Scottish Families Affected by Alcohol & Drugs Spotlight The role of telehealth & technology innovation in supporting families, carers and significant others. Scottish Families Scott Clements Training & Quality Manager

Scottish Families Affected by Alcohol & Drugs Overview Scottish Families Who are we and what do we do? Family Inclusive Practice The Family Charter Telehealth Let’s talk Tele health

Scottish Families Affected by Alcohol & Drugs Role of carers & families Families play an important role in the treatment, care and support for those using drugs. Families can contribute to the assessment process and provide support, from attending appointments to helping loved ones turn their lives around. However, the level of intensive commitment can come at a heavy price for the family. Ongoing support for families is vital. The Road to Recovery, The Scottish Government, 2008

Scottish Families Affected by Alcohol & Drugs Vision

Scottish Families Affected by Alcohol & Drugs Family recovery ‘Families need to recover too’ ‘We need to recover as well as the person with the addiction. We need the support to stick together and help each other to start the recovery process’ ‘Families need to be part of the recovery for their relatives, Don’t exclude us’

Scottish Families Affected by Alcohol & Drugs The Family Wheel

Scottish Families Affected by Alcohol & Drugs Support impact map

Scottish Families Affected by Alcohol & Drugs ROSCs Recovery-Orientated Systems of Care Person-centred Self-directed Strength-based Participation of family members, carers, significant others, friends and the community. The Quality Principles Services should be family inclusive as part of their practice

Scottish Families Affected by Alcohol & Drugs Recovery focus

Scottish Families Affected by Alcohol & Drugs Family inclusive practice A need to improve outcomes for all Refers to a range of different interventions that involve families in the substance users treatment and addresses the needs of the family. These interventions have common underlying principles that are based on a collaborative, strengths-based, solution- focused and empowering approach.

Scottish Families Affected by Alcohol & Drugs Family interventions Working with family members to promote the engagement of clients into services Involving families and others in assessment and treatment plans Providing services directly for family members (Copello, Velleman & Templeton, 2005)

Scottish Families Affected by Alcohol & Drugs Family inclusive practice Acknowledges that individuals influence and impact the family. Recognises that interventions are more effective when family is included. Considers the family behind the individual. Continuum of practices that involve families in accordance to needs of both the family and the substance user.

Scottish Families Affected by Alcohol & Drugs The Family Charter Information, signposting and referral for families Assessment of family relationships and networks on entry into treatment Programmes and services that provide help and support to family members in their own right Responses to family members delivered as part of service to alcohol/drug user Intensive family based therapeutic interventions Families will be actively included in a loved one’s treatment Scottish Families The Family Charter Continuum of practice: adapted from (Copello et al, 2009) Families will have access to adequate and appropriate support services. Families will be involved in the planning, implementation and evaluation of services both locally and nationally.

Scottish Families Affected by Alcohol & Drugs Rural and remote

Scottish Families Affected by Alcohol & Drugs Rural and remote 14 Scottish council areas deemed rural (population density is below 1 person per hectare) Individual can be ‘remote’ due to little or no support services available, mobility issues, or where transport costs may be prohibitive and preclude them accessing support.

Scottish Families Affected by Alcohol & Drugs Let’s talk Tele health

Scottish Families Affected by Alcohol & Drugs Level of support needs Listening and emotional support Brief advice Virtual family support group Brief intervention

Scottish Families Affected by Alcohol & Drugs Telehealth website Webchat Virtual family support group Online community forum Training courses Self-help resources Point-to-point video conferencing

Scottish Families Affected by Alcohol & Drugs Telehealth brief intervention CLIENT INTERVENTIONIST Rural or remote location Webchat Telephone

Scottish Families Affected by Alcohol & Drugs Telehealth brief intervention Explore and understand their situation and what they themselves can change. Develop and implement coping skills and strategies to manage difficult situations and behaviours. Increase their own personal choices and control over their own lives that have been affected by someone else’s behaviours. Improve their relationships. Improve social isolation and increase their network of support. Improve general health and wellbeing.

Scottish Families Affected by Alcohol & Drugs CRAFT CRAFT Intervention Community Reinforcement & Family Training (CRAFT) is a unilateral therapy for family/Concerned Significant Others (CSOs) of a substance user who doesn’t want change/refuses treatment. [Smith & Meyers, 2004] Promotes active, positive participation of CSO, utilising a motivational (vs. confrontational) approach, using reinforcement principles to enhance positive, non-using (competing) behaviours and decrease negative, substance using behaviours.

Scottish Families Affected by Alcohol & Drugs CRAFT Primary CRAFT objectives Improve the emotional, physical and relational functioning of family members/Concerned Significant Others. Get the substance user into treatment. Decrease/eliminate substance use of substance user.

Scottish Families Affected by Alcohol & Drugs Impact ‘I thought it was her (substance user) who had to change… I now realise I had to change too.’ ‘I didn’t believe anyone could help me.’ ‘Talking to, and hearing someone else has helped me cope… I am trying to maintain a positive and solid stance for the one who has lost the plot for now.’ ‘I would like to help others cope, once I’ve got to a safe(ish) shore myself.’

Scottish Families Affected by Alcohol & Drugs Scottish Families Affected by Alcohol & Drugs Scottish Families Affected by Alcohol & Drugs Let’s talk Tele health