Triangles and Family Engagement in Drug and Alcohol Addiction Treatment

Despite the large number of studies that demonstrate the need for family involvement in addiction treatment, mental health professionals (MHPs) are often reluctant to collaborate with the affected family members (AFMs), while several times they enter-consciously or unconsciously-into a competitive relationship with the family of the person with addiction problems (PAPs). The present study presents the results of a thematic analysis of 42 vignettes provided by MHPs working in drug and alcohol addiction treatment. Participants' experiences were depicted by two overarching themes: the caring and the traumatizing triangle. Present findings suggest that MHPs' awareness of triadic influences and attempts to build alliances with AFMs supports PAPs' needs for reconciliation with AFMs and is supported by multidisciplinary need containment. In the attempt to collaborate with AFMs, MHPs need to avoid accepting the idealization of the PAPs and not to ally into the underestimation of the family, in order to resolve possible separation phenomena and to avoid therapeutic failure. Additionally, MHPs are called upon working out their own difficulties and possibly their prejudices about triangular interactions, so that the triangle MHPs-PAPs-AFMs can function therapeutically in a multidisciplinary context. Clinical supervision and Balint groups may support addiction professionals in these challenging tasks.