Three Approaches to Treating Addiction, Part 2: Helping Significant Others Move Beyond Enabling

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March 14, 2013 by Dr. Bob Weathers

Tying into Part 1:

Cynthia Osborn (2012), in a recent overview of psychotherapeutic approaches to working with addiction, proposed a holistic approach, or “informed eclecticism.”  I would like to summarize three evidence-practiced models, with examples from each, which might add helpfully to those individuals in recovery whose primary work may be occurring in the 12-step program; in the spirit of holistic, informed eclecticism and adding auxiliary support and behavioral encouragement to that quality, ongoing 12-step work.

Next, Osborn describes the “community reinforcement” approach:

A comprehensive biopsychosocial approach to the treatment of substance use disorders based on the premise that one’s environment or community plays a critical role in reinforcing recovery efforts.  (p. 148)

Here there is a real emphasis on enlisting the support and active involvement of the recovering addict’s significant other(s), including life partner or spouse.  Such involvement includes highly practical suggestions; for example, not agreeing to speak to the addicted individual when he/she has ingested substance, or allowing “karma” (natural consequences) to take its inevitable course (“hitting bottom”) without enabling behaviors.  Since the home environment is where even addicts in recovery return after inpatient treatment, it makes good sense to focus on those whose behavior and reactions (or, “non-reactions”) may have the most leverage in the recovery addict’s immediate life.


Osborn, C.J.  (2012).  Psychotherapeutic approaches.  In Capuzzi, D., & Stauffer, M. (Eds.), Foundations of addictions counseling (2nd ed., pp. 142-164).  Upper Saddle River, New Jersey.



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