Support family members

of people with addiction

season 2 Episode 7: Helping family members of people with addiction

SOLUTION:

Addiction is a family disease and family members of people with addiction need help, too. Research shows that helping family members helps their loved one who has an addiction. We look at an approach that is more effective than an intervention or Al-anon to get family members into addiction treatment. It’s called CRAFT, or Community Reinforcement and Family Training.

STORY:

At a book group meeting, women went around the circle and introduced themselves. They found out that nearly everyone there had a son addicted to heroin. The book group soon became the only place that these Christian women could talk about the struggles of dealing with an addicted child and get support. Also, without knowing it, their group stumbled on evidence-based ways to help addicted family members access treatment.

The women's self-care and maintaining a relationship with their children is supported by research, though it runs contrary to the "tough love" intervention-style messages they were getting.

ALSO: Stick around for the end of the episode because we’ll have an update on the chronic pain patient at the mini boot camp for pain, Kimberly Bergrud. We check up with her a month after the program ended.

LINKS TO MORE INFORMATION AND RESOURCES:

A new book (and ebook) called A Family Guide to Coping with Substance Use Disorders focuses on information for loved ones about addiction and practical strategies to support a loved one with a substance use disorder.

More information about True Hope Community Church.

More information about CRAFT.

The Changes Parent Support Group also offers support for parents of troubled young people.

If you want help finding local drug treatment, support groups, or organizations in your community for yourself or someone else, you can call 1-800-662-HELP (4357) and speak with someone at the national helpline run by SAMHSA, the Substance Abuse and Mental Health Services Administration. It’s free, confidential, and open 24 hours a day/365 days a year, available in English and Spanish. More information here.

Learn more about Swedish Pain Services’ “mini boot camp” for chronic pain patients (called the Structured Functional Restoration Program) here.

TRANSCRIPT

Anna Boiko-Weyrauch: This is Finding Fixes—a podcast about solutions to the opioid epidemic, Season Two, Episode Seven. I’m Anna Boiko-Weyrauch. 

It’s really hard to see someone struggle with addiction, and it seems like these days more and more people have a friend or relative with an addiction to opioids. 

If you’ve been following along this season of the podcast, you know we’re looking at the opioid epidemic as if it were a big swimming pool. I suggest you go back to the first episode of season two, if you haven’t been following along, by the way. 

To recap, the swimming pool represents everyone using an opioid, like prescription pain pills or heroin. In the shallow end, those are people who just started. In the middle, are people who are physically dependent, and in the deep end are people who can't control their use—those are people with an addiction. 

What about everyone else? Where do the friends and families of these people fit in?

On this episode, we see what some solutions for families look like. How can they help their loved one who is struggling in the pool, without risking themselves? 

And stick around for the end of this episode because we’ll have an update from someone you met in Episode 3. We check in on chronic pain patient Kimberly Bergrud and see how she’s doing a month after she took part in a mini boot camp for chronic pain. 

And now Reporter Michelle Martin brings us this next story—it’s about one group of women who stumbled on something that worked. 

Michelle Martin: Henriet Schapelhouman is a Christian minister, a wife and a mother. She wrote a self-help book all about living a life based on Christian values. And once she had the book, she wanted people to read it. So she organized a book group at a coffee shop in Redmond, Washington. 

Henriet Schapelhouman: Well the first chapter is about everyone has a story. And so we went around and told our stories.

Martin: Henriet was eager to make the most of this group and she’s not one to shy away from honest, open conversation—so she went first. 

H. Schapelhouman: Part of my story is that my son Harrison started drinking at age eleven; got in trouble with the law; started smoking pot started using heroin. Well first oxycodone then heroin and he's on the streets and I'm praying for him daily. 

Martin: Her words were somehow familiar. Nearly everyone there could relate.

Henriet had no idea that this group would turn into something much bigger and much more healing than a book club. 

Six women were there that first day. Their eyes fixed on Henriet. She had hardly finished her story when the next woman spoke up.

H. Schapelhouman: But somebody else said, “Yeah me too.” Then pretty soon everyone was like, “Well yeah. Me three” and “me four.” 

