Families affected by harmful drinking

Harmful drinking can cause significant issues not only for the alcohol user, but also for members of their family.

This can appear in the form of health problems, financial worries, relationship breakdown and parenting difficulties. These families need and deserve support; family interventions can play a role in this, and in reducing overall alcohol harm.

Why help the family as well as the alcohol user?

Until relatively recently, interventions for harmful drinking have tended to focus on the individual user; however, researchers and practitioners are increasingly highlighting the vital role that family members can play in the treatment process. In addition, those family members need support.

The UK Government’s updated Drug Strategy commits the Government to providing greater support for families affected by alcohol and other substance misuse.

Family interventions cover three main areas:

  • Working with family members to encourage the person drinking harmfully to enter treatment
  • Working jointly with family members and alcohol users during the treatment process
  • Providing help and support to family members in their own right

Some of these interventions are delivered through formal alcohol programmes, but many others happen through community drop-ins, carers’ centres, and peer support. These informal interventions are vital and deserve attention and funding.

The impact of harmful drinking on families

Harmful drinking can have a potentially devastating impact on families. Some of the behaviours associated with harmful drinking can cause intense stress – for example domestic abuse, child abuse, individuals driving under the influence or disappearing for days at a time. Some of these behaviours can cause more upset than the drinking itself.

Encouraging the drinker to enter treatment

There is good evidence that family members can play an important role in helping someone who drinks harmfully to seek out treatment. A variety of approaches have been trialled and researched, including:

  • Community Reinforcement and Family Training (CRAFT) is designed to give anyone supporting a family member who drinks harmfully or uses drugs tools and strategies to achieve change for themselves and their loved one. Its three main goals are: to improve the non-drinking family member’s quality of life; to reduce the individual’s substance use; and to encourage the individual into treatment. CRAFT has been widely evaluated and accepted as a key intervention.
  • Unilateral Family Therapy (UFT) aims to provide a non-drinking family member with skills to help them encourage an individual to seek treatment. Research indicates that UFT can show improved outcomes for the individual, plus benefits for the non-drinking family member.

Working jointly with family members and alcohol-users during treatment

Working jointly with alcohol users and their families during treatment has been shown to be effective, particularly where the user is an adolescent.

  • Multidimensional Family Therapy is an intervention that extends beyond the young person and family to the wider social environment, for example school, work and justice systems in which the young person is involved. It is based on the principle that altering critical aspects of the young person’s environment can reduce harmful drinking, as well as lead to wider benefits such as decreased delinquency and improved psychological health.
  • Brief Strategic Family Therapy has shown some success in reducing or in some cases eliminating adolescent substance misuse, and changing family interactions associated with it.
  • Behavioural Couples Therapy has been shown to be particularly effective where a partner’s drinking is causing severe relationship stress. The drinker and partner arrange a daily Recovery Contract in which the dependent drinker states their intention not to drink or use drugs and the partner expresses support for their efforts to stay abstinent.

Supporting family members in their own right

Family members have often been seen primarily as a tool in addressing an individual’s harmful drinking. However, the needs of family members themselves are now beginning to be attended to as well.

  • The Five-Step Method: A key principle of the approach is that living with the impact of an addiction problem in the family may lead to psychological and physical symptoms for family members. These symptoms have been found to be improved by a practitioner working systematically with them through a series of steps, reducing their strain and improving their coping mechanisms.

What support is available?

There are many sources of support available for both individuals who drink too much and their family members.

  • If you think you or a family member may be drinking too much, contact Drinkline (England) on 0300 123 1110 or Dan24/7 (Wales) on 0808 808 2234
  • Al-Anon provides support to anyone whose life is, or has been, affected by someone else’s drinking. Visit www.al-anonuk.org.uk
  • You can find more support services through Adfam. Visit www.adfam.org.uk
  • Nacoa support anyone affected by their parent(s) drinking, including adults. Here are some of the questions that children often ask about alcohol and the effects on them and their family. For more information, visit nacoa.org.uk, call 0800 358 3456 or email [email protected]. You can also find them on Facebook and Twitter.