Understanding Family Structure and Opioid Use Disorder

Posted: October 28th, 2022

The family, according to the Generalist Intervention Model (GIM), would fall under the definition “a primary group whose members assume certain obligations for each other and generally share common residences” (Barker, 2014, p. 155) This family, whose set of challenges include opioid use disorder (OUD) and their communication difficulties, were the research article I incorporated in my Discussion.  Within the family system itself there are multiple communication challenges, including condemnation and indifference.  “Condemnation involves family members severely criticizing, blaming, negatively judging, or nagging other family members”. (Kirst-Ashman and Hull (2018). P.355) “Indifference involves remaining unconcerned, not caring one way or the other, and appearing detachedly aloof”. (Kirst-Ashman and Hull (2018). P.355) 

“Family structure refers to the organization of relationships and patterns of interactions occurring within the family”. (Kirst-Ashman and Hull (2018). P.356) In families who suffer from (OUD) the family relationships are archaic at times but do seem to follow semi-regular patterns of interacting with one another.  From a holistic standpoint the family structure is consistently unstable and chaotic.  The (OUD) issues and according to (FTS) “systems theory prescribes that an event affecting one family member will have an effect on all family members”. (Kirst-Ashman and Hull (2018). P.356) Opioid use disorder, like any other substance use issue within a family, affects the entire family.

The strengths of the family are that they see themselves as a unit, meaning they do their best to protect and provide for one another.  They are aware of their issues, and the communication between family members in working toward a solution is mentioned frequently.  The bonds between the family as a system, and its subsystems strong.  There is genuine love and protection offered by both parents, which is recognized by their children.  Other strengths include operating in the macro/community environment regularly.  They have friends and extended family, offering what help they can for others.

The family falls into the fourth category in terms of the family life cycle.  “Stage four concerned dealing with adolescent children, whose needs and strivings for independence called for very different types of interaction than that appropriate for younger children.  Stage four also often marked refocusing of the couple’s relationship and addressing the needs of their own aging parents”. (Kirst-Ashman and Hull (2018). P.360) The family subsystem of the parents is having to manage relationships, primarily with their own children, but also with the concerns of future care for their elderly parents.  The grandparents are a great source of strength for the entire family.

The roles of the grandparents at this point in the family life cycle is a primary strength, and their role is heavily relied upon in seeking advice, feeling safer financially, nurturing, and a consistent presence of reassurance and stability.  Their role within the family system as a whole, work very well with the two younger generations.  There is a non-verbal communication within the younger two generations of positive, reassuring, consistent presence, and non-judgmental reassurance offered by both.

The social worker, in having an understanding of this family system and its subsystems, is paramount.  The social worker, from their initial assessment to a deeper and better-defined assessment/understanding of the challenges the family faces, can better use their knowledge and skills in connecting the family with a more accurate set of resources in alleviating these issues.  The cliché, knowledge is power, applies here and always.  How can a social worker be truly effective in helping the family if so many of the families’ challenges remained unknown?  A doctor cannot accurately diagnose a patient without clearly seeing the symptoms of the patient as their starting point.  So, it is with the social worker in building rapport and coming to a deeper level of trust offered by the family, that the social worker, much like the doctor, will begin to see and “diagnose” the challenges more clearly.  This empowers the family and the social worker to put together the best plan of action to effectively help alleviate the challenges the family is facing.

“Thinking of the family as a system is helpful when working with the family to help solve its problems.  For instance, as in any system, all parts (family members) have relationships with all other parts (family members).  When assessing a family, you need to assess all the relationships among individuals, even those that superficially appear subdued and less significant”. (Kirst-Ashman and Hull (2018). P.356) Opioid use disorder (OUD) affects every member of the family, and every family member should feel that they are “seen” and “heard” by the social worker.  As the NASW code dictates in its third Principle, “Social workers respect the inherent dignity and worth of the person”.  (NASW Code of Ethics, 2017).


Kirst-Ashman, K. K., & Hull, G.H. Jr., Empowerment series: Understanding Generalist Practice (8th ed.). Cenage Learning

NASW Code of Ethics, (2017). National Association of Social Workers