Martin: It turns out, Four of the six were mothers of someone addicted to heroin;  a fifth had two brothers who were. Terri Bowman was there. Terri’s son had been prescribed Oxycodone and Xanax following surgery for a sports injury. But Terri had recently discovered that he was now battling an addiction to heroin. He moved in with Terri and her husband. They were three people and three big dogs in one small apartment.

Terri Bowman: We had just recently moved to Redmond from the east side of the state. We moved there to heal from a recent crisis in our in our life. And here we were with an addict. And it wasn't Plan A. And so we needed to have all the help and support that we could get because we were just so much in the dark and we felt so alone.

Martin: As people began sharing such intimate stories, Terri says it became easier for others to speak openly and honestly.

Bowman: If it weren't so serious it was almost funny that we were all there together. What were the odds?

Martin: The book group also became something of a support group. Terri had no idea what it meant for her son to be addicted to heroin and she looked to Henriet for answers.

Bowman: I naively thought well you know we'll get through this and just you know a few months. And you know we'll get him back in an apartment set him up and you know my husband and I will be alone in our apartment again and it'll all be okay.

Martin: Henriet says the book club got a little sidetracked from the book. 

H. Schapelhouman: We worked at a snail's pace. I think out of the 10 chapters we got through four in a year maybe five.

(laughing) 

Martin: The coffee shop was a rare place they could talk about challenges that they couldn’t share with anyone else in their community.

H. Schapelhouman: We were these people who had done our best to bring up these children in a safe environment: taking them to church, putting them in Christian school; giving them the healthy boundaries. And suddenly one day you wake up and your child is the opposite of anything you'd ever imagined; has become a criminal, an addict, a liar, a thief, is rude, angry, aggressive, scary, helpless, and on and on and on. And so our shared experience in so many ways wa,s “How did we get here? How does this even happen to us?” And none of us were equipped for any of it because we had no background in this story. 

Martin: The women at this coffee shop were doing something that recovery experts say is really important. And that’s taking care of your own needs. 

Addiction is a family disease and family members of people with addiction need help, too. 

Research shows that helping family members also helps their loved one who has an addiction. 

For these women,  having a safe, nonjudgmental outlet to share their experiences, gave them  more strength to go on. 

They didn’t know it at the time, but they stumbled upon a few practices that have been shown to help families get their loved ones into addiction treatment. 

Let’s back up for a second. When people have a family member with an addiction, they usually turn to one of two methods. 

The first is a dramatic intervention, like what you may have seen on TV. That’s where family and friends stage a surprise confrontation. 

The other method is called Alanon-based counseling. That’s all about the family member of addicted person taking care of their own needs. 

But there’s another way and research shows it’s more effective than the other two methods. It’s called CRAFT.

Lara Okoloko: Community Reinforcement and Family Training

Martin: Lara Okoloko is a licenced clinical social worker and therapist in Seattle. In her private practice she works with families of those struggling with substance use—and about half of those are with heroin. She uses CRAFT, because she’s says it works.

Okoloko: The paradigm that we live in with families and addiction is these ideas of co-dependence and tough love and kicking people out and hitting bottom, I think I just want people to know that if that doesn’t feel right to you, that’s not the only way to do it. 

Martin: She says CRAFT is a mix of techniques that help families take care of themselves, communicate more effectively and learn about family dynamics. 

Okoloko: An approach that someone can learn through counseling with a therapist who knows that approach or just reading about it.  

Martin: We’ll hear more from Okoloko later, but first back to the fledgling book group.

The members of book-slash-support group grew closer over time – they kept meeting at the coffee shop. The owner, who was in the group, was very supportive. At first they would meet in the front of the store, says Henriet.

H. Schapelhouman: But as our stories unfolded and became more personal and graphic in some ways she cleaned out a storage room and put put there a larger square tall table with eight bar stools around. 

Martin: Since Henriet wrote the book, she naturally led the discussion, but she got a lot out of it too. It was a place she could finally connect with people after being shut out for so long. Henriet used to be a pastor of adult ministries at a big church.

