Date of Award

Summer 2009

Document Type


Degree Name

Doctor of Psychology (PsyD)


Virginia Consortium Program in Clinical Psychology

Committee Director

Michelle L. Kelley

Committee Member

Desideria S. Hacker

Committee Member

Richard Handel

Committee Member

Bryan E. Porter

Committee Member

Karen B. White


Many family members are adversely affected by their loved ones drinking or drug problem. The aim of the present study was to explore changes in coping and enabling behaviors among family members who attended a community educational and psychosocial group for friends and family of a substance abuser, and to examine the concerns of these family members.

Participants were 32 family members (i.e., parents, spouses/romantic partners, and siblings) who attended one of four consecutive Family and Friend (FF) programs between fall and spring of 2008. Participants completed the Behavioral Enabling Scale (Rotunda & Doman, 2001) and Brief COPE Inventory (Carver, 1997) at pretreatment, posttreatment, and 30-day follow-up.

Results of a series of repeated measures ANOVAs were conducted to assess changes in enabling and coping over time. Participants reported significantly less enabling behavior from pretreatment to posttreatment and from pretreatment to 30-day follow-up. Participants also reported significant improvements on three of the Brief COPE Inventory subscales: Positive Reframing, Instrumental Support, and Behavioral Disengagement.

In addition, verbatim responses from participants were recoded and examined using a Grounded Theory Qualitative analysis of the concerns expressed in the sessions. The following four major themes were identified: 1) Behaviors in association with a loved ones substance abuse issues, 2) Ways of coping with loved one's use, 3) Feelings in association with loved one's use, and 4) Group themes reflecting thoughts about group process and mental health resources.

The qualitative information supported that family members of an active alcohol or drug abuser report the most enabling behavior around: 1) boundary setting, 2) paying their substance abusing loved one's bills, and 3) helping their loved one through a hangover or crisis. The most common coping strategies included: 1) rationalizing why the family members continued support of their loved one was necessary, 2) minimizing the loved one's addictive behavior, and 3) isolating from social support. Group themes most often reported during the sessions related to venting their frustrations and giving advice to other members especially regarding enabling behaviors.

Results indicate that a brief psychoeducational and support group such as the Friends and Family Program appears to be helpful in reducing behavioral enabling among the family members of substance abusing loved ones. Adaptive coping strategies also appear to improve with participation in this type of group over time. These results support the findings of previous literature with the family members of drug and alcohol abusers and highlight the unique concerns of parents, siblings, and romantic partners by using both qualitative and quantitative research methods.


A Dissertation Submitted to the Faculties of The College of William and Mary, Eastern Virginia Medical School, Norfolk State University, Old Dominion University in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology in Clinical Psychology through the Virginia Consortium Program in Clinical Psychology.