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Peart A, Horn F, Manning V, Campbell R, Lubman DI. The experiences of family members attending an online addiction education program: a qualitative study. DRUGS: EDUCATION, PREVENTION AND POLICY 2023. [DOI: 10.1080/09687637.2023.2184248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Annette Peart
- Eastern Health Clinical School, Monash University, Richmond, Australia
- Turning Point, Richmond, Australia
| | - Freya Horn
- Eastern Health Clinical School, Monash University, Richmond, Australia
- Turning Point, Richmond, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Monash University, Richmond, Australia
- Turning Point, Richmond, Australia
| | | | - Dan I. Lubman
- Eastern Health Clinical School, Monash University, Richmond, Australia
- Turning Point, Richmond, Australia
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Leonard R, Linden M, Grant A. Effectiveness of family-focused home visiting for maternal mental illness: A systematic review and meta-analysis. J Psychiatr Ment Health Nurs 2021; 28:1113-1127. [PMID: 33253463 DOI: 10.1111/jpm.12715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Maternal mental illness reduces a mothers' ability to bond with their infant and may adversely affect other family members. Family-focused practice is an approach which has the potential to support mothers with mental illnesses and reduce the risk of familial transmission of mental illness to children. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Findings suggest that current interventions are not effective in reducing depression or stress among mothers. The majority of interventions included in this review employed relatively low levels of family-focused practice. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: While there is a growing integration of family-focused practice into home visiting guidelines, this may be based on poor evidence. There is a need for the development of rigorously tested interventions which seek to include the whole family. ABSTRACT: Introduction The evidence on effectiveness of family-focused home visiting for maternal mental illness has yet to be comprehensively synthesized. Aim The aim of this study was to assess current home visiting treatments and interventions for mothers with mental illness and their families. Method The primary and secondary outcomes of interest were depression and maternal stress, respectively, both were included in meta-analyses. We identified 13 (n = 5,540 participants) studies which met inclusion criteria. Eight studies were included in meta-analyses; five studies were reported narratively. Results Findings from the meta-analysis suggest that home visiting interventions are not effective in reducing depression (SMD -0.13, 95% CI -0.33 to 0.07, p = .21) and maternal stress (MD 0.59, 95% CI -5.19 to 6.38, p = .84). Discussion and Implications for practice Findings suggest that current interventions are not effective in reducing depression or stress among mothers. While there is a growing integration of family-focused practice into home visiting guidelines, this may be based on poor evidence.
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Affiliation(s)
- Rachel Leonard
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, UK
| | - Mark Linden
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, UK
| | - Anne Grant
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University, Belfast, UK
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Leonard RA, Linden M, Grant A. Family-Focused Practice for Families Affected by Maternal Mental Illness and Substance Misuse in Home Visiting: A Qualitative Systematic Review. JOURNAL OF FAMILY NURSING 2018; 24:128-155. [PMID: 29683021 DOI: 10.1177/1074840718770612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Maternal mental illness is a major public health issue and can adversely affect the whole family. Increasingly, research and policy are recognizing the benefits of a family-focused approach to practice, an approach that emphasizes the family as the unit of care. This review was conducted with the aim of systematically analyzing the qualitative literature surrounding health visitors' family-focused practice with mothers who have mental illness and/or substance misuse. Through the synthesis, we developed three main findings: (a) parents' needs regarding health visitors' family-focused practice, (b) the ambiguity of mental illness in health visiting, and (c) the challenges of family-focused practice in health visiting. Above all, health visitors, families, and mothers with mental illness experience many challenges in family-focused practice, even though it is both desirable and beneficial. This calls for a deeper understanding of how family-focused practice can be effectively practiced in health visiting.
