Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems

This paper provides an account of the theoretical basis of a family-based intervention called Behaviour Exchange and Systems Therapy (BEST). The model described here has also been applied to adolescents with substance abuse and other mental health problems such as depression and anxiety disorders in...

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Main Author: Andrew J. Lewis
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-02-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fpsyt.2019.00948/full
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author Andrew J. Lewis
author_facet Andrew J. Lewis
author_sort Andrew J. Lewis
collection DOAJ
description This paper provides an account of the theoretical basis of a family-based intervention called Behaviour Exchange and Systems Therapy (BEST). The model described here has also been applied to adolescents with substance abuse and other mental health problems such as depression and anxiety disorders in both children and adolescents. Evaluative studies of the model have been published including randomised clinical trials as well as qualitative analyses. The current paper discusses a theory of the family system as a discourse and represents an integration of aspects of attachment, psychoanalytic, and systems theories. Key concepts elaborated are the attachment-family system, the family as a single discourse, the use of segregation as a defense in relation to trauma and loss and its manifestation in a family narrative, and the role of the family secure base in affect regulation. The paper also briefly describes specific treatment techniques that are derived from the theoretical model. Our approach has wide application as a discourse focused treatment for children and adolescents using a family systems approach. Future work requires the comparison of this model to similar attachment-based models of intervention for children and families, further development and validation of measures able to be used for whole families in a clinical setting, and further empirical demonstration of treatment efficacy in a variety of clinical settings.
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spelling doaj.art-4088b1287fba404da923cc5405e2cd4b2022-12-21T19:03:35ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-02-011010.3389/fpsyt.2019.00948486200Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of SystemsAndrew J. LewisThis paper provides an account of the theoretical basis of a family-based intervention called Behaviour Exchange and Systems Therapy (BEST). The model described here has also been applied to adolescents with substance abuse and other mental health problems such as depression and anxiety disorders in both children and adolescents. Evaluative studies of the model have been published including randomised clinical trials as well as qualitative analyses. The current paper discusses a theory of the family system as a discourse and represents an integration of aspects of attachment, psychoanalytic, and systems theories. Key concepts elaborated are the attachment-family system, the family as a single discourse, the use of segregation as a defense in relation to trauma and loss and its manifestation in a family narrative, and the role of the family secure base in affect regulation. The paper also briefly describes specific treatment techniques that are derived from the theoretical model. Our approach has wide application as a discourse focused treatment for children and adolescents using a family systems approach. Future work requires the comparison of this model to similar attachment-based models of intervention for children and families, further development and validation of measures able to be used for whole families in a clinical setting, and further empirical demonstration of treatment efficacy in a variety of clinical settings.https://www.frontiersin.org/article/10.3389/fpsyt.2019.00948/fulladolescentssubstance abuseattachmentsystems theoryfamily-based intervention
spellingShingle Andrew J. Lewis
Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems
Frontiers in Psychiatry
adolescents
substance abuse
attachment
systems theory
family-based intervention
title Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems
title_full Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems
title_fullStr Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems
title_full_unstemmed Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems
title_short Attachment-Based Family Therapy for Adolescent Substance Use: A Move to the Level of Systems
title_sort attachment based family therapy for adolescent substance use a move to the level of systems
topic adolescents
substance abuse
attachment
systems theory
family-based intervention
url https://www.frontiersin.org/article/10.3389/fpsyt.2019.00948/full
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