Re-Empowering Family Members Disempowered by Addiction: Support for Individual or Collective Action?

Just under one hundred million is a conservative estimate of the number of adults whose lives are adversely affected by the alcohol or drug addiction of close relatives. Including children in the figures would add tens of millions more. The particular qualities of the experience of having to cope with excessive drinking or drug taking in the family, in combination, can make it a unique and highly stressful

and disempowering experience. A programme of research over a number of years has 1) explored in detail the nature of affected family members’ experiences, and 2) developed and evaluated a method for helping affected family members in their own right. Work in Mexico, England, among indigenous Australians, and in different regions in Italy has suggested the existence of a common core of disempowered experience for family members, with some cross-cultural variations. Predominant cultural norms – individual, familial collective, or community collective – are amongst the factors that modify the core experience. A method of supporting affected family members – the 5 - step method – has shown promise in a number of countries. Its emphasis is upon listening carefully to a family member’s story,

providing relevant information, discussing coping dilemmas, and building social support. The method is flexible enough to be used in brief forms (including booklet and web forms), with anyone affected by or concerned about another person’s addiction, and it can be used in a wide variety of settings including primary care and other community settings. Examples will be given of the ways in which it can re-empower family members by building their confidence to cope effectively.

See few studies through link!

http://www.gjcpp.org/pdfs/V3i1-0006%20Orford.pdf

http://socialjustice.nic.in/pdf/sch-drug-1115.pdf

http://adaiclearinghouse.org/downloads/TAP-6-Empowering-Families-Helping-Adolescents-Family-Centered-Treatment-of-Adolescents-with-Alcohol-Drug-Abuse-and-Mental-Health-Problems-96.pdf

Dear Farimah,

Papers in your interest?

Article A review of substance abuse research in malaysia

Article Scientific Writing Seminar for Early-Stage Investigators in ...

Dear Prof. Kundu

Thank you for your useful points.

Best regards,

Thank you my dear Dr. Ewalds-Kvist.

Actually, I need to know:

1- The roles of family and community to prevent drug addiction 

2- The roles of family and community to support drug addicts to get out of addiction

3- The roles of family and community to prevent relapse

I have already found these papers but they are not functional regarding my objectives.

Best regrads,

Dear Farimah, 

Another try:) Community plays a role when it comes to prison. 

Article Drug substitution therapy: A new approach in preventing the ...

Article Appropriate medical care for persons in detention

Article Implementing methadone maintenance treatment in prisons in Malaysia

Article What has been achieved in HIV prevention, treatment and care...

Thank you for your time in order to help me my dear Dr. Ewalds-Kvist 

All the best,

In order to really find what you are looking for, you should find studies related to each link of the treatment continuum. ((Detox, Inpatient treatment (w/family component), outpatient treatment, transitional sober housing, mutual aid societies (and related programs for families), Collegiate Recovery Programs (how do they help families?), and/or vocational recovery support services (how do they involve family?)) Additionally, I would examine the the work of Bill White MA, on recovery support services, Dr. Alexandre Laudet, and Dr. Thom Kimball. Some links to researchers, their papers, bibliographies, and websites, which may provide you some direction are below. I would upload individual articles but I cannot access them expediently on this computer.

https://scholar.google.com/citations?user=7aLKsIkAAAAJ&hl=en

http://www.depts.ttu.edu/hs/mft/docs/Vita-Kimball.pdf

http://www.williamwhitepapers.com/papers/

As I am unsure exactly how treatment may differ regionally, you may need to expand into more culturally relevant work, or examine how some of these ideas have been adapted to fit the needs of regional addicts and families. Good Luck!

Dear Dr. Brown

Thank you for your helpful response.

Best regards,

SAMHSA publishes some excellent guidelines with good background on your subject. Pay special attention to their reference section as it seems to have good articles that fit what you are looking for:

http://www.ncbi.nlm.nih.gov/books/NBK64269/

Also, here are a few old articles I found that might help:

Botvin, G.J., Schinke, S.P., and Orlandi, M.A. (1989) Psychosocial

approaches to substance abuse prevention: Theoretical foundations

and empirical findings, Crisis (10)1, 62-77.