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Orford J, Padin MDFR, Canfield M, Sakiyama HMT, Laranjeira R, Mitsuhiro SS. The burden experienced by Brazilian family members affected by their relatives’ alcohol or drug misuse. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1393500] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jim Orford
- School of Psychology, The University of Birmingham, Birmingham, UK
| | - Maria de Fátima Rato Padin
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Public Policy for Alcohol and Other Drugs, São Paulo, Brazil
| | - Martha Canfield
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Ronaldo Laranjeira
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Public Policy for Alcohol and Other Drugs, São Paulo, Brazil
| | - Sandro Sendin Mitsuhiro
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Public Policy for Alcohol and Other Drugs, São Paulo, Brazil
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Rane A, Church S, Bhatia U, Orford J, Velleman R, Nadkarni A. Psychosocial interventions for addiction-affected families in Low and Middle Income Countries: A systematic review. Addict Behav 2017; 74:1-8. [PMID: 28554034 DOI: 10.1016/j.addbeh.2017.05.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/05/2017] [Accepted: 05/15/2017] [Indexed: 11/16/2022]
Abstract
AIM To review the literature on psychosocial interventions for addiction affected family members in Low and Middle Income Countries (LMIC). METHODS A systematic review with a detailed search strategy focussing on psychosocial interventions directed towards people affected by addiction without any gender, year or language specifications was conducted. Identified titles and abstracts were screened; where needed full papers retrieved, and then independently reviewed. Data was extracted based on the aims of the study, to describe the modalities, acceptability, feasibility and effectiveness of the interventions. RESULTS Four papers met our selection criteria. They were published between 2003 and 2014; the total sample size was 137 participants, and two studies were from Mexico and one each from Vietnam and Malaysia. The predominantly female participants comprised of parents, spouses and siblings. The common components of all the interventions included providing information regarding addiction, teaching coping skills, and providing support. Though preliminary these small studies suggests a positive effect on affected family members (AFM). There was lowering of psychological and physical distress, along with a better understanding of addictive behaviour. The interventions led to better coping; with improvements in self-esteem and assertive behaviour. The interventions, mostly delivered in group settings, were largely acceptable. CONCLUSIONS The limited evidence does suggest positive benefits to AFMs. The scope of research needs to be extended to other addictions, and family members other than spouse and female relatives. Indigenous and locally adapted interventions are needed to address this issue keeping in mind the limited resources of LMIC. This is a field indeed in its infancy and this under recognised and under-served group needs urgent attention of researchers and policy makers.
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Affiliation(s)
- Anil Rane
- Institute of Psychiatry and Human Behaviour, Goa, India.
| | - Sydney Church
- School of Oriental and African Studies, UK; Addictions Research Group, Sangath, Goa, India
| | | | - Jim Orford
- School of Psychology, University of Birmingham, UK
| | - Richard Velleman
- Addictions Research Group, Sangath, Goa, India; University of Bath, Bath, UK
| | - Abhijit Nadkarni
- Addictions Research Group, Sangath, Goa, India; South London & Maudsley NHS Foundation Trust, London, UK
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Orford J, Cousins J, Smith N, Bowden-Jones H. Stress, strain, coping and social support for affected family members attending the National Problem Gambling Clinic, London. INTERNATIONAL GAMBLING STUDIES 2017. [DOI: 10.1080/14459795.2017.1331251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jim Orford
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Jenny Cousins
- Formerly at the National Problem Gambling Clinic, London, UK
| | - Neil Smith
- National Problem Gambling Clinic, London, UK
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, UK
- Department of Medicine, Imperial College London, London, UK
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Lin CC, Tsai YF, Yeh WL, Kao JT, Chen CY. Perceptions of problem-drinker patients' family members about their own hazardous-drinking behaviours in Chinese general hospitals: a qualitative study. BMC Psychiatry 2017; 17:189. [PMID: 28521730 PMCID: PMC5437516 DOI: 10.1186/s12888-017-1348-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive alcohol use has been associated with health, social and legal problems. Alcohol-related problems have been studied primarily in problem-drinker patients, with few studies on their family members, particularly about their own hazardous or harmful alcohol-drinking behaviours. METHOD In this qualitative descriptive study, participants were recruited from three hospitals randomly selected from northern and central Taiwan (2:1). Hazardous-drinker patients and their family members were screened using the Chinese version Alcohol Use Disorders Identification Test (scores ≥8 indicate harmful or hazardous drinkers). Data were collected in individual, audiotaped, in-depth interviews using an interview guide. Verbatim interview transcripts were analysed using ATLAS.ti, version WIN 7.0. RESULTS The sample of 35 family members with hazardous or harmful drinking behaviours perceived that their own alcohol-drinking behaviours were related to six major patterns: family habits, leisure activities with friends, work pressures, personal taste, a way to forget one's problems and to express happiness. CONCLUSION We recommend that programmes targeting harmful or hazardous drinking among problem-drinker patients' family members should educate participants about the standard amounts of alcohol in alcoholic beverages, recommended amounts of alcohol consumption for males and females, the long-term effects of excessive alcohol consumption; address sources of risk factors at work; offer strategies to resist social pressures to drink; and build positive strategies for coping with stress.
