Family Therapy & Substance Abuse Cost Analysis

Family therapy & substance abuse cost analysis shows the value of these interventions.  Substance abuse has the potential for recovery & improved functioning.  The guideline developers reviewed published cost analyses.  Only a few studies have assessed the cost benefits of family therapy or have compared the cost of family therapy to other approaches such as group therapy, individual therapy, or 12-Step programs.  A small but growing body of data; however, has demonstrated the cost benefits of family therapy specifically for substance abuse problems.  Family therapy also has appeared to be superior in situations that might in some key respect be similar to substance abuse contexts.

For example, Sexton and Alexander’s work with functional family therapy (so called because it focuses its interventions on family relationships that influence and are influenced by, and thus are functions of, positive and negative behaviors) for youth offenders found that family therapy nearly halved the rate of re-offending – 19.8 percent in the treatment group compared to 36 percent in a control group.  The cost of the family therapy ranged from $700 to $1,000 per family for the 2-year study period.  The average cost of detention for that period was at least $6,000 per youth; the cost of a residential treatment program was at least $13,500.  In this instance, the cost benefits of family therapy were clear and compelling.  Other studies look at the offset factors; that is, the relationship between family therapy and the use of medical care or social costs.  Fals-Stewart et al. (1997) examined social costs incurred by clients (for example, the cost of substance abuse treatment or public assistance) and found that behavioral couples therapy was considerably more cost effective than individual therapy for substance abuse, with a reduction of costs of $6,628 for clients in couples therapy, compared to a $1,904 reduction for clients in individual therapy.

Similar results were noted in a study by the National Working Group on Family-Based Interventions in Chronic Disease, which found that, 6 months after a family-focused intervention, reimbursement for health services was 50 percent less for the treatment group, compared to a control group.  While this study looked at chronic diseases such as heart disease, cancer, Alzheimer’s disease, and diabetes, substance abuse also is a chronic disease that is in many ways analogous to these physical conditions.  Both chronic diseases and substance abuse:fam

* Are long-standing and progressive

* Often result from behavioral choices

* Are treatable, but not curable

* Have clients inclined to resist treatment

* Have high probability of relapse

Chronic diseases are costly and emotionally draining.  Substance abuse is similar to a chronic disease, with potential for recovery; it even can lead to improvement in family functioning.  Other cost benefits result from preventive aspects of treatment.  While therapy usually is not considered a primary prevention intervention, family-based treatment that is oriented toward addressing risk factors may have a significant preventive effect on other family members.  For example, it may help prevent substance abuse in other family members by correcting maladaptive family dynamics.



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