H. Schapelhouman: My son lived at home and I started homeschooling him in ninth grade because he had brought what I used to think was a fifth of tequila, but actually gallon of tequila, to a Christian high school. So they didn't like that very much. He got kicked out and I started homeschooling him in ninth grade not knowing what was going on with him and not knowing what the journey would entail. 

Martin: Henriet says she tried to work part-time at the church, but it didn’t look good for the church to have a pastor who had a son with addiction.

H. Schapelhouman: The reaction wasn't, “How can we help you? How can we support you?” It was more the attitude of, “What did you do wrong?” Or “What did your son do wrong?” And basically there was even pressure to, to leave. 

Martin: So, she resigned her job. Her son’s addiction got worse and her friends and community weren’t there for her.

H. Schapelhouman: They would just fade. They'd be too busy. They just wouldn't reach out. Nobody asked. And basically you're so tired because you're you're afraid to go to sleep, because you're afraid that your child’s never going to come home or might die that night. You're afraid to get a call from the police. You're expecting to get a call from jail, you're hoping to get a call from jail, because at least they're safe and not using. So sleeping is hard. You're just surviving day to day so you don't have bandwidth to reach out to begin with. 

Martin: Henriet and her family were on a rollercoaster.

H. Schapelhouman: There's the crazy that people that don't have an addict just don't understand that there's high highs where it looks like ‘oh they're better,’ because they're pretending really well. And so you fast forward and think, ‘Oh we're we're turned the corner; it's going to be better,’ and then the next—within hours it could be, or for sure within days—there's a crash because they're using again. There was a fight; they’re slamming the door. They're leaving. You find that stuff’s stolen. And you're just heartbroken and you just don't feel like you can go on. You don't know how to go on. 

Martin: Henriet and her husband didn’t feel like they had anyone they could talk to about it.

H. Schapelhouman: I would just walk up and down my driveway crying and and or I would be on my hardwood floor on my arm just sobbing and crying out and just saying just praying, “Jesus please help me Jesus please help me.” And sometimes for an hour.

Martin: Henriet was going through something a lot of mothers, fathers and family members of people with addiction go through—the chaos that comes with a substance use disorder can spread into the family. 

Lara Okoloko says that’s why the self-care piece is so critical. Lara is a social worker.

Social workers often think in terms of what will protect someone and what will put them at risk. Lara says that for people suffering with an addiction, the three most important protective factors are: involved family members, stable housing, and health care. And for young drug users, the family often has all three.

Okoloko:  They're often providing health care that providing stable housing and they are the safety net, the supportive loving family. I don't think I can overstate the importance of the family kind of taking care of themselves and sustaining themselves to be in this with their with their family member. 

Martin: That’s because Okoloko says relatives can burn out—get overwhelmed and overextended. First, they need to take care of themselves. 

Okoloko: You, the concerned loved one, you matter. And we need you to sustain this effort so that you don't get burnt out and want nothing to do with this person anymore because they need you. And so I think that's where the self care is vital. 

Martin: The book-slash-support group was a way for the families to take care of themselves so they could continue to care for their addicted children. 

Henriet says she got strength from being around people like her. Parents who understood the craziness of her life, the sleepless nights, and the calls from jail. 

H. Schapelhouman: Part of it was just being with people who you don't have to explain your feelings you don't have to explain your journey you can just say it. And we all get it. And that in and of itself is such support. 

Martin: The coffee shop meetings evolved. After about a year of meeting with the book group, Henriet--always the one to bring people together, to share food, to build community—did a very Henriet-thing, and that is, invite everyone over to her house and feed them. 

H. Schapelhouman: I said, “Hey would you guys ever want to just get together for dinner?” And we’re all like “Yeah, you know let's let's gather for fun.” And so that started and we invited our husbands. 

Martin: Over the course of a year they would gather once a month. 

Terri says the group shared almost  everything. 

Bowman: Every little tiny thing that happened with each one of our loved ones was such a joy. Just remaining sober for a week. If we heard that somebody had decided to, to start on heroin again or if they went missing, it would just it would be so hard for every one of us, but we would all go through it together. It was a place where we could cry together. Even these big guys that were there with us they could cry together and we could laugh. 