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Affiliation(s)
- Chen-Chun Lin
- 0000 0004 1756 1461grid.454210.6Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. .,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan. .,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
| | - Wen-Ling Yeh
- 0000 0004 1756 1461grid.454210.6Department of Traumatology Orthopedics, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Jung-Ta Kao
- 0000 0001 0083 6092grid.254145.3School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ,0000 0004 0572 9415grid.411508.9Department of Internal Medicine, Division of Hepato-Gastroenterology, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Yen Chen
- 0000 0004 0639 2551grid.454209.eDepartment of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan ,grid.145695.aCollege of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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Galvani S. Responding to child-to-parent violence: the experiences of family support group providers. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.3109/14659891.2016.1144802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sarah Galvani
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, England, UK
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Gethin A, Trimingham T, Chang T, Farrell M, Ross J. Coping with problematic drug use in the family: An evaluation of the Stepping Stones program. Drug Alcohol Rev 2015; 35:470-6. [PMID: 26365113 DOI: 10.1111/dar.12327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 07/16/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Problematic substance use by an individual is often highly destructive to their family, creating emotional turmoil and destroying healthy family functioning. The aim of this study was to evaluate the impact of participation in the Stepping Stones family support program on the coping capacity of family members affected by another's substance use. DESIGN AND METHODS A pre and post study of the Stepping Stones intervention for families was conducted, involving 108 participants recruited from March 2013 to March 2014. RESULTS Significant improvement in coping across all domains was observed post course and at follow up on both outcome measures (Coping Questionnaire and the Family Drug Support Questionnaire). Improvements for participants were either increased or sustained at 3 months follow up. Participants recorded high satisfaction ratings. DISCUSSION AND CONCLUSIONS The findings from this study demonstrate that participation in the Stepping Stones program assists family members to cope better with problematic substance use of a family member, as indicated by reductions in negative coping strategies, such as over-engagement, making excuses for the drug user or hopelessly tolerating the problem, and improvements in positive coping strategies such as self-care and engagement with their own activities and interests. [Gethin A, Trimingham T, Chang T, Farrell M, Ross J. Coping with problematic drug use in the family: An evaluation of the Stepping Stones program. Drug Alcohol Rev 2016;35:470-476].
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Affiliation(s)
- Anni Gethin
- Argyle Research and Training, Hazelbrook, Australia
| | | | - Theo Chang
- Family Drug Support, Blue Mountains, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Joanne Ross
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Inpatient treatment for pathological gamblers in Germany: setting, utilization, and structure. J Gambl Stud 2014; 31:257-79. [PMID: 24375259 DOI: 10.1007/s10899-013-9430-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In Germany, there are two different approaches to inpatient treatment of pathological gambling (PG): Facilities focusing on addiction or on psychosomatic illness. However, little is known about how these differences influence utilization and structure of treatment. Therefore, in our study, we analyzed all known German gambling inpatient treatment centers concerning patients' sex, age and number of comorbid disorders and evaluated an expert assessment of the treatment system, access to treatment, and structure characteristics of inpatient treatment facilities. In 2011, 2,229 pathological gamblers were treated. This amounts to 1 % of all past-year pathological gamblers. 90 % of the patients were men, 93 % had at least one comorbid disorder. Access to treatment was mostly gained via psychosocial counseling centers, but was not readily available. Facilities with addiction departments treated less pathological gamblers per year (29.3 gamblers) than facilities with psychosomatic departments (53.3 gamblers) or with both departments (76.4 gamblers). Treatment duration was significantly longer in addiction departments treating PG as secondary diagnosis only, with a low rate of gamblers on all patients, or treating few gamblers. Some facilities specialized on PG and treated more gamblers, had a higher rate of gamblers on all patients, and offered specific treatment programs. The impact of this specialization on treatment outcome is still unclear. Although treatment numbers have risen steadily for the past years, only a small fraction of affected gamblers seek inpatient treatment. Therefore, awareness to the disease and access to treatment needs to be improved.
