Forgiveness and Cohesion in Familial Perceptions of Alcohol Misuse

Alcohol is the most commonly misused substance in the United States (Substance Abuse and Mental Health Services Administration, 2002). It has been estimated that approximately 10% of Americans have serious drinking problems (Beck, Wright, Newman, & Liese, 1993), and the number of individuals engaging in risky drinking behaviors continues to rise (Mitka, 2009). Chronic alcohol use can have many negative physiological, social, familial, vocational, and legal consequences. As a result, counselors frequently see clients either who have substance misuse problems or whose substance misuse exacerbates other psychological symptoms. It is important for counselors to understand the aspects of clients' lives that can affect substance misuse (Harford, Grant, Yi, & Chen, 2005). Many researchers and counselors prefer the term misuse, which describes a broad pattern of behavior, rather than the terms abuse or dependence, which refer to diagnoses offered by the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). For the purpose of the current studies, alcohol misuse is defined as the use of alcohol to the point of disruption of at least one major area of daily functioning (Edwards & Unnithan, 1994). For example, if an individual uses alcohol to the point at which it causes legal problems (e.g., disorderly conduct, driving under the influence), social or family problems (e.g., frequent arguments over drinking), physiological problems (e.g., health problems related to alcohol use), and/or school or work problems (e.g., missing deadlines or calling in sick due to alcohol use), he or she could be said to misuse alcohol. Several factors may contribute to an individual's decision to misuse alcohol. These are environmental stressors, depression, anxiety, and poor self-efficacy (Beck et al., 1993; Martens et al., 2008). Moreover, family environment and strong relationships may help problems with alcohol misuse. For example, Moos and colleagues (Moos, King, Burnett, & Andrassy, 1997; Moos & Moos, 2006) found that social and familial support combined with a stable environment were positively related to completion of alcohol treatment programs for males who abuse substances. Others have theorized that a supportive partner may buffer against relapse by reducing the need to consume alcohol to be accepted (Booth, Russell, Soucek, & Laughlin, 1992). Familial environment and primary relationships, however, may also exacerbate problems with alcohol misuse. Families with low family cohesion may offer little support to family members and have few resources available to cope with stress (Maio, Thomas, Fincham, & Carnelley, 2008). People who misuse alcohol may place themselves at risk for illness and injury, increase caregiver burden, damage the family financially or emotionally, cause family members to worry, and say or do things that increase family stress. Also, family members may pressure the person who misuses alcohol to stop drinking through coercive strategies (Fitzgerald, Davies, & Zucker, 2002; Hops, Andrews, Duncan, Duncan, & Tildesley, 2000). Family members may initiate arguments and aggravate the person who misuses alcohol, which may result in the misuser relying more heavily on alcohol to cope with the additional stress. Improving the family relationships may reduce relational stress, which may reduce the need of the person who misuses alcohol to drink as a coping strategy. Thus, to develop effective interventions that can help clients struggling with substance misuse, counselors are encouraged to consider interventions that can help their clients repair family relationships (Collins, 2007). Forgiveness of self or others can be a valuable part of these interventions. Within the family, forgiveness of wrongs can improve relationships and reduce relational stress (Maid et al., 2008). Drawing on Exline, Worthington, Hill, and McCullough (2003), we define forgiveness as two distinct but related processes. …