Brook, J.S., Brook, D.W., Gordon, A.S., Whiteman, M., et al. (1990).

The psychological etiology of adolescent drug use: A family

interactional approach, Genetic, Social & General Psychology

Monographs. 116(2), 111-267.

DeMarsh, J., and Kumpfer, K. (1985) Family-oriented interventions for

the prevention of chemical dependency in children and adolescents,

Journal of Children in Contemporary Society, 18(1-2), 117-151.

Dishion, T.J., Patterson, G.R., and Reid, J.R. (1988) Parent and peer

factors associated with drug sampling and early adolescence:

Implications for treatment, National Institute on Drug Abuse:

Research Monograph Series. 77, 69-93.

Dear Dr. Krachenfels

Thank you for your helpful guide.

Best regards,

Farimah,

I would direct you to an approach with families that is quite unique and powerful called CRAFT: Community Reinforcement and Family Training.  It has good research support, has been tested in different socio-economic contexts (developed by Dr Robert Meyers), and succeeds 65% of the time in getting the identified substance using person into treatment within an average of 5 sessions with the participating family member (research treatment length 12 sessions with CRAFT therapist and family member), but also in vast majority of family members they experience increased sense of well-being and decreased depressive and anxiety symptoms.  This approach is being used in increasingly community-based contexts, eg peer parent coaches on hotlines and in groups of family members (vs individual therapist provision).  CRAFT uses CBT and MI strategies and teaches the family member concepts of positive reinforcement, effective communication skills, and focuses on improved self-care.

In my work I've seen it to be tremendously helpful and grounding for families in need of support and guidance.

Good luck!

Dear Farimah,

     I have published a number of papers on this subject.  I have attached one.  Others are posted at www.williamwhitepapers.com

Bill

Maybe because there are no appropriate treatment centres, I believe, certainly in the North east of England at any rate. There are no apt. detox or understanding the person or their journey. They often feel like dirt as that is often how they are treated in hospital, social services and in the community I believe.  Perhaps you could look at a study exploring identity with people with drug addictions or as your call them drug addicts. Families who try to get basic care are in  danger of being labelled as angry or aggressive and sometimes seen as addicts themselves. I do believe that fear stops people from moving forward and that we need to create safer environments for them. I worked on a project in Glasgow a few years ago called Project 218 where women from the criminal justice system often sent to Cornton Vale for minor charges related to drug addiction or prostitution or theft came to us as an alternative to custody and it was in a holistic and caring but not soft environment. More places like that would help, I also visited a 'wet house' in Glasgow for women who were alcohol dependent.

Dear Dr. Kosanke

Thank you for your useful explanation. 

Best,

Dear Dr.  White

Thank you for the attached file and link.

Best,

 Dear Dr. Hence

Thank you for  your helpful answer. 

Best,

Small article about family relations you can find in my profile.

Article Влияние заместительной терапии метадоном на отношения пациен...

Article The influence of methadone treatment on the patients’ relati...

Thank you & best regards

Dear Farimah,

You raised a very good question about the importance of including family and community support in addiction treatment and recovery.

Please see my articles on Congruence Couple Therapy and A Relational Framework for Pathological Gmabling on ResearchGate, or you can also access them at:

https://www.uleth.ca/dspace/handle/10133/546

I have developed a Congruence Couple Therapy model building on the work of a woman pioneer in family therapy (Virginia Satir) that allows a counsellor to work on four dimensions of couple relationships in a systemic fashion.

BTW, I did a sabbatical at USM in Malaysia in 2012 and enjoyed it very much. Hope to be visiting again!

Best wishes,

Bonnie Lee

Dear Dr. Lee

Thank you for your assistance. 

All the best,