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Hutchinson AJ, Galvani S, Dance C. Working with substance use: Levels and predictors of positive therapeutic attitudes across social care practitioners in England. DRUGS-EDUCATION PREVENTION AND POLICY 2013. [DOI: 10.3109/09687637.2013.765385] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Orford J, Velleman R, Natera G, Templeton L, Copello A. Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Soc Sci Med 2012; 78:70-7. [PMID: 23268776 DOI: 10.1016/j.socscimed.2012.11.036] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 11/22/2012] [Accepted: 11/29/2012] [Indexed: 11/26/2022]
Abstract
This paper offers a conceptual overview of a neglected field. Evidence is presented to suggest that, globally, addiction is sufficiently stressful to cause pain and suffering to a large but uncounted number of adult affected family members (AFMs), possibly in the region of 100 million worldwide. A non-pathological stress-strain-coping-support model of the experience of AFMs is presented. The model is based on research in a number of different sociocultural groups in Mexico, England, Australia and Italy and aims to be sensitive to the circumstances of AFMs in low and middle income countries and in minority ethnic and indigenous groups as well to those of majorities in wealthier nations. It highlights the social and economic stressors of many kinds which AFMs face, their lack of information and social support, dilemmas about how to cope, and resulting high risk for ill-health. The public sector and personal costs are likely to be high. Attention is drawn to the relative lack of forms of help designed for AFMs in their own right. A 5-Step form of help aiming to fill that gap is briefly described. Family members affected by addiction have for too long been a group without a collective voice; research and action using the model and method described can make a contribution to changing that state of affairs.
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Affiliation(s)
- Jim Orford
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
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Lee KMT, Manning V, Teoh HC, Winslow M, Lee A, Subramaniam M, Guo S, Wong KE. Stress-coping morbidity among family members of addiction patients in Singapore. Drug Alcohol Rev 2012; 30:441-7. [PMID: 21726307 DOI: 10.1111/j.1465-3362.2011.00301.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED INTRODUCTIONS AND AIMS: Research from western countries indicates that family members of addiction patients report heightened stress and psychological morbidity. This current study aimed to examine stress, coping behaviours, related morbidity and subsequent resource utilisation among family members of patients attending a national treatment program in Singapore. DESIGN AND METHODS The study used a matched case-control design. One hundred family members of addiction patients attending treatment and 100 matched controls completed a semi-structured interview with a researcher. This included the Beck Depression Inventory-II, Short-Form Health Survey-36, General Health Questionnaire-28, Perceived Stress Scale, Family Member Impact Scale and Coping Questionnaire, and also assessed service utilisation. RESULTS T-tests revealed significantly greater depression, stress and psychiatric morbidity and poorer overall well-being (Short-Form Health Survey-36) among family members compared with controls. Despite the apparent negative impact on mental health, their physical morbidity did not differ from controls and services utilisation was low. Tolerant-inactive coping was found to be most strongly correlated with psychological well-being. Multivariate analysis indicated that perceived stress was the strongest predictor of overall strain (General Health Questionnaire), but this was not moderated by coping style. DISCUSSION AND CONCLUSIONS Subjective appraisal of stress and coping responses are essential factors affecting the morbidity of family members. Family members demonstrated a need and willingness to engage in formal treatment/counselling for their own problems that were attributed to living with an addiction patient. This provides an opportunity for stress management and brief interventions to modify coping styles, thereby minimizing the potential negative mental health impact on family members.