Martin: Henriet remembers the laughter too.

H. Schapelhouman: Somebody might report that their kid who had been missing—didn't know where they were and they'd gotten a call from jail and we'd all go, “That's great!” We're all really—we are all genuinely really happy about that, because they're safe and they're sober and then we'd promptly laugh and kind of look at each other like you know normal people don't celebrate when someone goes to jail, right? 

Martin: Henriet says it was hard to share stories like these outside the group. With those quote unquote normal people  

The conventional wisdom of tough love and hitting bottom didn’t make sense to Henriet. So, she decided this group was not going to dish out advice. 

H. Schapelhouman: Our rule was we are not telling people how they should do it. One size does not fit all. What works for one doesn't work for another, but we are here for you. We will share what we would do in that situation, if you want to hear it. But we're not going to tell you how to handle it, because you need to become the expert on your child and what works for them.

Martin: One day, Terri hit a crisis point—she called Henriet. And then, she did what she felt was best for her son, even though it was hard. 

Bowman: I remember the day that I had to call the police on my son. 

Martin: Terri found heroin in the house. And that crossed a line, a boundary that was important for her and her husband. 

Bowman: So the police came; they got they got the heroin and they took it. But my son when he heard that they came, it was a changing day in his life. And he said that he realized how serious that we were, because we had told him you cannot lie in our house and you cannot have drugs in our house. And he said it changed his life and he had to stop doing this. And the next day he went out and he got on the methadone program—and it usually takes months, but for him that—and the Lord I think parted the waters and got him in that program the next day 

Martin: The last day of May 2014, Henriet’s son Harrison called her with excruciating belly pain—so bad that a mildly bumpy car ride was agony. They discovered he’d been living with a burst appendix.  He got surgery, gave up heroin and meth and started suboxone. 

In the meantime, Henriet stopped the support group meetings. 

H. Schapelhouman: I had a son who was barely making it and I knew that. 

Martin: But as her son, Harrison, got better he saw a need to keep the support groups going. 

Harrison Schapelhouman: All these people I was running into were in the same situation and it was just—they had nowhere to go and nothing to do and I kept coming home and my mom telling her stories about this and we eventually decided that a group was the way to go 

Martin: Sometime in mid-2017 the idea to turn the regular dinners into an actual church took hold. Henriet resisted—she had no desire to be on staff at a church again. But slowly, she came around. True Hope Community Church became a reality in January 2018. About five years after the first book club meeting. 

(People greeting each other, music)

Martin: These days, they meet in a small white church with a wrap-around porch. Lush evergreen trees buffer the sound of freeway traffic nearby. Church service starts at 12:30. 

(Sermon, songs)

H. Schapelhouman: Our mission is to just be a safe place for families of addicts and families of people in recovery and those who are addicts and those in recovery to heal, to find hope, to find their faith, to put their lives back together,  to receive the support much like we did at our table. So we meet at a very un-church time. And then we have lunch and then we immediately meet in these support groups.

Martin: Delaney Bird comes here with her mom.  

Delaney Bird: Here you know it doesn't matter how you're getting sober as long as you're willing to get sober or in other communities in recovery it feels like if you don't do it their way then they're going to judge you for it. Whereas here you don't get judged for you know just trying to make your way and stay sober the best way that you can. 

Martin: Delaney says she became more trustworthy and her mom, Ky, also was able to start to trust her more. Ky agrees that the church has helped her too.

Ky: I find peace here. I mean just automatically a sense of peace and I crave it throughout the rest of my week in my life and so for me to walk through these doors and to know that I am at peace and that my daughter is here and we're together experiencing this—there is nothing more that somebody could give me, because one of the things that you look for when you have someone who is out there in drugs is you just want some peace of mind. 

Martin: Henriet’s son, Harrison is also here today. He moves easily through the church, greeting everyone, and smiling. He’s pleased how the church supports families. 

Harrison Schapelhouman: I think that the parents actually get a lot more out of it than the kids do in a sense even though that wasn't our goal. But that is what kind of has been happening and because the parents are changing, they are, the kids are changing simultaneously. 

