By Frank Sanchez, PhD, LMFT, Clinical Director, Promises Young Adults Program Maggie knew she needed help with her drug problem and advocated to be in rehab, but she was having extreme difficulty with her family members. There was a toxic relationship with her older sister. Her mother had severe mental health issues. Her father tried to support the family the best he could, and had to travel a great deal for work, but he also had issues with avoidance. Since it was difficult to have a cohesive family therapy experience with all members, much of Maggie\u2019s focus in recovery was doing the work of healing on her own. And she did well. She succeeded through all phases of residential treatment, and she had a hopeful attitude backed up with skills she had learned.\u00a0 At 21, she was eager to get back to school. She felt ready when it came to the point of returning home to her parents\u2019 house, which was in the same town as the university she attended. Past Problems Resurface She was OK, initially, but after a while back in the same toxic environment her defenses kept getting beaten down. And she couldn\u2019t help but run into people from her drug-related past. Eventually she relapsed. Fortunately, she reached out to her clinicians at Promises before things got too far out of hand. They were able to help her create a longer-term plan that included a full year of treatment in outpatient care and transferring to a different school, in a different city. While it is never a goal to split families up, young adults sometimes need special help moving on and individuating from their families after rehab. Having a clear understanding of this can help young adults recognize issues that can impede recovery in the family environment. It was clear in Maggie\u2019s case that she would be better off moving out of the family home and reestablishing herself in a new community and school. The Family Pattern Trap Although they have sobriety and more coping skills, a young adult fresh out of rehab will often walk back into the same destructive patterns of behavior. It\u2019s akin to visiting family during the holidays. They\u2019ve barely seen each other all year but fall right back into those same family dynamics. Everyone in the family has their role. The behaviors are the same. Emotions run high and everyone aligns with the dynamic. It can cause people to regress to immature feelings and behaviors. It's the same for the person in recovery going back home to live with the family. They are immediately brought right back into that same emotional rhythm \u2014 and it is not always a healthy one. So much of the early trauma they experienced occurred in their family and returning can expose them again to the people who were (or still are) abusive or have drug problems themselves.\u00a0 One young adult just out of rehab was asked to go back home to live with her father, who was an abuser. It didn\u2019t take long for trauma to kick in and she feared it would drive her back to addictive behavior. She opted to move out of the house and start anew. It\u2019s not always easy, but it may be necessary Relatives May Not Be Able to Support Recovery Whether just past adolescence and or into their late 20s, young adults may still be living at home or planning to return home after rehab. There are a variety of reasons for this, but once home, they should be aware of some of the following issues that may endanger their sobriety: \tDifficult or unhealthy relationships. There are many relationships that existed previously and haven't changed. When someone is accustomed to living in this familial pattern and is thrust back into it, they sometimes revert back to prior behaviors because the emotions are the same. The experience is the same. And it can trigger the previous response, which was to use drugs. \tRelatives have not done emotional work. While a young adult has done a lot of therapy and inner work on trauma and emotional regulation, sometimes family members have not \u2015 yet. Or maybe one person has tried to make changes but the rest are living an unhealthy lifestyle. For example, a mother may have taken the lead in trying to welcome an adult child returning from rehab, but the father may be unsupportive. \tDrug and alcohol use in the home. If other family members are using, the person in recovery is returning to a household filled with temptation. Some young adults, for example, come from homes where the parents are using substances like marijuana. It doesn\u2019t make any sense to the person in recovery. Why are they being asked to be sober when they see family members, even their parents, using substances? The sober family member will have a difficult time living in such an environment and, worse yet, it can unravel their recovery.\u00a0 \tUnhealthy family dynamics. Even loving families may live in circumstances that do not support a recovery program. Family members may suffer from depression or other mental illnesses, withhold emotional support or be overly controlling of the young adult. It could just be that the family is angry and ashamed at the person who went to rehab and insists on hiding and denying it. The young adult needs to be able to actively and openly pursue recovery and to be able to discuss it at home. \tEnabling. Sometimes the family dynamic is one in which parents do too much to support their returning young adult child and end up enabling drug use. This is obviously also detrimental to recovery. Promises offers a group where family members can connect with others in similar situations and receive support. Not every family can or is willing to partake in a group like this, so Al-Anon meetings are also suggested to help prepare them for helping a loved one in recovery. It is challenging for young adults who must return to families that have not done any of their own transformational work. And the individuation process is difficult to accomplish for any person, and becomes more difficult in a family where addiction has been present. \u00a0This is why it may be best for the young adult to establish a life someplace else. The ultimate goal for the young adult in recovery is to have a support program in place to help them stay sober and a living environment that will help them stay on track.