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Research over many years indicates that individuals with problematic alcohol or drug use or gambling disorders can cause considerable burden on family members. And yet, affected family members (AFMs) are largely neglected in research, health and social care policy and provision. To address the needs of AFMs of people struggling with a substance use or gambling disorder, the 5-Step Method was developed. The goal of this study is to evaluate the routinely delivered 5-Step Method in the Netherlands using measures at baseline (N = 145), and end-of-treatment (N = 102). In addition, a subsample at three-month post intervention (N = 70) was included. The intervention was delivered via video-conferencing to half (47.6%) of the participants. Participants reported significantly lower rates of Total Family Burden after completing the 5-Step Method, when comparing measurements at baseline and end-of-treatment (d = 0.56), and measurements at baseline and three-month post intervention (d = 0.85). In addition, participants following the intervention via video-conferencing (N = 69) performed equally well or better compared to participants following the intervention face-to-face (N = 76). Following the 5-Step Method for AFMs results in lower Total Family Burden. In accordance with the Stress-Strain-Information-Coping-Support (SSICS) model, the effectiveness of the intervention could be improved by finding new ways of increasing support for AFMs. [ABSTRACT FROM AUTHOR]

Introduction: Despite the large burden of a relative's drinking on their family members, the latter's perspectives and experiences are largely neglected. The aims of this article are to assess the coping strategies used by affected family members (AFMs) in Goa, India, and to examine the nature of the support they have for dealing with their drinking relative. Method: In-depth interviews were conducted with adult AFMs selected through purposive and maximum variation sampling. Data was analyzed using thematic analyses. Results: The commonly used coping strategies included accommodating to the relative's behavior, financially adapting to their means, self-harm, attempting to reason with the drinking relative, covert intervening, and avoiding fights and arguments. There was a general reluctance to seek support, and the type and quality of support that was available was also limited. Support from neighbors or relatives was primarily through providing a 'listening ear' or financial support. Religious and spiritual pursuits were commonly used to seek solace, and to manage negative thoughts and feelings. Formal support was sought for themselves or the relative through existing health services and Al-Anon, and occasionally from the police. Discussion: AFMs experience a considerable amount of strain in relation to their relative's drinking, and have to rely on different ways of coping and social support, as is available to them. Although there is a universality to the experiences of families affected by addictions, this must be interpreted with caution, as it is also accompanied by variations in cultural factors related to these experiences. Keywords: alcohol, family, India, qualitative, Alcohol use disorders (AUDs) affect not only the person struggling with alcohol but also their family. This substance use disorder is similar to that of someone having a disability or [...]

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]