1. Families having a member with substance related problems are more likely to face:

• overall dysfunction, 
• feeling of shame, 
• behaviour problems; 
• financial difficulties and 
• indebtedness.

2. Children having a father with substance abuse have a higher risk of developing:

• substance problems at an earlier age and 
• male children are found to be more vulnerable.

3. Counsellors working in the field of addiction can help families of substance users to:

identify, screen as well as prevent future problems in children and their families.

4. In case of substance abuse, family functioning is affected in areas such as:

• leadership, 
• problem solving methods and communication between members, 
• reinforcement of appropriate behaviour, 
• support systems, 
• roles and 
• cohesion at home.

5. ‘Co-dependency’ means:

the family members deny the problem, become as dysfunctional as the addicted person, try to control the situation and attempt to maintain a balance.

6. The non-drinking spouse may also face problems like:

• neglecting children leading to emotional distancing
• difficulty with carrying out roles and responsibilities
• psychological problems and 
• low self esteem.

7. Coping by spouses may be through unhealthy means like:

• drinking (leading to serious substance abuse problems)
• self- medication and 
• misuse of tranquilizers.

8. Children of alcoholics may be affected in the following ways:

• They witness parental conflicts; 
• observe the three unwritten laws; 
• face emotional and behavioural problems; 
• don survival roles; 
• imitate their parents especially drinking.

9. The three unwritten laws are:

‘don’t talk, don’t trust, and don’t feel’.

10. Adults children of substance abusers may have problems such as:

• negative adjustment, 
• depression and 
• relationship difficulties.

11. After the person receives treatment for substance abuse related issues, the Counsellor has to prepare the family members to face certain issues/problems. What are the areas you would discuss?

• Let the recovering person take responsibility;
• not treat the person with caution or like a ‘brittle doll’: help the person to undertake old roles; 
• let the old feelings go; 
• strengthen social contacts; 
• improve family interactions,
• discuss unsettled debts/ financial problems, help in difficulty with job, sexual problems; 
• increasing trust.

12. What are the areas/skills that need to be strengthened for family members to improve overall family functioning?

• Improving family interaction - better communication between family members
• Problem solving skills;
• Parenting skills;
• Managing stress and anger effectively; and
• Increasing assertiveness and improving self esteem.

13. The counselling process should create an atmosphere for the family that is:

1. Safe, 
2. accepting and 
3. supportive where family members can openly discuss their problems.

14. Allowing family members to vent their negative feelings of anger, guilt, shame and fear about the future is important because (state 2 benefits):

1. Carrying these feelings is unproductive and increases tensions at home.
2. Refocussing on themselves, their needs (away from addicted person) enables positive changes in their own behaviour.

15. With the help of examples, analyse the need for families to be included in intervention with reference to substance abuse.

16. Discuss protective factors within families of substance abusers that we should seek to foster and strengthen in the course of counselling and family therapy.