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Section 13
Family Treatment: Making Amends

Question 13 | Test | Table of Contents

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In the last section, we discussed the spiritual principles in middle recovery. These spiritual principles are, accountability, humility, gratitude, and discipline.

In this section, we will discuss the Amends Process for helping recovering addicts reconnect with their families.

As you have observed in your practice, sometimes the recovering addict is the member of the family who directly seeks help with making amends to their loved ones. I have found that the Amends Process provides a good structure for these individuals to work within. 

Doug, 25, had a long history of substance abuse and addiction. He had begun drinking and using cocaine at 17, and his relationship with his family had become very strained over the years. Doug stated, "I’ve been clean and sober for 3 years now, and working really hard. Things are actually starting to look better. But… it’s like there’s a wall between my family and me. I did some really terrible things to them, so I understand. I mean, I punched my sister Karen in the face when she wouldn’t give me cash. But I really want to make things better. I love them!"

10 Steps of the Amends Process

Step # 1 - Approach Each Person in the Family
I explained to Doug that the first step in the Amends Process is to consider approaching each person in the family and tell them about his problem with alcohol and cocaine. I stated, "because of your addiction, you haven’t really communicated with your family in years, or discussed your behavior with them. A good place to start in making amends is to let them know you understand your problem."

Step # 2 - Admit Your Role
I then told Doug that the second step in the Amends Process is to admit your role. I stated, "don’t minimize how seriously you disappointed your family when you approach them. Listen to their complaints, and admit what you did. This is also a good time to explain that you’re now sober, and committed to them, not the drugs now. Another part of this discussion is to acknowledge the hurt."

Step # 3 - Acknowledge the Hurt
I have found in my practice that encouraging recovering clients to put themselves in their family’s shoes helps with this third step. Doug stated, "I understand. I’ve done a lot of thinking about how disgusted and hurt they must have been. I think I can honestly tell them I understand how they must have felt.

Step # 4 - Apologize
In addition to approaching each person, admitting your role, and acknowledging the hurt, I have found a good fourth step in this technique to be apologizing. I explained to Doug, "this may sound too obvious, but an honest apology to Karen and your parents may go a long way towards rebuilding with them."

Step # 5 - Absorb the Family’s Anger
The fifth step in the Amends Process is absorbing the family’s anger. As you have seen, dealing with the family’s anger can be very hard for the recovering addict. I explain to my clients to remember that their family got fed up with their addictive behaviors long before they did, and that it is natural for the family to feel angry. I told Doug, "even if your family expresses anger, they still love you. The best thing you can do is let them express it." I found it useful to teach Doug some deep breathing relaxation exercises to help him deal with his family’s anger. Are you treating a client, like Doug, who might benefit from some additional relaxation skills?

Step # 6 - A sk How You Can Help
Doug stated, "I know I can’t undo or make up for all the shitty things I did to Karen and my parents. I really wish I could. Isn’t there any way I can make them see that I wish I could take it all back?" I told Doug that the sixth step in the Amends Process is to ask how you can help. Clearly, by asking how they can help, recovering addicts can show their commitment to the family, and find some concrete ways to help the family work better. Doug stated, "That really is a good idea. You know, I bet my dad would like some help with the yard work. He always took great pride in his lawn, but his arthritis has gotten pretty bad."

Step # 7 - Assert Your Love
My seventh step in this technique is to assert your love. I explained to Doug, "we’ve talked before about how a lot of your parent’s pain comes from feeling rejected and betrayed. Sometimes, it’s better to simply express your real feelings for them, rather than trying to explain why you didn’t really reject them. Tell them as much as you can that you care for them and love them."

Step # 8 - Anticipate Mistrust
Another difficult step, as you know, is the eighth step in the Amends Process, to anticipate mistrust. I stated, "remember that you can’t expect Karen and your parents to believe you when you say you’ll never use again. Expect that this mistrust may go on for a long time." Doug stated, "I understand. I mean, they have a hell of a lot of reasons not to trust me ever again. I’ve told them I’ve quit a lot before, and it never took. So I guess I shouldn’t expect anything else. They’ve been patient with me before, and they deserve me being patient with them."

Step # 9 - Accept Fallibility
In addition to approaching each person, admitting your role, acknowledging the hurt, apologizing, absorbing anger, asking how to help, asserting love, and anticipating mistrust, my ninth step in the Amends Process is accepting fallibility.

As you know, accepting personal fallibility is a key step for recovering addicts in reclaiming their self-esteem and emotional independence. I have observed that many recovering addicts are waiting for their families to recognize their progress and make them feel better about themselves. I encourage my clients to stop expecting this from their families, and to try to do it themselves, thus reducing their dependence on others, as well as on substance use.

Step # 10 - Adventure
 The final step in my Amends Process for addicts to help mend their relationships with their families is to adventure. I told Doug, "One of the best things you can do for yourself is to explore new activities and new relationships. Follow your interests, and take your family with you." Doug stated, "you mean like in my recovery hiking group? I know some of my friends there take their family with them. My buddy John brought his dad to the last hike. Karen always liked the outdoors… I should invite her sometime."  Would playing this section be beneficial to one of your clients? 

In this section, we have discussed the Amends Process I have devised for the recovering addict to help mend bonds with their families members.

In the next section, we will discuss the spiritual principles of late recovery. These spiritual principles are harmony, balance, service, and community.

Peer-Reviewed Journal Article References:
Cordova, D., Huang, S., Pantin, H., & Prado, G. (2012). Do the effects of a family intervention on alcohol and drug use vary by nativity status? Psychology of Addictive Behaviors, 26(3), 655–660.

Hogue, A., Dauber, S., Samuolis, J., & Liddle, H. A. (2006). Treatment techniques and outcomes in multidimensional family therapy for adolescent behavior problems. Journal of Family Psychology, 20(4), 535–543.

Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., Miller, M., Burlew, K. A., Hodgkins, C., Carrion, I., Vandermark, N., Schindler, E., Werstlein, R., & Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents. Journal of Consulting and Clinical Psychology, 79(6), 713–727.

What are the steps in the Amends Process for helping recovering addicts mend bonds with their family members?
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Section 14
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