Is Tough Love Effective in Treating Addiction?

Parents yelling at teenager
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Tough love is a common expression used to describe any behavior that is a firm, sometimes cold, approach to handling someone's actions. It is somewhat controversial, particularly when used in the treatment of certain disorders, such as drug addiction or other addictive behaviors. 

What Is Tough Love?

Tough love is an expression that was first introduced to the public by author Bill Milliken in his book, Tough Love, published in 1968.

While the term tough love has become very popular in a variety of contexts ranging from parenting to relationships, it cannot be used effectively in all situations, including addiction. 

There are several ways that tough love is used in everyday language. Most commonly, it is used to describe any type of parenting in which the child experiences some negative emotions as part of a learning process. This can range from a healthy set of firm boundaries, common in authoritative parenting styles, to abusive parenting styles in which humiliation, belittling or physical violence are used to control the child.

For instance, a parent may use tough love against their adult child who has not gotten a job. The parents practicing tough love would withhold paying bills and would let the child deal with the consequences, such as late payments or bill collection, rather than swooping in and fixing the problem.

In a harmful example of tough love, a parent would belittle or physically injure a child for failing to get a good grade or complete their chores. Having consequences can change behavior, but this is an extreme example that can have long-lasting negative repercussions. 

While tough love may appear to be effective in the short-term, it can actually worsen the condition and lead to dangerous relapses later on.

Tough love can refer to a positive approach to parenting in which the child learns valuable lessons in a way that is supportive and preserves the dignity of the child.

Does Tough Love Work?

While tough love can sometimes force people with substance and alcohol use disorders into treatment, research suggests that more empathetic, voluntary approaches are more effective. For example, studies have shown that a program known as Community Reinforcement and Family Training (CRAFT) can help people encourage their loved ones to seek treatment. The program utilizes behavioral principles to reduce substance use, encourage treatment, and reduce the stress felt by the individual's loved ones.

Research also suggests that compulsory drug treatment may not improve outcomes. Approaches that encourage voluntary treatment may be more effective in getting people to initiate and maintain abstinence.

Tough Love vs. Setting Boundaries

In particular, tough love has been derided as a dangerous technique in handling teens or adults struggling with addictions, such as those who engage in substance abuse. Some treatment centers use the term tough love to refer to a harsh approach that breaks down the will of the person.

Tough love can have its place in addiction treatment, but it should not be engaged in without input from a physician or therapist. If you have a child or loved one struggling with addiction, seek out an addiction therapist for a consultation on how you can help your loved one. Your therapist can advise you on the best approaches and boundaries to help your child recover in a sustainable way. 

Rather than focusing on simply using a "tough love" approach to dealing with a loved one who has an addiction, learning how to establish healthy boundaries can be more effective.

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3 Sources
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  2. Werb D, Kamarulzaman A, Meacham MC, et al. The effectiveness of compulsory drug treatment: A systematic reviewInt J Drug Policy. 2016;28:1-9. doi:10.1016/j.drugpo.2015.12.005

  3. Substance Abuse and Mental Health Services Administration. What is substance abuse treatment? A booklet for families. Published January 2014.