Families and SUDs – Are You Care Taking or Care Giving?

care taking or care giving family group holding each other up

You are a family member of someone with a substance use disorder (SUD). And that special person has finally entered treatment for their SUD. You have been following all the recommended steps for family members of folks with SUDs. You’re even feeling pretty good about things now. When suddenly, it hits you. Do I really understand the difference between CARE TAKING and CARE GIVING in relationship to my loved one?


Care Taking & Care Giving

A good look at some of the aspects of each of those behaviors can help answer that question.

Known Facts about CARE TAKING

You are doing something for someone they can do for themselves.

It’s associated with caring for inanimate objects and large areas of land.

Care Taking has “strings attached” to the behaviors performed.

It is also taking self-direction away from the receiver.

It’s performed more for the benefit of the giver than the receiver.

And more about the receiver’s perceived expectations.

Care Taking is believing you know what’s best for the receiver.

It’s associated with emotional reactivity.

And with chronic feelings of anxiety and depression.

In relation to addiction specifically, CARE TAKING means a mutually codependent relationship. And that means acting in ways that promote the progression of a chronic and potentially fatal disease.


care giving or care taking family on beach


Known facts about CARE GIVING

Care Giving is freely given with no expectations of “attached strings”.

The giver does not feel anxiety or depression.

The giver also uses good self-care.

And promotes the receiver’s choice.

Care Giving promotes communication and planning with the receiver.

It involves arrangements or agreements.

With Care Giving, there are aspects of equality and reciprocity.

It is associated with possible changes and consequences.

And Care Giving also involves implementation of personal boundaries and limit-setting by the giver.


Clarifying Care Taking and Giving …

These two lists aid in clarifying the differences between CARE TAKING and CARE GIVING.  Many times, for family members of folks with addictive disease, the lines between these behaviors become blurred. Because everyone is under the stress of dealing with a person with an addictive disease.


Reviewing these lists for behaviors that are consistent with family recovery, the behaviors of CARE GIVING are where family members want to set their behavioral goals. But the behaviors of CARE TAKING are associated with enabling, controlling, people pleasing, and lack of good self-care and honest emotional expression.


care giving or care taking family of sud schedule

For the families of Sanford clients


Following is one method that family members can use to improve their use of CARE GIVING in their own recovery program.

  Read through the entire list before trying this exercise in a quiet time and space.

  1. Begin by identifying 1-3 behaviors you engage in that you consider to be CARE TAKING behaviors.  Write down those behaviors and a bit about the situations when you have done them.
  2. Own them! It’s not a crime, it’s a learned coping technique and it can be unlearned.
  3. Think about 2-3 emotional or physical sensations you experienced right before engaging in the CARE TAKING behavior.
  4. And identify what you were thinking would be the result of not performing CARE TAKING.
  5. Next, ask yourself-what was I trying to avoid by CARE TAKING?  Was it displeasing the other person? Did I feel frozen? Did I feel like my worth or purpose in my role wouldn’t be needed?  
  6. Share it!  Share your results with a trusted person in your life (good friend, support group sponsor, therapist or even your loved one). Because this will assist you to understand yourself and your motivations behind your CARE TAKING. Your shift to CARE GIVING will flow with more ease.


In our next article we will look aspects of boundary and limit setting in family recovery. That article should prove helpful to your family healing process and is an effective follow-up to this information.


In the Sanford Family Program, we encourage family members to attend informal support groups, engage in family sessions with their loved ones while they are in treatment, and engage in individual mental health counseling for themselves. Along with education on addictive disease, these are some of the best ways to promote overall family healing.




Caroline (Carli) Parmelee-Noffsinger has 20 years clinical experience including: primary therapist and case manager for residential, IOP and outpatient therapy. Carli’s primary role at Sanford House is facilitating the Family Program. She is currently updating and revising the program design and content and hopes to improve upon an already successful approach to family intervention. In her free time, Carli spends time with her horse. She has been a horse lover and owner for most of her life and has facilitated equine therapy sessions. She says, “The back of a horse is good for the inside of a person.” You can reach Carli with questions about The Sanford House Family Program at cnoffsinger@sanfordhouse.com