training (CRAFT). J Sub Ab. 1999;10:291–308.CrossRefGoogle Scholar
  38. 38.
    Meyers R, Miller W, Smith J, Tonigan S. A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others. J Consult Clinical Psych. 2002;70:1182–5.CrossRefGoogle Scholar
  39. 39.
    Miller W. Alcoholism Psych Addict Behav. 1993;7(2):129–36.CrossRefGoogle Scholar
  40. 40.
    Miller W, Meyers RJ, Tonigan S. Engaging the unmotivated in treatment for alcohol problems. J Consult Clinical Psych. 1999;67:688–97.CrossRefGoogle Scholar
  41. 41.
    Moyers TB, Miller WR. Therapists’ conceptualizations of alcoholism. Psych Addict Behav. 1993;7:238–45.CrossRefGoogle Scholar
  42. 42.
    Mwinituo PP, Mills JE. Stigma associated with Ghanaian caregivers of AIDS patients. Western J Nursing Research. 2006;28(4):369–82.CrossRefGoogle Scholar
  43. 43.
    CASAColumbia. Behind bars II. Center on addiction and substance abuse (CASA). 2010. https://www.centeronaddiction.org/addiction-research/reports/behind-bars-ii-substance-abuse-and-america%E2%80%99s-prison-population. Accessed 19 Jul 2018.
  44. 44.
    Norwood R. Women who love too much. New York: Pocket; 1990.Google Scholar
  45. 45.
    Orford J, Velleman R, Copello A, et al. The experiences of affected family members: a summary of two decades of qualitative research. Drugs. 2010a;17(sup1):44–62.Google Scholar
  46. 46.
    Orford J, Copello A, Velleman R, Templeton L. Family members affected by a close relative’s addiction. Drugs. 2010b;17(sup1):36–43.Google Scholar
  47. 47.
    Orford J, Velleman R, Natera G, et al. Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Soc Sci Med. 2013;78:70–7.PubMedCrossRefGoogle Scholar
  48. 48.
    Park S, Park KS. Family stigma. Asian Nurs Res. 2014;8(2014):165–71.CrossRefGoogle Scholar
  49. 49.
    Peleg-Oren N, Teichman M. Young children of parents with substance use disorders (SUD). J Soc Work Pract Addict. 2006;6(1–2):49–61.CrossRefGoogle Scholar
  50. 50.
    Reid J, Macchetto P, Foster S. No safe haven. New York: National Center on Addiction and Substance Abuse at Columbia University; 1999.Google Scholar
  51. 51.
    Rogers S, Chamberlin J, Ellison M, Crean T. A Consumer-constructed Scale to Measure Empowerment among Users of Mental Health Services. Psych Services. 1997;48:1042–7.Google Scholar
  52. 52.
    Romijn C, Platt J, Schippers G, Schaap C. Family therapy for Dutch drug users: the relationship between family functioning and stress. Int J Addict. 1992;27:1–14.PubMedCrossRefGoogle Scholar
  53. 53.
    Roozen HG, De Waart R, Van Der Kroft P. Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment. Addiction. 2010;105(10):1729–38.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Rüsch N, Angermeyer MC, Corrigan PW. Mental illness stigma. European Psych. 2005;20(8):529–39.CrossRefGoogle Scholar
  55. 55.
    Singleton N. Attitudes to drug dependence. London: Drug policy commission; 2010.Google Scholar
  56. 56.
    Smith J, Meyers R. Motivating substance abusers to enter treatment: working with family members: Guilford Press; 2004.Google Scholar
  57. 57.
    Song H, Shin H, Kim Y. Perceived stigma of alcohol dependency: comparative influences on patients and family members. J Subst Use. 2015;20(3):115–61.CrossRefGoogle Scholar
  58. 58.
    Struening EL, Perlick DA, Link BG, et al. Stigma as a barrier to recovery. Psychiatr Serv. 2001;52(12):1633–8.PubMedCrossRefGoogle Scholar
  59. 59.
    Substance Abuse and Mental Health Services Administration (SAMHSA). 2014. https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf.
  60. 60.
    Wahl OF. Mental health consumers’ experience of stigma. Schizophr Bull. 1999;25(3):467.PubMedCrossRefGoogle Scholar
  61. 61.
    Wahl OF, Harman CR. Family views of stigma. Schizophr Bull. 1989;15(1):131.PubMedCrossRefGoogle Scholar
  62. 62.
    Waldron B, Kern-Jones K, Turner W, et al. Engaging resistant adolescents in drug abuse treatment. J Sub Abuse Treat. 2007;32:133–42.CrossRefGoogle Scholar
  63. 63.
    Walker LO, Avant KC. Strategies for theory construction in nursing. 4th ed. Upper Saddle River: Pearson; 2005.Google Scholar
  64. 64.
    Werner P, Mittelman M, Goldstein D, Heinik J. Family stigma and caregiver burden in Alzheimer’s Disease. The Gerontologist. 2012;52(1):89–97.PubMedCrossRefGoogle Scholar
  65. 65.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.The Center for Motivation and ChangeNew YorkUSA

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