WORKING WITH FAMILIES-An Overview By Dylan Kerr at Hope Rehab

HOW BIG IS THE PROBLEM?

It is a Global Problem

HOW BIG IS THE PROBLEM?When someone is an addict, there is always other people

affected

It is estimated that there are approximately 15 million people with drug use disorders globally and 76 million with alcohol use disorders (Obot,

2005).

If you consider that at least one other person is seriously affected by someone’s drug and alcohol

using an estimate of just one person seriously affected in each case suggests a minimum of 91

million affected family members.

HOW ARE THEY AFFECTED?

FinanciallyPhysically Mentally

Substance AbuseNeglect

HAVING AN ADDICT IN THE FAMILY HAS A UNIQUE SET OF STRESSES:

Addiction causes a “Serious stress” effect on the family, the same way diseases like Cancer has on the family.

THE UNIQUE STRESS OF ADDICTION IN THE FAMILY1. Has the nature of severe stress, harms and

abuse2. Involves multiple harms to self and family,

including emotional, social, financial, health and safety

3. Can damage children4. Worry and concern is constant5. Negative influences from other addicted people and

anti-social attitudes that encourage the troubling behaviour

6. there is no guidance on for families on how to cope7. Support for the family is needed 8. Professionals who could help are badly informed

REASONS TO WORK WITH FAMILIES?

1. Increases knowledge of the problem2. Reduces stress related health problems for

the family3. Reduces relapses for the client4. Improve outcome for the client – 5. making treatment more effective6. Adds accountability7. Reduces the impact of addiction on the

children

IT SAVES COSTS Health Services globally are already very

busy taking care of peoples basic health needs

In the UK addiction creates many extra costs for the health service treating the family members, such as

Anti depressants Stress related illness Social services involvement

UK DRUG POLICY 2010 SAYS:

“Evidence shows that treatment is more likely to be effective, and recovery to be sustained, where families, partners and carers are closely involved.

We will encourage local areas to promote a whole family approach to the delivery of recovery services and to consider the provision of support services for families and carers in their own right.”

THE APPROACH:

Interventions working with the family promoting treatment for the addict

Examples..

The joint involvement including the addict and their family in treatment

Examples….

CO-DEPENDENCY

Co-dependency is where the family learns how to deal with addiction in an unhealthy way to create some form of balance within a family.

DIFFERENT TYPES OF CO-DEPENDENCY Co-dependency – Dysfunctional relationship

where a person is supported or maintained in addiction called enabling

Dependency – relying on others to meet their needs

HEALTHY ALTERNATIVES TO CO-DEPENDENCY Independent – Unattached

Inter-dependent – Healthy exchange and support

CO-DEPENDENCY Theory suggest if the co-dependency cycle is

not broken consequences get worse not better.

It is more typical for females to have a feature of co-dependency around addiction, as they naturally have more of a care giver role.

WHERE DOES THE SOLUTION LIE?

1. Intervention2. Family feedback3. Al-Anon4. Family counselling/psychology5. SBNT6. Family Social mapping 7. Genaology – Looking at the family tree8. Social media – facebook, online support

groups, forums, 9. Tough love

SBNT – SOCIAL BEHAVIOUR AND NETWORK THERAPY Social behaviour and network therapy was

developed in the England

Dylan Kerr worked with Professor Alex Copello in collecting information and conducting interventions around Northamptonshire in UK

FIRST INTERVENTION IN SBNT

NameFamily

member

Friends

Wife / Husband

5 STEP MODELListen non-judgementally to the concerns

of the family member

Provide information – This focuses on the family member

Discuss ways of responding

Explore sources of support – Meetings, al-anon, doctors, other family members

Arrange further help if needed

REVIEW SOCIAL NETWORKSPeople need to review what their social networks are like

E.g. Friends

Some relationships may be unhelpful

ACCOUNTABILITY Healthy limit, being accountable to others is

important

Those who show accountability are less likely to relapse back on to their drugs

WHO IS IN THE FAMILY?

Family Nuclear Origin Extended Immediate Co-habiting Using friends Friends Friends of friends Acquaintances Work Colleagues Professionals

TECHNIQUES TO BROADEN THE NETWORK

Who have you seen/spoken to in the last week? (day-by-day)

People you knew ‘before drugs’

Who is in your phone?

If I asked your mum/partner/brother, who would they add to the diagram?

AL-ANON

Is the oldest running family support network in the world for addicts (advert from 1968)

PROBLEMS FROM FAMILY INVOLVEMENT1. Family members don’t want to get involved2. Privacy issues 3. Takes more time and logistic problems4. People delivering service may lack of

experience of working with more than one person

5. Danger of conflict or Family member taking over control

6. Difficulties within the family

OVERALL FAMILY INVOLVEMENT IS A BENEFIT “The family programme (makes) a clinically

significant contribution to the psychological well-being of this often neglected group.” Georgakis et al (1998) Forgotten families on Al-Anon.