Julia has just completed a 28-day residential treatment program for her alcoholism. Her older sister, Maria, was instrumental in sending Julia to treatment and took care of her children during the program. She has agreed to participate in Julia’s post-treatment recovery counseling. Julia also wants to bring her parents in for family counseling, but Maria says she does not think that would be appropriate given their own history of alcohol dependence. Julia believes that she cannot change her role in the family unless the others in the family also change their roles and relationship with her. Maria suggests that they just cut their parents out of their lives, pretending they have died and perhaps even have a mourning ritual for their loss. Unbeknownst to Julia, Maria was sexually abused by her father when she was a teenager. Maria still feels afraid and vulnerable when her father is present or even mentioned. Maria has also been hiding another secret from the family, that she is a regular user of cocaine. She uses cocaine to boost her confidence. Outwardly, Maria always conveys that she is confident and in control. Inside, Maria feels uncertain, confused, and very much out of control.

1) Analyze the roles that each member of the family plays in this scenario.

2) How would you approach this situation as an addiction counselor?

3) What questions would you ask Julia? Maria?

4) What recommendations would you make to ensure maintenance of Julia’s success?