The family-centered treatment approach to substance use disorder and mental health 

By Luciana Perez Uribe Guinassi, North Carolina Health Journalism Fellow

People who have experienced substance use disorder — and their loved ones — said at Health Journalism 2025 that involving family is crucial to recovery, challenging the idea that people must “hit rock bottom” or recover alone.

The panel was moderated by Joseph Lee, M.D., president and CEO of the Hazelden Betty Ford Foundation. All panelists had participated in programs offered by the foundation.

Reyna, who comes from generations of alcoholism, said her drinking left her physically present but unable to be the parent her daughter needed. She entered Hazelden Betty Ford’s Children’s program through a family court order during divorce proceedings. She and her daughter, Miaveya completed the children’s four-day program in December 2019. “Six years later, here I am,” she told the audience.

The program centered on the children, she said. After dropping Miaveya off, she didn’t see her until pickup. On the last day, they sat “knees to knees” as Miaveya read a letter she’d written. 

She was “quivering, reading off what she wrote. She wrote, ‘Mommy, I love you, and I was worried about you.’ And she wrote that I would get scared when you fell asleep because I thought you were dying,” Reyna said. “If that doesn’t sober you up, I don’t know what does.”

Miaveya, now in ninth grade, said her mother was at the height of substance use disorder when she was 7 or 8 years old. It was difficult, she said, because she didn’t know anyone else facing a similar situation and didn’t know how to talk about it.

Through the program, she said she learned that addiction wasn’t her mother’s “choice, and it’s not my fault, and all I had to do — my only job — was to be a kid.”

Lee said the program provides children with the language to understand and talk about a parent’s recovery — similar to how counselors help kids navigate divorce. Before the program, he said, “young people didn’t really have a language to talk about their (parents’) addiction. They would often come up with reasons like, ‘Maybe my parents are using because I’m bad,’ or ‘Maybe my parents are using because they don’t love me.’” 

Ermanno, also in recovery, first encountered the Betty Ford Center with his son in the Children’s program, which was founded there, and later as the parent of a child addicted to marijuana.

“The news that our son was an addict unbalanced us,” he said. But the programs enhanced their communication and understanding and his son later told him, “It was easier to get into recovery because I held the door open for him.” 

David said his husband experienced a series of traumas four years ago that led to his drinking spiraling. The first rehabilitation attempt at another facility failed. But Hazelden Betty Ford’s programs helped turn things around. “His journey is really, really on the mend,” said David.

“There’s this concept of letting someone hit rock bottom, or just sort of kicking him out, or whatnot — that didn’t resonate with me,” said David.

“As a family member, you’re quite powerful to choose to reinforce positive behaviors,” he said. 

Luciana Perez Uribe Guinassi is a politics reporter at The News & Observer in Raleigh, N.C.