L’incidence de la famille de l’adolescent toxicomane sur l’efficacité thérapeutique

Abstract

The present thesis entitled "The impact of family of adolescent substance abusers on therapeutic effectiveness" is based on the observation that parents of adolescents with substance abuse problems are very often distressed and not often involved in the therapeutic process. Therapeutic approaches are systematically patient-centred. At least, the families are not always involved in the therapeutic process. Yet the symbolic parental function plays a crucial role in the adolescent's socialisation process and identity construction. This being the case, the therapeutic management of adolescents in situations of dependence on psychoactive substances such as cannabis, cocaine, heroin, etc., oriented towards abstinence, withdrawal or controlled consumption, via systemic family therapy, is the object of our attention. Our problem is therefore that of the specificity of the correlation of therapeutic approach that may exist in the impact of the family of the drug-addicted adolescent on therapeutic effectiveness. The evocation of a transparent correlation between the family and the use of psychoactive substances leads us to question the role of the family in addiction therapy. Therefore, the question we try to answer in this work is the following: how can the family of the addicted adolescent have an impact on the therapeutic effectiveness? In other words, how can the therapeutic action be influenced by the family of the addicted adolescent? This questioning led us to formulate the following General Hypothesis: the involvement of the family of the adolescent drug user in the care process will improve therapeutic effectiveness. On the basis of this General Hypothesis (GH), we formulated the following Specific Hypotheses (H1 and H2): H1- The involvement of family members as stakeholders in the care of the adolescent drug user will enhance the therapeutic work on the adolescent. H2- The interactions brought into play by the therapist during the care of the adolescent drug addict will favour the therapeutic work on the adolescent. Based on the structural version of family transaction theory of Minuchin (1974, 2005), we followed the clinical approach according to Minuchin's structural family therapy model, which we applied to seven adolescents in an addiction situation and their families, using purposive sampling. We examined the hypothesis of this research through semi-structured interviews and, after analysis and interpretation of the results, came to the conclusion that the participation of the parents of adolescent drug addicts in the treatment process optimises therapeutic effectiveness and produces a beneficial effect on the patient and on each of the members of his family. In other words, involving the parents of adolescent drug users in the therapeutic process gives satisfaction from the point of view of the therapeutic management of adolescents with substance abuse problems. In view of this result, we can also envisage a theoretical presupposition which would consist of the idea that a therapeutic extension is more easily adapted to the care of patients by favouring a family catharsis with family members who generally lend themselves to group or collective therapeutic care. It is in this perspective that systemic family therapies have been considered. Thus, this study may be part of a new line of research on the metafamily problematic in a systemic approach to care.