Martin: Piper Mazerak found that after a year of attending True Hope, she was able to shed her burden of guilt. She became more patient and thoughtful responding to her three children, who all dealing with addiction. 

Piper Mazerak: When my son was out on the streets or living on couches or wherever he was he noticed a huge change in the way I was talking to him. So then when he was ready to get clean he reached out to me. 

Martin: Although Henriet’s group didn’t know anything about CRAFT, they naturally adopted some of the things that make CRAFT effective. Lara Okoloko explains.

Okoloko: I really liked their rule about not telling each other what they have to do. And so I think that kind of non-judgmental support from somebody else who can have real understanding about what they are going through is a wonderful act of self care. 

Martin: CRAFT also focuses on positive communication. 

Okoloko: People are sometimes surprised at what a big difference that can make. Using positive communication is not just about saying nice things or about only saying what the other person wants to hear. That’s not what it’s about, but instead being able to connect to your own feelings to be able to express understanding about the other person. To be able to communicate clearly, even about difficult subjects and that can really change the whole family dynamic. 

Martin: Lara says she also likes that Piper maintained a connection to her son.

Okoloko: She continued to make herself available to him and when he was ready to ask for help then it was that connection that she had that he used. 

Martin: Communication doesn’t have to be talking.  And the communication doesn’t have to be deep to matter.

Okoloko: Sometimes those conversations that parents want to have which is we’re going to sit face to face and we’re going to make eye contact and we’re going to have a long conversation—sometimes that’s just not doable for someone who is experiencing a lot of chaos and disorganization and shame within themselves. 

Martin: Lara says that though it may be hard to believe, texting might even be better sometimes than a face to face conversation.

Okoloko: The great thing about texting is that if you’re trying new communications strategies you get to take it really slow. You get to think about what you want to say you don’t have to kind of volley like you do in real life.

Martin: She says that just being in a relationship with someone means we can and do influence one another. She says keep the connection and communicate clearly, but also learn how one person’s behavior influences another.

Lara says multiple studies show how effective CRAFT is.

For example, it appears to be 2 to 3 times more successful at getting resistant loved ones to start addiction treatment compared to an intervention or Alanon-based counseling. 

Something that works for one person may not work for another, though. And when someone seeks treatment, they might and often do relapse. In the end, its about making progress. The therapists we talked to who used CRAFT say moving in a positive direction is useful and good.  Better communication, closer relationships, and reduced burn out. These might or might not lead to a loved one overcoming addiction. But in the meantime, they can make the challenges of addiction more bearable.  

For Harrison, he says the support his mom got from the book group turned support group turned church helped his mom. And she helped him.

Harrison Schapelhouman: I always used to tell my mom, “How are we supposed to get better if you aren’t better?” And I was like, “Please don’t take that as an insult, I know I’m a lot worse than you guys are, but this is a family disease. Everyone knows it’s a family thing. So, if it affects everybody than everybody’s going to have to do something to become un-affected.”

Martin: As Harrison explains, the chaos of addiction affects everyone in a family. Families have alternatives to cutting off loved ones or letting them hit the proverbial bottom. Instead, as family members heal their own wounds, take care of their own needs and learn to communicate in new and effective ways, things can improve and in many cases, there’s a greater chance that the loved one will enter treatment.

For Finding Fixes, I’m Michelle Martin in Seattle.

Boiko-Weyrauch: This is Anna Boiko-Weyrauch again. We’re going to check in with someone we spent time with in episode number three, about chronic pain and opioids.  

Kimberly Bergurd lives in Seattle, Washington. She’s a gardener, grandma, and a member of the Led Zeppelin generation.

Right now it's lunch time. Kimberly spoons out orange mush from a bowl for her baby granddaughter, Edie.

Kimberly Bergurd: She's not a fussy baby at all and she's funny. She makes funny faces and. She likes. She's really determined like she's really trying to crawl. And so what she does instead of crawling is she rolls and she'll roll all over the living room. 

Boiko-Weyrauch: Kimberly babysits her granddaughter two days a week, and watches her grow. 