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Affiliation(s)
- Kae Meng Thomas Lee
- National Addictions Management Service (NAMS), Institute of Mental Health (IMH), Singapore
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Lee CE, Christie MM, Copello A, Kellett S. Barriers and enablers to implementation of family-based work in alcohol services: A qualitative study of alcohol worker perceptions. DRUGS: EDUCATION, PREVENTION AND POLICY 2012. [DOI: 10.3109/09687637.2011.644599] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Shorey RC, Anderson S, Stuart GL. Early Maladaptive Schemas in Substance Use Patients and their Intimate Partners: A Preliminary Investigation. ADDICTIVE DISORDERS & THEIR TREATMENT 2011; 10:169-179. [PMID: 22745593 PMCID: PMC3382969 DOI: 10.1097/adt.0b013e318214cd11] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recent research has documented that substance users have a number of early maladaptive schemas that may underlie their substance use and that treatment that addresses these schemas may result in improved outcomes. Research has also shown that intimate partners of substance users have a number of mental and physical health problems, although no known research has examined the early maladaptive schemas of these relationship partners. The current study examined the early maladaptive schemas of substance use treatment patients and their intimate partners (N = 80). Findings showed that both patients and intimate partners had a number of problematic early maladaptive schemas; that patients scored significantly higher than their intimate partners on a few early maladaptive schemas; and that patient and intimate partner schemas may be interrelated. Implications of these findings for treatment and future research are discussed.
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Affiliation(s)
- Ryan C. Shorey
- University of Tennessee – Knoxville
- Cornerstone of Recovery, Louisville, Tennessee
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Iwen J, Bischof G, Reinhardt S, Grothues J, Hapke U, John U, Freyer-Adam J, Rumpf HJ. The impact of having a loved one with alcohol consumption-related problems on subjective health status and health-risk behaviors in a general hospital sample. Subst Use Misuse 2010; 45:2470-80. [PMID: 20536354 DOI: 10.3109/10826084.2010.487233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Consecutively admitted inpatients of a general hospital in Northern Germany (N = 2903) completed a standardized screening questionnaire in 2005-2006 containing questions about alcohol consumption-related problems in loved ones, their own alcohol consumption, and other health-related aspects. Almost 26.2% reported having a loved one with alcohol consumption-related problems. The proportions of smokers and those who screened positively for at-risk consumption or alcohol abuse were significantly higher in those patients; they were significantly younger and reported worse overall states of health and emotional health. Since those patients showed a high risk of numerous health problems, psychological interventions were implemented. The study's limitation noted.
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Affiliation(s)
- Julia Iwen
- Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee, Luebeck, Germany.
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Ibanga A. Web-based 5-Step Method for affected family members. DRUGS: EDUCATION, PREVENTION AND POLICY 2010. [DOI: 10.3109/09687637.2010.514810] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Copello A, Templeton L, Orford J, Velleman R. The 5-Step Method: Principles and practice. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687637.2010.515186] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Orford J, Templeton L, Copello A, Velleman R, Ibanga A. Working with teams and organizations to help them involve family members. DRUGS: EDUCATION, PREVENTION AND POLICY 2010. [DOI: 10.3109/09687637.2010.514807] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Templeton L. Meeting the needs of children with the 5-Step Method. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687637.2010.514149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Copello A, Templeton L, Orford J, Velleman R. The 5-Step Method: Evidence of gains for affected family members. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687637.2010.514234] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Arcidiacono C, Velleman R, Procentese F, Berti P, Albanesi C, Sommantico M, Copello A. Italian families living with relatives with alcohol or drugs problems. DRUGS-EDUCATION PREVENTION AND POLICY 2010. [DOI: 10.3109/09687630902824262] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Orford J, Templeton L, Copello A, Velleman R, Ibanga A, Binnie C. Increasing the involvement of family members in alcohol and drug treatment services: The results of an action research project in two specialist agencies. DRUGS: EDUCATION, PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630802258553] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Templeton L. Use of a structured brief intervention in a group setting for family members living with substance misuse. JOURNAL OF SUBSTANCE USE 2009. [DOI: 10.1080/14659890802695832] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arcidiacono C, Sarnacchiaro P, Velleman R. Testing fidelity to a new psychological intervention for family members of substance misusers during implementation in Italy. JOURNAL OF SUBSTANCE USE 2009. [DOI: 10.1080/14659890802211291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Howells E, Orford J. Coping with a problem drinker: A therapeutic intervention for the partners of problem drinkers, in their own right. JOURNAL OF SUBSTANCE USE 2009. [DOI: 10.1080/14659890500142459] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Orford J, Templeton L, Patel A, Copello A, Velleman R. The 5-Step family intervention in primary care: I. Strengths and limitations according to family members. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630600997451] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Orford J, Templeton L, Patel A, Velleman R, Copello A. The 5-Step family intervention in primary care: II. The views of primary healthcare professionals. