Bradshaw, Shumway, and Kimball: The Impact of Substance Use Disorder on Families
Research by Spencer Bradshaw, Sterling Shumway, and Thomas Kimball has contributed to an important shift in how we understand addiction: a substance use disorder affects the entire family system, not only the individual using substances.
In their work examining family members of people with SUD, Bradshaw, Shumway, Kimball, and colleagues describe the significant emotional, physical, relational, and cognitive effects that can occur when a loved one has an addiction. Their research suggests that family members—particularly those closest to the person with SUD—can experience chronic stress and may develop patterns of behavior that become focused on managing, protecting, or responding to the loved one’s substance use. (PubMed)
One particularly important area of their research concerns codependency and family-member functioning. In a 2019 study, Zielinski, Bradshaw, Shumway, and colleagues examined the relationship between codependency characteristics and prefrontal-cortex functioning among family members affected by SUD. The researchers noted that addiction can alter the family environment and that family members themselves may experience changes in functioning as they adapt to the ongoing stress of addiction. (PubMed)
Bradshaw, Shumway, and Kimball have also emphasized the concept of “family member recovery.” Their work suggests that when addiction changes the family’s patterns, relationships, and functioning, the family may need its own process of healing and recovery—even when the individual with SUD enters recovery. Their 2021 chapter specifically addresses the relationship between SUD in the family, prefrontal-cortex functioning, codependency, and the importance of family-member recovery. (Texas Tech University)
This perspective has important implications for treatment. Family members should not be viewed only as resources for the person with SUD; they are also individuals who may need education, support, skills, and opportunities for their own recovery.
Their research on multifamily interventions provides additional support for this approach. A 2022 study of a multifamily group curriculum found evidence that the intervention could benefit family members of individuals seeking recovery, while also emphasizing the need for continued and longer-term support for families. The study further found that changes in factors associated with family well-being and family recovery were related to the loved one’s relapse status at follow-up. (Taylor & Francis Online)
- Why This Matters for Family Support
- The work of Bradshaw, Shumway, and Kimball provides a strong rationale for approaches such as CRAFT and Invitation to Change (ITC). Rather than asking families to simply wait for their loved one to change, these approaches recognize that family members can work on their own understanding, communication, boundaries, coping strategies, and well-being.
The central message is powerful:
- When addiction affects the family, recovery needs to include the family.
- Family education and support are therefore not secondary services. They can be an important part of helping families move from crisis, fear, and reactivity toward greater awareness, healthier relationships, and sustainable support for recovery.
- Key References
- Bradshaw, S. D., Shumway, S. T., & Kimball, T. G. (2021). Associations between SUD in the family, PFC functioning, and codependency: Importance of family member recovery. In Family resilience and recovery from opioids and other addictions (pp. 145–168). Springer. (Springer)
- Kimball, T. G., Shumway, S. T., Bradshaw, S. D., & Soloski, K. L. (2020). A systemic understanding of addiction formation and the recovery process. In The Handbook of Systemic Family Therapy (Vol. 4). Wiley. (Wiley Online Library)
- Zielinski, M., Bradshaw, S., Mullet, N., Hawkins, L., Shumway, S., & Story Chavez, M. (2019). Codependency and prefrontal cortex functioning: Preliminary examination of substance use disorder impacted family members. The American Journal on Addictions, 28(5), 367–375. (Wiley Online Library)
- Shumway, S. T., Bradshaw, S. D., Zielinski, M., D’Aniello, C. D., Kimball, T. G., & Soloski, K. (2022). A multifamily group curriculum for family members of individuals with substance use disorders: Updates, perceptions, and outcomes. Alcoholism Treatment Quarterly, 40(3). (Taylor & Francis Online)
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