Many parents and children face difficulties at some time in the family life cycle. Family Therapy works with families to overcome their challenges and nurture change and development within their relationships and their life. It offers a powerful setting for the disclosure of secrets, emotions and experiences that may be difficult to discuss. Licensed Marriage and Family Therapists (LMFTs) are the most specifically trained in this type of psychotherapy.

Family counseling provides family members with skills and tools to effectively deal with their issues, implement change and reach their goals. It helps clients communicate and solve problem effectively, build and maintain trust, with the purpose of developing a satisfying relationship among all members of the family.

Here are a few warning signs that someone may have a substance abuse problem:

relying on drugs or alcohol to have fun, forget problems, or relax, having blackouts, drinking or using drugs while alone, withdrawing or keeping secrets from friends or family, losing interest in activities that used to be important,performing differently in school (such as grades dropping and frequent absences), building an increased tolerance to alcohol or drugs — gradually needing more and more of the substance to get the same feeling, lying, stealing, or selling stuff to get money for drugs or alcohol.

It’s usually hard for people to recognize they have a problem, which is why friends or family often step in. Quitting is hard to do, and many people find they can’t do it without help.  By talking with to someone you trust, you don’t have to deal with your problem and secrets alone.

Today, the term  addiction can also be applied to compulsions that are not substance-related.  In these kinds of common usages, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences, as deemed by the user himself to his individual health, mental state, or social life.  Some examples include: gambling, food, sex, pornography, computers, video games, internet, work, exercise,  watching TV or certain types of non-pornographic videos, spiritual obsession, pain, cutting and shopping that are also considered psychological and physiological addictive substances or behaviors.   These addictions may cause feelings of guilt, shame, fear,hopelessness, failure, rejection, anxiety, or humiliation symptoms associated with, among other medical conditions, depression and epilepsy.

The related concept of drug addiction has many different definitions. Some writers give in fact drug addiction the same meaning as substance dependence, others for example provide drug addiction a narrower meaning which excludes drugs without evidence of tolerance or withdrawal symptoms.

The American Society of Addiction Medicine has this definition for Addiction: Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), substance dependence is defined as:

Substance dependence can be diagnosed with physiological dependence, evidence of tolerance or withdrawal, or without physiological dependence.

Grief is a reaction to a major loss. It is most often an unhappy and painful emotion.

Infidelity is one of the most common presenting problems for marriage and family therapists.  It is devastating to relationships and can be one of the more difficult problems to treat.  While the majority of couples disapprove of infidelity, some national surveys indicate that 15% of women and 25% of men have experienced intercourse outside of their long-term relationship. And, by including emotional and sexual intimacies without intercourse, these percentages increase by 20%.

During the initial assessment a marriage and family therapist will help the couple clarifying the purpose of treatment by externalizing the options. After an affair, couples who want to rebuild their relationship need to resolve any ambivalence about staying in the relationship, or work toward separating in a constructive way. One partner may want to reconcile while the other is still ambivalent or has decided to leave. Either way, painful emotions will get activated inside and outside of the therapy room. The injured partner feels angry while the involved partner commonly struggles with feelings of shame and guilt.

Most family therapists work with the couple together as the primary approach. However, in cases of an ambivalent or a severely agitated partner, the therapist may suggest some individual therapy sessions. Treatment can be confusing and difficult for couples, and the manner in which couples recover or uncouple after an affair depends on various factors including each partner’s commitment to healing the relationship, cultural values and norms, and the impact on children should they disband the relationship.

When working with infidelity therapists often use an integrative approach best suited to the couple. There are a number of modalities such as experiential and emotion focused therapy that a therapist can use when treating infidelity. Regardless of the theoretical preference guiding the recovery process treatment is rooted in a common ground approach that emphasizes safety and forgiveness.

In the initial stages of therapy, the primary task is to establish safely and address painful emotions and traumatic symptoms. In essence, the therapist needs to manage and stabilize the emotional reaction to the affair, and also get a clear picture of the circumstances surrounding the affair.

Once safety has been established and emotions aren’t as high, the therapist will ascertain what made the affair possible. Understanding the vulnerabilities for the infidelity and telling the story of the affair allow couples to move toward the final phase of therapy— forgiveness. Successful outcomes are closely linked to the development of empathy and hope in each partner— one of mutual exploration with a compassionate process.

Establishing and maintaining safety is a crucial part of treatment. Recovery cannot begin until contact with the affair partner is terminated. Stopping an affair does not just mean ending sexual intercourse. All personal discussions, coffee breaks and phone calls must also be stopped. When the affair partner is a co-worker, the contact must be strictly business, and necessary or unplanned encounters must be shared with the spouse in order to rebuild trust.

Telling the story of the affair is not easy for either partner. A guiding principle is how information will enhance healing. The injured partner may engage in a destructive process of interrogation and defensiveness, which never promotes healing, even if the answers are truthful. The initial discussions commonly resemble the adversarial interaction between a detective and a criminal. Simple facts such as who, what, where and when can be answered during the early stage of therapy to relieve some of the pressure for information. It is preferable to delay complex questions about motivations and explicit details about sexual intimacy until the process itself is more healing. The disclosure process evolves in therapy from a truth-seeking inquisition to the neutral process of information seeking – similar to a journalist and an interviewee.