CJHS425 Family Counseling Live Chat #1 Family Dynamics: Impact of substance use on family members, friends and caregivers Dr. Ros Burton-Robertson PhD, PsyD, ThD, DBA (ABD), EdD (ABD) QMHP-R, CNMP, CCRP, CCTS -I Introduction • When someone has problems relating to their substance use, the attention is focussed on that person, how to help them and, for some people, what type of intervention is available for them. • A number of interventions involve family members/ friends/carers – usually these are focussed on how those family members can support their friend or relative with the substance problem. Introduction (cont.) • Far less attention is paid to the impact the person’s substance use is having on family members and the support they need in their own right. • This lecture focuses on the impact of substance use on family members/friends/ carers and what to consider in your discussions with them, however brief. For brevity, ‘family member’ will be the term used to represent these relationships throughout this resource. Impact • It also links with other resources focussing on How to support family members, The impact on children of parental substance use and Safeguarding. Who may be affected • There are a range of people who can be affected when someone they love or care for has problems relating to their substance use. These include: • Parents of substance using children • othis could be children of any age, be they 11 or 51! • Brothers and sisters • Partners • Carers • Extended family members, e.g. Grandparents • Friends Negative impact? We tend to think problematic substance use (be that alcohol or other drugs) will automatically have a negative impact. While this is likely when someone’s substance use is consistently problematic, people do report some positive aspects of using substances, e.g. sociability or expressing themselves more openly under the influence of a substance. The positive aspects of use need to be heard in order for it to inform any further discussions about challenges to change and what support the person may need to be offered in different aspects of people’s lives. However, this resource will focus more on the negative impact of problematic substance use on family members. Types of impact Living with, or being close to, a person with problematic substance use can result in a range of social and health problems for the family member. These include: • Physical health problems • Psychological and mental health problems • Financial problems • Emotional problems • Relationship stress and breakdown • Loss of employment • Domestic violence and abuse Impact: research evidence Copello et al.’s (2000) research shows that the health and wellbeing of family members living in the household with someone with substance problems can be negatively affected. This stress has been found to heighten risk of mental and physical health problems and also worsen preexisting health problems. Watch Prof Alex Copello talk about the impact of the experience of family members and the stress they experiences. Impact: research evidence (cont.) Orford et al. (2005) found evidence of family members being exposed to “multiple and often chronic stressors” resulting from the problematic use of close relatives. Barnard’s research (2005) focussed on the impact on families where one child was using problematically . Barnard identified feelings of loss, sadness and anger within the family. It led to tensions between parents and other children in the family as well as between parents. Factors affecting impact? A number of factors can affect the type of impact, and extent of the impact, a person’s substance use can have on other family members. As a reflective practitioner it is helpful to ask yourself the following questions to consider what the impact might be: • Is the family member responsible for the wellbeing of the person with the substance problem, for example, due to the person’s age or a disability? • Does the family member live in the same household/ family home? • If so, is the family member in a position to walk away or leave the relationship or situation to get some respite or space? • If not, how is this lack of respite going to impact on the person’s experience? Factors affecting impact? (cont.) Other questions to consider in determining impact on family members include Has the individual’s problematic substance use resulted in problems at school, work or in the community for other members of the family? • If so, in what way? • Are finances or other practical responsibilities shared? • If so, are there debts, for example, adding to stress levels? • Has the family member’s health and well being suffered as a result of their loved one’s problematic substance use? • If so, what support or treatment are they receiving? Factors affecting impact? (cont.) Does time spent trying to help the person with the problem detract from time spent with other members of the family? • What type of additional stress and strain does this put on other family relationships and communication? What other support does the family member have to draw on? • Are there family and friends outside the household the family can go to or talk to or are they dealing with this on their own? Is their loved one’s problematic substance use leading to, or exacerbating, other problems they may have? • How is their physical, emotional and mental health? Factors affecting impact? (cont.) Co-use of substances • Some partners or family members may be using a substance with the person identified as having problems relating to their use. • This could be as a result of coercion, as a coping mechanism for the stress of living with someone with problematic substance use, or because they also choose to use substances....or all of the above! • Consideration needs to be given to whether the family member is in need of specialist substance use services in their own right, as well as support as someone who is affected by the problematic use of their loved one. • They may not realize that using when the person with the problem is around is unhelpful – even if their own use is non-problematic. Factors affecting impact? (cont.) Domestic abuse and child-to-parent abuse • Conflict and arguments are often a feature among families where a person has a substance problem. • This is not the same as domestic or child-to-parent abuse which is frightening and controlling. • However, domestic abuse, from child to parent/ grandparent, from sibling to sibling, or between partners is also common among people with substance problems. • This can add to the negative impact on the family members’ health and well-being, particularly their psychological and emotional well-being. • Use the following link to take you to the resource focussing on Domestic Violence and Substance use References Barnard, M. (2005) Drugs in the family. The impact on parents and siblings. Final report. York: Joseph Rowntree Foundation Copello, A., Templeton, L., Krishnan, M., Orford, J. and Velleman, R. (2000) A treatment package to improve primary care services for relatives of people with alcohol and drug problems. Addiction Research, 8, 471-484. Copello, A., Orford, J., Velleman, R., Templeton, L., & Krishnan, M. (2000). ‘Methods for reducing alcohol and drug related family harm in non-specialist settings.’ Journal of Mental Health, 9, 329–343 Orford, J., Natera, G., Copello, A., Atkinson, C., Mora, J., Velleman, R., et al. (2005). Coping with alcohol and drug problems: The experiences of family members in three contrasting cultures. London: Brunner-Routledge.