Adfam peer
Russell Webster

Russell Webster

Criminal Justice & substance misuse expert and author of this blog.

Peer support for family members affected by substance misuse

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Royal College of Psychiatrists identify the complex constellation of risks that older people with addictions face and the lack of awareness in a range of helping services.

Recovery champions

Adfam recently (19 March 2018) launched a new report sharing the learnings from the Whole Family Recovery Project in the Royal Borough of Greenwich.

Over the last five years, Adfam has pioneered a new model of work with families affected by drugs and alcohol in Greenwich to provide them with the training, resources and support to understand the impact of drugs and alcohol on their lives, and to build sustainable relationships and positive futures.

The approach has been to empower families to develop, deliver and evaluate sustainable services for themselves and for other families living in the Greenwich area.

The model has sprung from the use of Recovery Champions – peers recovering from addiction and supporting others – which has become a mainstream approach in the substance misuse treatment sector.

Individuals in Greenwich have become visible Family Recovery Champions, inspiring others to make positive changes in their lives and redress the negative impact of drug and alcohol use in their families and communities. 

The level of need

In 2009, the UK Drug Policy Commission estimated that there are at least 1.5 million people in the UK affected by someone else’s drug use. However, this figure only includes those family members and carers living with someone using drugs, and only when the drug use is at the extreme end of the spectrum.

Other estimates, based on the assumption that every substance misuser will negatively affect at least two close family members, suggest that the true number is nearer 8 million. Family members affected by a relative’s alcohol use are likely to be far more numerous, given the greater prevalence of alcohol misuse in the general population.

We know that living with a substance user can have a detrimental effect on a family
member’s health. Research has found, for example, that family members:

  • are more likely to be diagnosed with their own medical conditions than non-drug using families, to levels of seriousness comparable with psychiatric outpatients
  • suffer stress-related physical and psychological symptoms that can be severe and long-lasting, which are associated with high use of primary care services
  • are at a similar or higher risk of disease, emotional issues and behavioural problems to families with a relative suffering from a chronic health condition.

The model of family support

Adfam designed the project model to have three key components:

  1. One-to-one practitioner support: listening, signposting and advice
  2. Information: on drugs and alcohol, self-care, communication, boundaries, keeping safe, enabling and other important topics
  3. Peer support: often, but not exclusively, delivered in a group setting. 

Findings

The peer support model proved to be extremely successful with the following key conclusions:
 
 Peer support can engage family members in a way that other services cannot
Family Recovery Champions were often the first point of contact for family members attending the treatment service drop-in. Many of these family members did not think that they needed support and would be unwilling to access a formal ‘family support service’. For these family members, a FRC provides a listening ear and informal peer support from the basis of a shared understanding of how hard it can be to accept support in your own right.

Family Champions can see issues from the family member’s perspective
Families see issues in a way professionals frequently cannot. For example, participants at a peer support session discussed how professionals speaking of
‘setting boundaries’ and ‘letting a loved one hit rock bottom’ can make sense in the safe setting of a counselling room but not within the chaos of family life.

Family members can be visible examples of recovery
By working in their communities, Family Recovery Champions became visible advocates, helping people to access services they would otherwise shun, thus challenging stigma and cultural mores.

Family Recovery Champions model of provision
Family Recovery Champions can offer a flexible, practical and tangible approach, for example, meeting a family member for a coffee. More formal services are unable to provide this.
 
Peer support benefits those giving peer support, not just those receiving support
Testimonies from Family Recovery Champions underpin the research about the positive benefits of volunteering to volunteers themselves, including enhanced self-esteem and self-worth.
 

Challenges

The report concludes by highlighting two key challenges:
 
 Finding the optimum partner organisations
The drop-in at the mental health and substance misuse treatment service attracted very few referrals, despite Adfam’s best efforts. The Family Recovery Champions decided it was not a good use of their resources to continue to offer this service
but they also agreed with Adfam that this lack of uptake was likely to be due to the stigma and shame attached to every aspect of caring for a loved one with a substance misuse issue.
 
Sustainability
 The biggest challenge is funding. Once Adfam’s Big Lottery funding expires at the end of this month, no funding from commissioners has been identified despite the positive evaluation of this project.
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