By: Sabrina Spotorno, LSW, CASAC and therapist on the Monument platform

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There are many ways that Alcohol Use Disorder (AUD) impacts family members beyond the person living with it, which is why the phrase “family disorder” is used frequently in the therapy world. Family members of folks with AUD are oftentimes assigned the role of rescuer or the rock to secure stability in the home. 

Within the family system, trust has typically been broken. For those who are supporting a loved one with AUD, feeling helpless is commonplace. Supporters may even question the validity of their emotional reactions, as they appear secondary to their loved one’s substance use cycle. There is often a tug of war at play: ‘I want to support them,’ and ‘I want to leave.’ 

We have to normalize getting support for those with AUD and for those in supporting roles, too. In opening up this dialogue, I hope that I can affirm that whatever your experience as a supporter looks like, it is completely valid. I also hope to give you the tools to begin your own recovery journey, because your pain and healing matters. Helping yourself and your loved one doesn’t have to be mutually exclusive. With awareness, compassion, and actionable tools, you’ll be able to better care for others, and better care for yourself. 

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Reshaping the family dynamic

Therapists love alliteration, and I am no exception! I want to introduce a framework called the Three E’s. This framework helps build (or build back) resiliency at any stage of coping with a loved one’s disordered drinking cycle. Think, education, empowerment, and engagement. Let’s break it down.


It’s important to recognize that AUD is a medical condition. More specifically, AUD is a biopsychosocial disorder, which means biological, psychological, and social conditions interact to influence someone’s drinking behaviors. Drinking habits are not in any way related to someone’s moral compass. Relapse is not indicative of a lack of understanding that right is right and wrong is wrong. Relapse is not a matter of ethics. Relapse is not an indicator that they don’t care about you and your feelings. Understanding that your loved one is navigating a medical issue, and possibly co-occurring mental health conditions, can help reduce resentment and build compassion. 


It can be empowering to hold yourself accountable for the actions you take to support a loved one in a recovery-based lifestyle, whether their goal is moderation or abstinence. Empowerment comes with showing up for yourself and others when you say you will, doing the internal work you’ve committed to, and being there for your loved one in the ways you’ve said you would be. I want to emphasize the importance of self-care, which many supporters overlook. 

Carve out separate time for you and the both of you. What reminders can you set out for yourself to make time for yourself? What actions can you and your loved one collaborate on to feel like you are a part of their network, but not their entire net? Your mental health is just as important as anyone else’s. Taking ownership over your wellbeing can bring genuine confidence, stability, and clarity to introduce into the family system. 

Lastly, Engagement 

Engagement doesn’t necessarily mean engaging with others in your family. Engagement can mean carving out a space for something that nourishes you, on your own. Building moments that ground us set us up for groundedness in the face of challenges. Think of it as practice. Remaining centered or calm in light of your loved one’s challenges doesn’t mean you’re denying the severity of their AUD. When grounded, you can more easily access and leverage your education and empowered self to make sound assessments and decisions. 

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Remember, your needs matter. 

In any relationship, an ideal circumstance is one where we are comfortable sharing our needs and wants with the other person. However, in many family systems, I often see how codependence or avoidance can get in the way of that. Creating healthy boundaries is an important component of ensuring our needs are met.  

When you’re assessing how to set healthy boundaries, it can be challenging if you don’t have a firm understanding of your own needs. When we understand our needs we can better articulate them to others without fear. I suggest identifying needs and boundaries based on the eight dimensions of wellness: social, emotional, intellectual, physical, spiritual, vocational, financial, and environmental wellness. 

After reading about the categories, answer the following questions for each dimension:

  1. What is something I can do personally in this dimension?
  2. What is something my partner/child/sibling/parent can do in this dimension?
  3. What is it that we can do together to help each other?

This exercise works to separate the “me, you, and us” in relationships. The goal here is to build your sense of autonomy as a person and family member while acknowledging the space for your loved one to build theirs as well.

If you’ve taken on the responsibility of supporting a loved one navigating alcohol use disorder, that can be a lot of weight to carry. For today, I encourage you to take a moment, think about what you need, and give it to yourself -- maybe that's your favorite meal or a rom-com or a run. You deserve autonomy, self-care, and empathy. And you are not alone in this. 

If you have any specific questions you’d like me to address about supporting a loved one with AUD, I encourage you to post in the Community. We’re here to listen, and we’re here to support you. 

I am Sabrina Spotorno, a Licensed Clinical Social Worker (LCSW) and Credentialed Alcoholism and Substance Abuse Counselor (CASAC), ready to help you see just how capable you are of making long-lasting recovery-focused changes in your life. Graduating summa cum laude from Adelphi University, I had a generalist education with training in several modalities, including Trauma-Focused Cognitive Behavior Therapy, Compassion Focused Therapy, Systemic Family Therapy, Dialectical Behavioral Therapy, and Narrative Therapy.  I am always interested in learning new approaches to meeting clients’ needs, with a recent study in Liberation Based Healing and Collaborative Proactive Solutions.   

Having worked in several outpatient substance use and mental health clinics, I am excited to see how virtual therapy will break barriers for clients to get the care they need in the most accessible ways possible.  I value adapting to the client's changing needs.  I am a strong believer in integrative approaches since recovery is not a one-size-fits-all experience.  I have a passion for empowering clients to recognize their strengths amidst their life transitions to increase their sense of efficacy to align their actions with their beliefs and dreams. 

Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.