Family Interventions for Drug and Alcohol Misuse: Is There a Best Practice?

Alex G. Copello; Lorna Templeton; Richard Velleman

Disclosures

Curr Opin Psychiatry. 2006;19(3):271-276. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: Recent developments in research and practice have highlighted the effectiveness of family interventions in substance misuse treatment. The present paper will critically review studies of family approaches published over the past 12 months, assess the current state of this field and suggest future directions.
Recent Findings: Family interventions lead to positive outcomes for both misusers and family members. Some recent interventions have widened the focus also to include other members of the user's social networks and have focused on a range of treatment goals.
Summary: An increasingly robust evidence base supports family-focused and social network-focused interventions in substance misuse treatment. Recent studies have continued to show that family and network approaches either match or improve outcomes when compared with individual interventions. Research needs (and is starting) to consider a broader set of outcomes relevant to family and network interventions, besides simply making an impact on substance use. The major challenge involves implementation of family approaches in routine service provision; interventions with most evidence supporting them are not used routinely in practice. Research studies and policy initiatives need to focus on dissemination of family approaches and their integration into treatment services.

Introduction

Substance misuse is associated with a range of social and health problems affecting an individual as well as the family within which the individual lives.[1*] Despite the well documented negative impact that substance misuse has on the family unit, treatments tend to focus on the substance misuser, with families receiving little attention.[2] During the past three decades, however, researchers have increasingly recognized the key role that families can play in substance misuse treatment, in terms of preventing and/or influencing the course of the substance misuse problem, improving substance-related outcomes for the user and also helping to reduce the negative effects of substance misuse problems on other family members. During this time, a range of interventions that incorporate a family component have been empirically tested. In addition, recent research has also focused on the potential helping role that other members of the substance misuser's social network can play in treatment.

In this paper, we review the evidence for family interventions (including those focused on wider social networks) in the treatment of alcohol and drug problems, and we focus more specifically on five questions: (i) Are family and social network interventions for alcohol and drug problems supported by research evidence? (ii) What can we conclude from the more recent studies reported in the past 12 months? (iii) Would it be useful to standardize assessment and outcome measures? (iv) Overall, is there enough evidence to propose a best practice? (v) What are the future research and clinical directions?

Throughout this paper we use the term substance 'misuse' as an overarching term to include substance abuse and substance dependence.

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