Bergurd: What I love about it is that I get to build a relationship with her. And it kind of distracts me from other things that are going on in my life. And I just feel so blessed to be able to participate.

Boiko-Weyrauch: Kimberly has chronic health issues that cause chronic pain, including a form of rheumatoid arthritis. Her body often hurts—through her shoulders, neck, knees, feet, and ankles. 

Two months before this interview, she went through a program at Swedish Hospital in Seattle for people with chronic pain. It was like a mini boot camp, three days a week, five hours a day. 

At first, Kimberly was skeptical.

Bergurd: After the first day I didn’t think this would work for me, at all. I thought, no way, they don’t understand me they don’t know what’s wrong with my body. But I made a commitment, so I just went there. And by the 1st week I could see it was already helping, 

Boiko-Weyrauch: You can hear about her first day in Episode 3. The program gave her new skills. 

When we met up with her this time, it was about a month after the program ended. We were curious what stuck with her. 

Bergurd: You know I have a lot of things that I can do to take care of myself. It's just a matter of stopping what I'm doing and doing something different.  

Boiko-Weyrauch: In the program Kimberly learned how to pay attention to her body and appropriately respond to it. Like when she gets angry at her husband and her body feels tense.

Bergurd: I'll stop what I’m doing. I tell Bjorn I need to go in the bedroom and lay down and do a body scan or do the mindful meditation and even just 15 minutes of that it takes me into a totally different space. My body just simmers down. 

Boiko-Weyrauch: Kimberly puts it into practice when she babysits, too, watching ChiGong or Tai Chi videos on YouTube when she gets a chance. 

Bergurd: Like when she goes down for a nap. ChiQong is very very helpful for me to settle down my nervous system. And then I also have exercises to strengthen the muscles that are weak that cause me to have more pain.

Boiko-Weyrauch: But just remembering all the exercises she should do everyday is hard. One of her classmates made Kimberly a spreadsheet to help her keep track.

Bergurd: I wouldn't say that I'm the kind of person that gets up in the morning and does all your exercises does QiQong and takes her walk and does that.  I'm just not that kind of person. 

Boiko-Weyrauch: Still, all these exercises, Tai Chi, QiQong, and meditation make a big difference. 

Kimberly has also cut way down on her pain medication. 

Bergurd: So, I'm really proud of myself you know to not have to need those. And don't want to need those.

Boiko-Weyrauch: Kimberly is looking ahead. One day she would like to be able to feel even more free in her body. 

Bergurd: Well I’d love to be able to cross country ski again. And we used to just—in the winter—cross country ski right in our neighborhood. It was a real bonding thing with my daughters. My husband from Norway he loves to ski. In fact the first time we skied, I said, “Bjorn, don’t you need your poles?” He looked at me and goes, “Kimberly I’ve been skiing since I was two.” And he just cross country skis and doesn’t need poles. It was kinda funny.

Boiko-Weyrauch: Kimberly says she still has pain, but now she knows what to do about it. 

And she’s focusing on the blessings in her life, like dancing to pop music with her little granddaughter Edie.

That’s a wonderful way to keep her mind off the pain.   

Boiko-Weyrauch: Next time on Finding Fixes—

Suzanne Seyton: Those three, they get up and they go to methadone every morning and they sit in the apartment together and they hang out and they have coffee. And truthfully, they would not be here today—like specifically because of Dave. 

Boiko-Weyrauch: The story of the first needle exchange in the United States. And how it’s about more than just clean needles.

Finding Fixes is a project of Investigate West, a nonprofit journalism organization working in the public interest. 

Financial support comes from the Philadelphia Foundation, Moccasin Lake Foundation, and listeners like you. And if you’d like to support this podcast, make a tax deductible donation at FindingFixes.com. 

While you’re there, you can drop us a note. Or you can send us an email at fixes@findingfixes.com.

This episode was produced and reported by Michelle Martin, Julia Drachman and me, Anna Boiko-Weyrauch. It was edited by Kyle Norris and Alisa Barba. Our producer is Nicolle Galteland. Music by Jake Weholt.

Thank you to everyone we talked to in this episode for being so generous with your time and experiences and thank you so much for listening.