Family Behavior Therapy (FBT)

Family can play an integral role in addiction treatment; serving as emotional cheerleaders, accountability partners, and positive reinforcement all in one. However, that doesn’t mean that family is immune from the harmful effects of substance abuse. The emotional and financial burdens of addiction can severely strain these important relationships, leaving the addicted person without a familial safety net to fall back on. 

Family behavioral therapy can help address addiction as well as restore these complex interpersonal relationships. By including the family members that are directly impacted by addiction, participants can understand the extent of substance abuse’s influence on the family dynamic and ultimately, improve it. 

What Is Family Behavioral Therapy?

Family behavioral therapy (FBT), sometimes referred to as family behavior therapy, is one of several different types of family-based treatment. It is a promising evidence-based approach that combines behavioral modification with contingency management that focuses on cognitive and behavioral skill development and utilizes role-play, role-reversal, and goal-setting to accomplish this.

This approach is unique to other traditional types of addiction treatment in that instead of solely focusing on the addicted person, family behavioral therapy takes into consideration the thoughts and behaviors of the entire family. This can help family members become better equipped to respond to an addicted loved one’s behavior and to reconcile with their own feelings and needs. FTB does this by focusing on family relationships and resolving the issues between people rather than attempting to fix problematic thinking or behavior patterns within the individual themselves (as is the case with cognitive behavioral therapy)

How Does It Work?

Family behavioral therapy relies on a goal-orientated approach using specific and practical objectives in a wide range of areas such as home safety, home beautification, employment, and more. These goals help develop behavioral skills and provide opportunities to practice implementing them in day-to-day life. FBT has been shown to be highly effective, not just for addressing drug use, but other co-occurring issues as well such as child mistreatment, conduct disorders, and general family conflict.

There are four key elements that shape family-based therapies such as FBT, and each offers a precise benefit for the family dynamic.

  • Family engagement
  • Relational reframing
  • Family behavior change
  • Family restructuring

These skills can help mitigate drug usage both directly and indirectly. In addition to imparting substance-avoidance strategies, family behavioral therapy techniques can improve the overall home environment and family dynamic, resolving household conflict that might otherwise precede substance abuse or other problematic behavior. It is particularly well-suited for dealing with comorbid familial issues.

What To Expect

Family behavioral therapy can be adult-based or adolescent-based (and therapist engagement adapts accordingly) involving as few as two family members or the entire family unit, even if members do not live under the same roof).  

FBT is conducted with both children and/or parents in a single session, but each party receives individual attention from a therapist, often in a separate room. Although FBT can be particularly effective in cases of adolescent drug abuse, it can also be used to treat issues with drug-using spouses without children.

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