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Treatment for drug and alcohol misuse should involve families and communities


Alcohol and other drug treatment in Australia is generally only provided to individuals, often outside their families.

Treatment may include drug withdrawal, counseling, and residential rehabilitation. All these treatments work to improve health and well-being and reduce the harm of substances.

But people’s families and communities can influence substance use and the ability to do so aid the healing journey of people in treatment.

Read more: Why do some people struggle to make “healthy” decisions day in and day out?

For many First Nations peoples, health and wellness is not just about the individual. Are connected with family, culture, connection and country.

That is why treatment services such as Pinangba in Queensland – a First Nations alcohol and other drug service whose approach we examined – includes families, culture and the country in treatment.

This method of treatment should be available to everyone.

The role of families in treatment

Families and the community can play an essential role in helping people quit alcohol and other drugs and prevent relapse. Research shows advice or encouragement from family members is an important reason to stop or reduce problem substance use.

However, some people often go to treatment facilities alone have limited support back home in their communities to stay sober or consume less.

Families and communities do not always have the right resources to support the individual in treatment, and some family members may experience substance use problems themselves.

Family members may not have the resources to support a loved one after treatment.

What’s happening in Pinangba?

Pinangba is an Indigenous-led residential rehabilitation service in Queensland. It is one of the few alcohol and other drug treatment services in Australia to take in the whole family of adults and children for the residential stay.

Pinangba adopts one systemic family therapy model. The therapist is invited to consider not only the context of the individual within their family, but also the context of the family in relation to the wider social, political, and historical systems.

The emphasis is on building, strengthening and repairing relationships as part of the client’s healing work.

Pinangba also considers the most influential environments in a client’s life (social services, work, court) that may impact their healing journey.

The family-based approach helps clients enter and stay in treatment, maintain abstinence, and improve relationships. This approach also positively influences the alcohol and other drug use of other family members and improves the functioning of their children.

Pinangba family therapy approach to addiction positively received by clients, families, the community and other health and social service providers.

Read more: Alcohol problems aren’t for life, and AA isn’t your only option. 8 things film and TV get wrong about drug and alcohol treatment

Immigrants also benefit from this model. Family-centered interventions for non-Indigenous people with substance use problems do been effective for both young people and adults. These interventions not only reduce substance use, they also improve family functioning compared to individual treatments.

Despite these positive results, family-oriented interventions within alcohol and other drug treatment services are still uncommon.

Barriers to Deployment not only have to do with the individual treatment focus, but also with issues such as difficulties in involving family in treatment, limited staff time, lack of experience and insufficient training.

There are a number of barriers to overcome to roll it out more widely.

Expand access in 3 ways

In order to incorporate this family-centered care model into both Indigenous and non-Indigenous alcohol and other drug services, we need better data collection and better funding. Here are three key steps towards this implementation:

1. Careful evaluation of family involvement, family therapy, and holistic treatment programs.

There is currently little knowledge about the effectiveness of this model for First Nations people. That’s exactly what we do with Pinangba: with money from the Queensland Mental Health Commission we are building an assessment that is integrated into routine services to demonstrate how such holistic, family-centered treatment works.

It is vital that data is collected as part of routine practice so that an evidence base can be built.

2. Routine data collection practices not dependent on external funding.

Organizations that fund alcohol and other drug treatment for First Nations peoples (including the Commonwealth, Primary Health Networks, and state governments) must ensure funding levels are adequate so services can spend time collecting and inputting data on progress and outcomes of clients.

This is currently not the case. The collection of evaluation data is seen as an extra, not an essential part of the ongoing service. This has to change.

Read more: What is ‘success’ in rehab? Programs need more than just anecdotes to prove they work

3. Financing that looks beyond individual care models.

Newer ways of working, with families becoming the “treatment unit”, will bring new costs, new buildings, new ways of working, new data collection and will require more funding and planning.

When we really think about families, we need to think about treatment with a family, not an individual. This shift in thinking needs to happen at all levels of the system.

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