The Family-Based Recovery Model
FBR Families have:
- A parent who is using substances (including alcohol), or has recent substance use, and meets diagnostic criteria for a substance use disorder
- A child under the age of 72 months
FBR treatment teams are composed of:
- 2 Full-Time Master’s level clinicians
- 1 Full-Time Bachelor’s level Family Support Specialist
- A Half-Time Supervisor
- Access to a prescriber for psychotropic medication management
FBR is more than a treatment model for parents who are using substances: it is a way of engaging, treating and being with clients and their children. The FBR approach combines good clinical skills, Motivational Interviewing techniques, and principles of Attachment Theory with lessons learned from in-home work.
Most families in FBR are referred by DCF rather than voluntarily seek treatment, thus the model places particular emphasis on safe relationship building and engagement. It is crucial that staff consider the ways in which clients’ stage of change, trauma history and life experiences impact engagement. Parents with substance use disorders who are identified by child protection services face discrimination and scrutiny that can activate trauma responses or further impede the development of a therapeutic relationship. The ability for FBR staff to maintain a non-judgmental and reflective stance rather than confront with authority is paramount. Thus, the model dissuades from terminology such as manipulative, addict, and treatment resistant. Such language, often used in relation to substance use and other mental health disorders, impacts the goal of building a safe treatment relationship.
The motivation to parent offers a uniquely powerful opportunity for substance use recovery. Both the pleasure of bonding with a young child and the satisfaction of competently parenting reinforce abstinence. FBR employs principles of attachment theory, infant mental health, developmental guidance and reflective functioning.
Interventions in the parent-child home visit are focused on bolstering the dyad’s attachment relationship. Working towards a secure attachment, teams provide the parent and child a time to be together. Naturally occurring moments can be used to promote discussions around a child’s need for a safe base; developmental milestones; assistance with managing strong feelings; as well any parental concerns for the child. The home visits offer a space for parents to explore their own experience of being parented and how that affects their parenting of this child today. Always holding the child in mind, FBR staff work with parents to build the capacity to view their child’s behavior as having meaning and to be curious about what the child needs. Lastly, addressing the parent’s expectations of their child through a developmental lens allows families to decrease stress by adjusting expectations to line up with the child’s current developmental stage.
Substance Use Intervention
The goal of abstinence is approached with an understanding that substance use behavior serves a function and that alternative behaviors can be effective replacements. FBR teams work with parents to understand the emotional, psychological and relational roots of substance use behavior, as well as acknowledge the losses often associated with substance use: intimate relationships, family support, children, social support, financial resources, housing and physical and psychological health. Treatment aims to pair recovery with feelings of parental competence, thereby increasing parenting confidence, and further positively impacting recovery.
Building Recovery Capitol
Housing, vocational involvement, and child care, are integral to wellbeing and recovery. The treatment team works with parents to address these needs by providing case management and linkage to services. The Family-Support Specialist takes the lead in these matters.