The National Family Support Network 01/02/2011 The National Family Support Network 5-Step Method Conference – 5-Step in Groups Siobhán Maher/Robert Browne 11.11.14

What is Family Support What is Family Support? Family Support can be offered on a one-to-one basis or in a group setting. The model of family support that the Network advocates is peer family support. This is where a number of people with a common problem, in our case living with drug use, come together to share their experiences. What does a Family Support Group do? A Family Support Group is a safe, confidential, non judgemental place for family members to discuss issues emerging from the problem of drug use within the family

The stress-strain-coping-support (SSCS) model (Copello, Ibanga, Orford, Templeton, Velleman) This model underpins the 5-Step Method. While previous models of substance misuse have typically blamed family members for dysfunction – the SSCS Model does not. In the SSCS model, family members are BOTH part of the solution, AND also have needs in their own right. Family members are at the heart of the response. Considers how harms to individuals and families can be reduced. Firstly I would like to say how delighted the FSN was to come across this particular model. This model developed by the ADF group in the UK is a non-judgemental and non-blaming view of families living with substance misuse. While this may be seen as the most natural starting point for those of us in the room unfortunately this has not always been the case. Some of you may have experienced more pathologising models or frameworks over your lifetime where families living with substance misuse have been viewed as dyfunctional or lacking in certain ways. You may have experienced models where the family has been seen to cause the addiction. This is reflected in throwaway phrases such as “She drove him to drink”. This has most often been the case relating to women and wives and mothers particularly. The stress-strain-coping support model is different and views addiction as a similarly stressful experience to other common long-term chronic problems or issues such as unemployment or long-term illnesses like cancer. The idea is that long-term chronic stressors create strain whereby coping strategies inevitably are developed in response and support is looked for either from informal or formal sources. The researchers recognise that while addiction is similar to other issues there are specific elements to this experience to warrant it’s own model. 3

The Experience of Family Members How difficult it is to live with someone (as a spouse, or as a parent or as a child) when that person misuses alcohol or drugs. The various impacts that the drinker or drug user has on their lives. How this has affected them as family members, who have to worry and often bear the brunt of any changes in the substance misuser. How they often become anxious, or depressed, or how the worry seems to lead to effects on their physical health too. How they cope or deal with these difficulties. From a careful examination of what they say about how they cope, it seems that there are 3 main ways that people cope with living with a drug or alcohol misuser. And people across the world have also said that the amount and type of social support that they receive is an important influence on the well-being of the family member. A huge similarity in the experience of family members : about the users changeable moods, or their aggression, or their violence, or their disruption of family or social occasions, or the impact on the family’s finances or of their worries over the users failing health. : their sleep is disturbed, or their eating is disrupted or they develop headaches or gastric problems that if they get more support (of the right type: i.e. that they find supportive), then it becomes easier to bear the problems resulting from living in this type of environment. 4

The stress-strain-coping-support (SSCS) model (Copello, Ibanga, Orford, Templeton, Velleman) Developed from what family members told the ADF Group in various research studies: Families experience stress as a result of someone else’s problem drinking or drug use; this has an impact on them. The strain of dealing with the substance misuse leads to physical and psychological ill health. The strain is influenced/mediated by: Method(s) of coping Level and quality of social support From hearing all these stories from so many family members, the ADF Group developed a simple model to help understand better what was going on: a model that was developed directly from the things that family members have said. 5

5-Step Method Step 1: Listen, reassure and explore concerns 23/03/2010 5-Step Method Step 1: Listen, reassure and explore concerns Allow family member to describe situation Identify relevant stresses Identify need for further information Communicate realistic optimism Identify need for future contacts Step 2: Provide relevant, specific and targeted information Increase knowledge and understanding Reduce stress arising from lack of knowledge or misconceptions Step 3: Explore coping responses Identify current coping responses Explore advantages and disadvantages of current coping strategies Explore alternative coping responses Explore advantages and disadvantages of alternative ways of coping The FSN intend to roll out training in the 5-step method in 2013 to family support workers and facilitators of family support groups. These steps will be very familiar to you and that most of you will probably be working in a similar way within your group. This is a positive thing as it means that the method will be easily adopted and adapted into your current support giving systems. What is also great is this is an evidence based interevention; this means that the method has been evaluated and has shown to provide improvements in family members well-being. This also means that by using this method it will give you the opportunity to evaluate the work that you do which is often very difficult in family support. It will also provide you with a more formal structure to your work. The first step is as follows.

5-Step Method Step 4: Discuss Social Support 23/03/2010 5-Step Method Step 4: Discuss Social Support Draw a social network diagram Aim to improve communication within the family Aim for a unified and coherent approach Explore potential new sources of support Step 5: Discuss and explore further needs Is there a need for further help? Discuss possible options with family member Facilitate contact between family member and other sources of specialist help KEY ASPECTS AND PRINCIPLES OF THE 5-STEP METHOD The method is focussed on affected and concerned family members The method takes a view of family members as ordinary people attempting to respond to highly stressful experiences The method is very flexible and adaptable to a range of settings and circumstances The orientation of the person delivering the 5-Step Method is very important

The Benefits of Family Support 01/02/2011 The Benefits of Family Support It interrupts the negative dynamic of drug use within the family. It helps family members look after their own needs. It helps the families of drug users to make constructive choices. It helps families to reinforce the work of the service agencies. It enables families to be a resource to their own communities.

Structure of the session Welcome Ground Rules/contract Confidentiality Outline of group session Self help handbook FMQ/3 Month follow up Time management

Group Norms Non judgemental acceptance of others Willingness to self-disclose Respecting confidentiality Recognising the available support in the group Respecting others Willingness to accept feedback

Group Facilitation Techniques Give your attention to members as they share their story Being aware of your own body language and reactions when listening and responding to speakers Offering all the opportunity to speak and not allowing one member to dominate Encouraging calmness and serenity within the group Make sure members leave the group with a sense of support

Preparation for next session Home practice – suggest that members complete exercises in self-help handbook Encourage members to read through next step and practice new skills learned Encourage members to bring any unanswered questions to the next session

Relaxation Exercises http://www.beaumont.ie/index.jsp?a=473&n=532&p=528#relaxation

Please prioritise a maximum of 2 of each. Q’s for Feedback What are the two most positive outcomes of using 5-Step Method with groups? What blocks/barriers might present in using the method in a group setting? Please prioritise a maximum of 2 of each.