Family roles in homes with alcohol-dependent parents: an evidence-based review.

The behavioral health care field has seen attempts to understand the functioning of families in which a parent is dependent on alcohol as a set of roles into which the other family members fall. The most popular of these classifications taught in the United States includes five roles (enabler, hero, lost child, mascot, and scapegoat) that are used to conceptualize families and individuals in treatment and support group settings, as well as in popular self-help literature. Attempts to operationalize and measure these roles have, however, been fraught with difficulties. The resulting research base has seen conflicting evidence for the support of such roles, as well as little work on diverse families. The evidence against such well-defined family roles, the questions surrounding their development, and the difficulties of applying such constructs in real-life situations (with numerous confounding factors and unknown associated conditions) may indicate that their clinical utility does not win out over the problems inherent with this manner of classification.