If you have someone in your life who is using substances in a problematic way, you may often wonder what you can do to help them decide to change. You may be frightened or mad at them for making bad choices. It’s also likely you have absorbed the cultural message that there isn’t anything you can do to help because that would be enabling or that the only way they will change is when they bottom out. Science, however, offers some different options about how to help someone change.
Step 1: Shift Your Understanding
The first step is to shift your understanding of substance use. Your loved isn’t likely using substances because they are a bad person or a crazy person. Your loved one’s behavior makes sense in some way; it serves a purpose for them. We understand that at times it can be hard to see what your loved one is getting from their use of substances with all the other downsides it can bring, including your disapproval. If you make some room for understanding what their connection to the behavior is, you can have more empathy for what they would have to walk away from when changing, which can strengthen a desire to help them. In addition, one size does not fit all when it comes to things that may help them change and ambivalence is normal and to be expected when it comes to making behavioral changes. If you understand your loved one’s behavior in a different way you can create the conditions for change. And there is a mountain of scientific evidence that you can help them change!
Step 2: Invite, Don’t Force
What many people don’t realize is there is the power of inviting change, not forcing it. Forcing or mandating change is a short term approach that usually doesn’t last. Our bet is that you would like to see change happen over the long haul. Ask yourself “If I try to help my loved one, what kind of impact do I want to have?”
Maybe you have heard that people with addiction problems need to be confronted and that their denial needs to be broken. Maybe you have heard that consequences are the only thing that makes a person change and that helping someone get to their “bottom” (by cutting them off or kicking them out) is the best way to help. These ways of helping put all the weight on squashing the bad behaviors and finding ways to force change to happen and are based on the idea that change happens by subtraction and erasing behaviors.
Unfortunately, there are no research studies showing that confrontation has any effect other than setting the change process back and letting someone hit bottom can result in death. These strategies also sacrifice the relationship with your loved one and prevent you from harnessing the power of noticing your loved one’s good behaviors or helping them engage in new behaviors that can eventually replace the destructive ones you are hoping to discourage.
Step 3: Find Healthy Alternatives
What we know about behavior change in general, and substance use in particular, is that change is hard. Old behavior patterns cannot be erased out of our memory banks and substances have a powerful impact on learning and memory. For someone to stop using substances they have to learn how to stop and they have to learn to do something else instead. As someone who cares and wants to help, there are communication strategies you can learn that will help you start talking about the problem in a way that pulls your loved one into a constructive conversation rather than pushes them away and generates more conflict between you. Your behavioral choices can have a positive impact on the interactions you have with your loved one and you can provide support for the new behaviors your loved one needs to learn in order to change their relationship with substances. You can help by introducing new behaviors and you can help them grow by rewarding them. You can also learn to set limits around the destructive behaviors you are hoping they change and allow natural consequences to play a role in motivating them to change.
Our Invitation to Change Approach incorporates all of CRAFT – Community Reinforcement and Family Training, one of the most robust and research-supported set of strategies for helping people with substance use problems with additional skills pulled from other evidence-based treatment (Motivational Interviewing, Acceptance and Commitment Therapy). The science is in: you can help your loved one change and you can take care of yourself in the process.