A Call for Kindness, Connection, and Science

J Subst Abuse Treat. 2022 Oct:141:108839. doi: 10.1016/j.jsat.2022.108839. Epub 2022 Jul 16.


Introduction: This personal narrative describes our family's struggle with my adult son's substance use disorder (SUD). Years of traditional tough love treatment programs worsened his SUD and our relationship. When he experienced drug induced psychosis and was hospitalized, I realized I needed to change my approach and understand his behaviors.

Methods: I reached out to the recovery community and spoke with many individuals who had walked in my son's shoes. They described feelings of loneliness, self-loathing, and hopelessness while being on the receiving end of tough love. They further described the contrast between those negative feelings, and the life affirming hope associated with communication, empathy, and inclusion. I became inspired to research programs that are based on communication, science, and connection, rather than isolation, judgment, and punishment.

Results: Family and community are powerful tools and can motive change. An evidence-based program called CRAFT (Community Reinforcement and Family Training) encourages relationships and teaches families skills to connect with their loved ones by effectively communicating and reinforcing positive behaviors, even in the context of unhealthy behaviors. Receiving praise for healthy behavior, recognition for good work, or even a positive acknowledgement for taking baby steps toward self-care can activate the same dopamine-producing reward system as drugs. Individuals with SUD can learn how to feel good in ways that do not involve using substances. Traditional patient-focused treatment programs, which encourage separation, punishment, and distance should not be considered the only approach to treatment.

Conclusions: Loved ones are not powerless. While we can't make a person change, we can contribute to making them want to change. We have more influence than we once thought possible and need to proactively seek out empirically supported family-based programs that reinforce these approaches.

Keywords: CRAFT; Evidence-based treatment; Family unilateral therapy; Lived experience; Personal narrative; Science, kindness and compassion; Substance use disorder; Treatment approaches.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect
  • Communication
  • Empathy*
  • Humans
  • Male
  • Self Concept
  • Substance-Related Disorders* / therapy