Beyond addiction. Science and kindness for positive change.

Jeff Foote is a clinical psychologist who has been involved with addiction treatments and programme development and research for over thirty years. He now runs treatment centres and a foundation for families of people struggling with substance issues. He has also written some books aimed at families to amplify the messages about evidence based approaches that families never hear about when they are helping their loved ones with their substance issues.

Jeff’s work has not always been based around families. For the first twenty-five years of his career he felt that he, along with many other clinicians, downplayed the role and involvement of families when it comes to mental health issues and peoples psychological struggles. During the first two thirds of his career he ignored families and focused on the person struggling with the addiction. Over the last ten years through, he has been working with organisations geared towards helping families.

Jeff had a pivotal experience talking with fifteen parents who he was just about to start training to coach other parents. Their kids had had terrible substance issues and they wanted to help other parents through evidence-based ideas rather than the things they had been told for years and years. That series of interviews changed his view and helped him realise the huge pain families go through, the levels of motivation they have to help and understand and the huge resource they are in helping to produce change.

Jeff has spent the last ten years shifting his focus and trying to make the tools and information more accessible to families so that they can see that they do this, both themselves and in the community, that they don’t need professionals and that they can take this up and be effective.

The US has been a blaming society when it comes to substance abuse. This is gradually changing but it is still there. One message has always been that you have to detach. If your loved one is struggling you need to step away and take care of yourself. The tough love idea that you have to let someone hit rock bottom before they will change. This has nothing to do with evidence or effectiveness and is an approach that is heartbreaking for families who come scared, concerned and asking for help.

The 12 Step Programme is often considered to be the only solution for addiction. Jeff feels that it has helped many people and many families over the last seventy years. The problem is that it's a ‘one size fits all’ process. If it doesn’t help you then there must be something wrong with you and it’s your fault. It's a programme that has been both helpful and harmful because of its demand characteristics rather than an invitational approach.

The approach Jeff has been working on over the last ten years is called the Invitation to Change‘ which is an invitational idea rather than a command one. Its basis is in community reinforcement and family training, an approach called CRAFT which is the most powerful evidence based approach for helping families help loved ones. Before that, it was a case of letting go/detaching or confrontational interventionist approaches. What we know from CRAFT and other psychological based approaches is that you can take care of yourself and stay connected to them and that this is actually the most powerful way to help someone to change.

Jeff’s process starts by having to have an understanding of what the person you are trying to help is going through, to ‘Open the door to change by viewing your loved ones substance abuse by viewing it through another lens’. By shifting your perspective and starting to understand that you can step into their shoes. People do things because they are reinforcing. They act and behave because there is something in it for them. Substances are very reinforcing and they are reinforcing in different ways for different people.

Family members need to sit back and understand that their loved one is doing this not because they are morally reprehensible, lazy but because it makes sense to them in a powerful way. This creates an entirely different relationship and atmosphere – I still feel scared, I don't like or agree with it but I can understand it now. You’re a human being and these things mean something to you. This changes everything – what you’re doing makes me want to turn away to what you’re doing makes me want to turn towards you. The thing that changes is the understanding of their motivation.

The person struggling with the addiction is the one whose behaviour is not acceptable. The family is involved in a blame way. Studies about family support and family health show the barriers to are practical and economic but the major one is stigma. When a family member steps into the change process or treatment system they get blamed, ‘why didn't you see it earlier’ and there is shame and blame. It rips the family fabric of trust and safety apart and how you reengage is different for all families. Their values are different but most are invested in staying connected, of being loving and bringing safety, connection, respect and collaboration into a family unit that might have been damaged by the substance abuse.

Jeff feels Science and Kindness is what helps people change and that although strategies, understanding and data related research trial concepts are powerful without kindness the uptake and effectiveness is much less. Kindness is an evidence-based strategy as well.

You can find out more about Jeff at Center for Motivation and Change Foundation or The Beyond Addiction Workbook for Family and Friends: Evidence-Based Skills to Help a Loved One Make Positive Change, 

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