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630600997477] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Templeton LJ, Zohhadi SE, Velleman RDB. Working with family members in specialist drug and alcohol services: Findings from a feasibility study. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630600901123] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Velleman R, Arcidiacono C, Procentese F, Copello A, Sarnacchiaro P. A 5-step intervention to help family members in Italy who live with substance misusers. J Ment Health 2009. [DOI: 10.1080/09638230701677761] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Family, network or couples-based therapies have been helping to support people with substance problems for decades. Their value in supporting a person to change their alcohol or drug use is clear. However, as links between substance use and domestic abuse are increasingly recognised, these approaches need to reflect on the potential safety risks they present to people taking part. The prevalence of domestic abuse among people receiving drug and alcohol services is considerably higher than general population estimates, yet this does not appear to have been adequately addressed in network therapies. This article suggests that this needs to change and that safety of service users needs to be at least as important as the intervention itself. It offers for debate a number of potential safety issues raised by network therapies where there is evidence of domestic abuse; it provides examples of three approaches used to marshal social and network support in substance interventions; and offers a number of suggestions for how network therapies can ensure their use remains safe and supportive where there is domestic abuse.
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Affiliation(s)
- Sarah A Galvani
- Institute of Applied Social Studies, University of Birmingham, Edgbaston, Birmingham, UK.
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Copello AG, Velleman RDB, Templeton LJ. Family interventions in the treatment of alcohol and drug problems. Drug Alcohol Rev 2009; 24:369-85. [PMID: 16234133 DOI: 10.1080/09595230500302356] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Alcohol and drug problems affect not only those using these substances but also family members of the substance user. In this review evidence of the negative impacts substance misuse may have upon families are examined, following which family-focused interventions are reviewed. Several family-focused interventions have been developed. They can be broadly grouped into three types: (1) working with family members to promote the entry and engagement of substance misusers into treatment; (2) joint involvement of family members and substance misusing relatives in the treatment of the latter; and (3) interventions responding to the needs of the family members in their own right. The evidence base for each of the three types is reviewed. Despite methodological weaknesses in this area, a number of conclusions can be advanced that support wider use of family focused interventions in routine practice. Future research needs to focus on (1) pragmatic trials that are more representative of routine clinical settings; (2) cost-effectiveness analyses, in terms of treatment costs and the impact of interventions on costs to society; (3) explore treatment process; and (4) make use of qualitative methods. In addition, there is a need to define more clearly the conceptual underpinnings of the family intervention under study.
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Affiliation(s)
- Alex G Copello
- Birmingham and Solihull Substance Misuse Services and School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
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Arcidiacono C, Velleman R, Procentese F. A synergy between action-research and a mixed methods design for improving services and treatment for family members of heavy alcohol and drug users. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2009. [DOI: 10.1002/casp.1015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Copello A, Templeton L, Orford J, Velleman R, Patel A, Moore L, MacLeod J, Godfrey C. The relative efficacy of two levels of a primary care intervention for family members affected by the addiction problem of a close relative: a randomized trial. Addiction 2009; 104:49-58. [PMID: 19133888 DOI: 10.1111/j.1360-0443.2008.02417.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES A randomized trial to compare two levels of an intervention (full versus brief) for use by primary health-care professionals with family members affected by the problematic drug or alcohol use of a close relative. DESIGN A prospective cluster randomized comparative trial of the two interventions. SETTING A total of 136 primary care practices in two study areas within the West Midlands and the South West regions of England. PARTICIPANTS A total of 143 family members affected by the alcohol or drug problem of a relative were recruited into the study by primary health-care professionals. All recruited family members were seen on at least one occasion by the professional delivering the intervention and 129 (90 %) were followed-up at 12 weeks. MAIN OUTCOME MEASURES Two validated and standardized self-completion questionnaires measuring physical and psychological symptoms of stress (Symptom Rating Test) and behavioural coping (Coping Questionnaire) experienced by the family members. It was predicted that the full intervention would show increased reduction in both symptoms and coping when compared to the brief intervention. RESULTS The primary analysis adjusted for clustering, baseline symptoms and stratifying variables (location and professional group) showed that there were no significant differences between the two trial arms. The symptom score at follow-up was 0.23 [95% confidence interval (CI): -3.65, +4.06] higher in the full intervention arm than in the brief intervention arm, and the coping score at follow-up was 0.12 (95% CI: -5.12, +5.36) higher in the full intervention arm than in the brief intervention arm. CONCLUSIONS A well-constructed self-help manual delivered by a primary care professional may be as effective for family members as several face-to-face sessions with the professional.
