Identification of A Change In On-Line Relational Family Therapy With An Addicted Person

In dealing with addiction relational family therapy is based on the following assumptions: the adult is responsible for his own behavior and thus also for addiction; addictive behavior is about compensating for a deficit in relationships; dependent behavior is led by a mechanism of compulsive repetition of satisfying unfulfilled relational needs and specific regulation of affect (shame, anger, sadness). The Covid-19 pandemic also posed a challenge to relational family therapy when the basic assumptions had to be applied in on-line conduct of therapeutic meetings. In the presented case study, we identified key moments of change in on-line therapeutic treatment with an addicted person. The therapeutic treatment of a married couple (they have been married for 17 years) is presented, where the man has been struggling with alcohol addiction for 5 years, while maintaining abstinence for the last 10 months. The couple were involved in one therapeutic cycle, in which the first 4 meetings were live and a further 8 were held on-line. The process of change in therapy was identified in the following events in therapy: (1) excessive affective response of the client, (2) regulation of identified affect, (3) connection with interpsychic experience of affect, and (4) double awareness. In the initial therapeutic meetings, which took place live, shame was recognized as the main affect, and in subsequent on-line meetings, the affects of anger and sadness. The research provides a starting point for further research to identify therapeutic change in on-line therapeutic practice.