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Background: Despite evidence of the burden of alcohol use on families, there is a lack of adequate and targeted support. We aimed to examine the feasibility, acceptability and impact of Supporting Addiction Affected Families Effectively (SAFE), a brief lay counsellor-delivered intervention for affected family members (AFMs). Methods: Parallel arm feasibility randomised controlled trial [1:1 allocation to SAFE or enhanced usual care (EUC)]. The primary outcome was mean difference in symptom score assessed by the Symptom Rating Test and secondary outcomes were difference in coping, impact and social support scores measured by the Coping Questionnaire, Family Member Impact Questionnaire, and Alcohol, Drugs and the Family Social Support Scale. Process data examining feasibility and acceptability were also collected. The primary analysis was intention to treat at the 3-month endpoint. Results: In total, 115 AFMs were referred to the trial, and 101 (87.8%) consenting participants were randomised to the two arms (51 SAFE arm and 50 EUC arm). Seventy-eight per cent completed treatment, with the mean number of sessions being 4.25 sessions and mean duration being 53 min. Ninety-five per cent completed outcome assessment. There were no statistically significant differences between SAFE and EUC on any of the outcome measures, except for the between-group adjusted mean differences for social support scores (AMD −6.05, 95% CI −10.98 to −1.12, p = 0.02). Conclusion: Our work indicates that it is possible to identify AFMs through community networking, and have high rates of participation for lay counsellor-delivered psychosocial care. Nevertheless, there is a need for further intervention development to ensure its contextual relevance and appropriateness. [ABSTRACT FROM AUTHOR]

Aims: To explore the effect of the relatives' drinking on their family members, and the preliminary impact of the 5-step method intervention on the adverse effect of the relatives' drinking on their family members. Methods: In-depth interviews were conducted with eligible Affected Family Members (AFMs) (n = 30) to understand the effect of the relatives' drinking on their family members. Subsequently, a different group of consecutive eligible AFMs (n = 21) received the five-step method from lay counsellors, with outcomes measured at baseline and 3 months after delivery of the first session, to examine the impact of the intervention on AFMs. Findings: In the in-depth interviews, the perceived impact of the relatives' drinking on the AFM included substantial physical/emotional abuse, financial difficulties, shame, poor health, impaired interpersonal relationships and change in the AFM's role in the family. In the case series, for AFMs who received at least one session of the intervention, there was significantly increased engaged coping, increased stress and increased professional social support; and in those who completed the intervention, there was significantly increased engaged coping, increased strain, and increased informal social support. Conclusions: Compared to developed countries, stresses experienced by AFMs in our study are somewhat qualitatively different. The impact of an un-adapted five-step method intervention is less helpful than found elsewhere; hence an adapted version of the five-step method which is responsive to the realities of the cultural context may be better suited to Indian settings. [ABSTRACT FROM AUTHOR]