Setting boundaries in addiction treatment

Introduction: The boundaries of people allow them to preserve their integrity, take responsibility for themselves and have control over their life by protecting them from being violated by others.

Aim: This study attempts to describe the efforts of addiction therapists to support family members who have problems with alcohol / psychoactive substance use in enforcing boundaries.

Methodology: Focus group interviews with addiction therapists were conducted and 42 vignettes of collaboration with families were collected. The Atlas-t program was used for the coding.

Results: Boundaries setting is a frequent intervention with affected family members, which is related to both the motivation and the process of differentiation of the family member who faces problems related to substance use. A necessary condition is the decrease of emotional intensity and the de-escalation of the use-conflict cycle within the family system. Behaviors that lead to unnecessary conflict or alienation are avoided, while behaviors that strengthen family relationships are reinforced.

Conclusions: Containment of affected family members’ negative feelings ensures that boundaries encourage change, avoiding the control and the blaming of the person experiencing addiction problems. Limit setting is especially difficult when there is a history of abuse, alcoholism and other problems associated with a heavy burden of guilt for the past.

Keywords: addiction, affected family members,  family, boundaries, limit setting