Table 1 Key terms: defining family-based treatment, family involvement in treatment, and family
Family-based treatment (FBT) | Family involvement in treatment (FIT) | |
|---|---|---|
Definitions (provided to respondents in the survey instructions) | Family-based treatment involves engaging both the individual with an opioid use disorder and their family members in treatment. Families are active members of treatment, along with the patient. Family strengths are utilized and bolstered to support the individual with OUD | Family involvement in treatment is when an identified caregiver or family member is provided with opportunities to be involved in their loved one’s OUD treatment |
Family: In this survey, the word “family” refers to biological and non-biological individuals within the patient’s residence and/or who participate in caretaking and guardianship over the patient such as parents, grandparents, siblings | ||
Level of familyparticipation | High: Family member involvement is required and family members are active and essential participants in treatment. Family engagement is an initial goal of treatment | Variable: Family involvement is typically not required and can be customized based on the patient’s preferences and needs. The level of family involvement may fluctuate over time [depending on the patient’s and/or family’s preference] |
Key content/components: | Intervenes at the family-systems level (rather than the individual level). Aims to improve family relations, address family dysfunction that may be contributing to AYA opioid use, and leverage family strengths to support the success of the individual with OUD Evidence-based principles of FBT (summarized by Hogue et al. [25]): • Family engagement • Relational reframing (aiming to motivate family members to make changes in their relationships) • Family behavior change (via skills building, coaching, and reinforcement) • Family restructuring | Can occur in the context of individualized, evidence-based behavioral and psychosocial treatments for OUD **Move this up to the top of the cell |
Example activities: | • Family therapy sessions • Skills building to increase emotion regulation, effective family communication, parental monitoring etc • Assess, discuss, and modify family dynamics • Initiate behavioral changes based on family’s goals Models for delivery: Functional Family Therapy [26], Brief Strategic Family Therapy [27], Multidimensional Family Therapy [28] | -Collaborative treatment planning and goal setting -Family education about medication for opioid use disorder -Inviting family members to periodically attend therapy sessions with their loved one -Offering group programming for family members -Sharing updates on patient’s treatment progress with their family |