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Working with the family
(written by Sarah Zohhadi)
There is evidence that working with family members in their own right can be beneficial to the health and well-being of the family members themselves – who are shown to respond quickly to support. Working with the family members has also been shown to benefit the person with the problem, in terms of supporting their entry and engagement with specialist services. However, family members often struggle without support for long periods of time, only coming to the attention of services when they have reached crisis point. Family members may not consider that they need support, or may not know what support is available to them. They may feel too afraid or ashamed to ask for help. Social workers are well placed to identify families in need of support well before their difficulties escalate, however they often lack the confidence, and resources, to respond.
Why support family members?
Offering family members even the most basic support can have a real impact on their well-being. Spending a little time listening to a family member and assessing their needs can pave the way for early intervention and crisis aversion. The social worker role provides a good opportunity for making that initial contact and setting the scene for more detailed work (either by the social worker or another agency).
What support do family members need?
Family members commonly report wanting:
- information about substance problems and professional interventions;
- advice on how to help their relative get better;
- emotional support (time and space to talk and be listened to, reassurance); and,
- practical support (advice on how to care for the person, finances and employment).
How can I support family members?
Meeting these needs can be fairly simple and straightforward, and, as mentioned elsewhere on the website, you don’t need to be a substance use specialist to do so. The ‘tools’ needed to work with family members are no different to those that social workers already possess, including, for example, basic counselling skills. In addition, some knowledge about substance use (key facts and figures), and information about what support is out there (both for the person using substances but also for the family member), is helpful.
In the first instance, offering the family member some time and space to share how the situation is impacting on them can make a real difference. Some family members report having gone for years without anyone asking them how they were coping. It is often not until they are asked the question that family members realise they are struggling, and are in need of support in their own right.
If the time and resources are available for more detailed work, an effective yet simple and time-limited model has been developed for use with family members. The following pointers are taken from a brief five-step intervention developed and tested for use by both primary and secondary care workers (see Copello et al (2000) for more information and guidance).
5-steps
- Give the family member the opportunity to talk about the problem;
- Provide relevant (targeted) information about the substance use and its impact on the person and the family;
- Explore how the family member responds to their relative’s substance, discuss alternative coping methods;
- Explore the family member’s social support, discuss ways to enhance this; and,
- Discuss the possibilities for onward referral for further specialist help.
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Ref: Copello, A, Templeton, L, Krishnan, M, Orford, J & Velleman, R (2000) A treatment package to improve primary care services for relatives of people with alcohol and drug problems. Addiction Research, 8, 471 – 484.
Sarah Zohhadi is a Researcher in the Mental Health Research & Development Unit (University of Bath, Avon & Wiltshire Mental Health Partnership NHS Trust) and works on the Alcohol, Drugs and the Family Programme.
Impact on family members | Support services | Websites
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