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Sabotaging siblings: an overlooked aspect of family therapy with drug dependent adolescents.

Successful family therapy for drug dependence on the part of an adolescent must include sensitivity to the roles that other siblings play in the family system. Therapists must be aware of the possible infectiousness of substance abuse from an older sibling to a younger sibling. The sabotaging positions and roles that siblings play in relationship to the drug abuser must receive the kind of attention in family therapy that allows a loosening of these roles. What too often happens is a tightening of the grip on these positions when the drug dependent adolescent is identified as the patient, client or the one with the problems as well as the one who is responsible for the family's pain. Without an emphasis on confronting needed changes by others in the sibling subsystem, the recovering adolescent will experience a deep discouragement from a lack of genuine support from brothers and sisters. Feelings of failure and inferiority will point in the direction of rejection and a likely return to an identity as sick, bad and delinquent. Sabotaging siblings understandably fear changes in the familiar family positions and functions. However, in order for these brothers and sisters to welcome the former scapegoat back home, they must make room for the returning member, not as a drug abuser but as a person. They must allow him/her to find a new role of achievement, success identity and inclusion within the total family system, and provide acceptance as a truly valued sibling.