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Affiliation(s)
- Alex Copello
- School of Psychology, University of Birmingham and Substance Misuse Services, Birmingham and Solihull Mental Health Trust, Birmingham, UK.
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Orford J, Templeton L, Velleman R, Copello A. Family members of relatives with alcohol, drug and gambling problems: a set of standardized questionnaires for assessing stress, coping and strain. Addiction 2005; 100:1611-24. [PMID: 16277623 DOI: 10.1111/j.1360-0443.2005.01178.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To describe a set of standard questionnaire measures for the assessment of the needs of family members of relatives with alcohol, drug or gambling problems, and to present evidence of their reliability and validity from a series of related studies. DESIGN Includes cross-sectional and repeated-measurement studies. SETTING AND PARTICIPANTS Family members affected by and concerned about the problem drinking or drug-taking of close relatives in treatment and non-treatment samples in the United Kingdom (white and Sikh) and Mexico City; family members of untreated heavy drinkers; and family members of problem gamblers. MEASUREMENTS Four measures derived from a stress-strain-coping-support model of alcohol, drugs and gambling problems and the family: Family Member Impact scale (FMI), Symptom Rating Test (SRT), Coping Questionnaire (CQ), and Hopefulness-Hopelessness scale (HOPE). FMI, SRT and CQ assess stress, strain and coping, respectively. The exact role of HOPE in the model remains to be determined. The support component remains unmeasured. FINDINGS Results from a number of studies support the internal reliability, discriminant and construct validity and sensitivity to change of the SRT and its two constituent scales (psychological and physical symptoms) and at least two subscales of the CQ (engaged and tolerant-inactive coping). Although showing evidence of satisfactory reliability and some evidence of discriminant validity, further work may be required on the CQ withdrawal coping subscale. Evidence suggests that the FMI is reliable and valid and may have a factor structure that will support future research (distinguishing worrying behaviour from active disturbance). HOPE is a new measure showing promising characteristics. CONCLUSIONS A set of standard measures is available for helping to assess the needs of concerned and affected family members, derived from an explicit model of the family in relation to excessive drinking, drug taking or gambling. It may have a role to play in correcting the current neglect of the needs of such family members, estimated to be in the region of nearly a million adults in Britain alone.
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Affiliation(s)
- Jim Orford
- Alcohol, Drugs and Addiction Research Group, School of Psychology, The University of Birmingham, Edgbaston, Birmingham, UK.
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Copello A, Orfor J, Hodgson R, Tober G, Barrett C. Social behaviour and network therapy basic principles and early experiences. Addict Behav 2002; 27:345-66. [PMID: 12118625 DOI: 10.1016/s0306-4603(01)00176-9] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present paper reports on the basic principles of a treatment approach currently being used in a National Multicentre Randomised Controlled Trial of Alcohol Treatments in the United Kingdom (UK Alcohol Treatment Trial). The treatment: Social Behaviour and Network Therapy (SBNT) is novel as a package but has been developed by integrating a number of strategies found to be effective in other treatment approaches. The intervention is based on the notion that to give the best chance of a good outcome people with serious drinking problems need to develop positive social network support for change. A brief review of the evidence supporting social treatments for alcohol problems is followed by an outline of the feasibility work and the basic principles that guided the development of SBNT. Process data from the first 33 trial cases and 2 case vignettes are described and discussed. It is concluded that SBNT is a feasible and coherent treatment approach that can be delivered by a range of therapists in the alcohol field.
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Affiliation(s)
- Alex Copello
- School of Psychology, The University of Birmingham, Edgbaston, UK.
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