17 research outputs found
Web-based 5-Step Method for affected family members
No full textThough affected others probably outnumber those actually misusing alcohol and drugs, the services that are available to them are marginal and do not adequately meet the needs of this growing population of concerned family members (FMs). Evidence available suggests that the 5-Step Method is effective in supporting FMs who are concerned about their relatives' drinking or drug misuse. However, not all evidence-based treatments are being used by health care practitioners. The challenge of the 5-Step Method would thus be making it available to the FMs in need. This article looks at the development and experience of providing this intervention in a format that can be accessed on the internet by FMs. Preliminary results show that the internet is viable for the dissemination of the 5-Step intervention with the potential of reaching many affected FMs. FMs reported this online version as straight forward, easy to use and helpful. Ways in which the delivery of the programme might be improved for the increased benefit of FMs are discussed
Investigating the development, delivery and outcomes of internet based help for family members affected by addiction problems
No full textThe aim of this dissertation was to investigate the feasibility of developing, delivering and outcome of the internet delivery of evidence based manualized intervention, for family members. Family members are often the ones to start feeling the negative effects of a loved one’s misuse of alcohol of drugs and service delivery though expanding to recognise the needs of family members, is not yet fully addressing these needs. The 5-Step Method which was developed based on the Stress-Strain- Coping-Support Model offers a way to work directly with family members in addressing their needs. There is evidence available suggests that when the 5-Step Method is delivered in other formats, in a variety of settings, by various health care professionals; that it does lead to positive changes for the family member. The challenge of the 5-Step Method therefore was to make it more widely available. The internet offers an option through which this intervention may be made available to family members. Results of the internet delivery of this intervention show that family members found it acceptable, easy to use, and helpful. It did lead to changes in the way family members cope, as well as reductions in the impact and symptoms. These results suggest that the internet is a viable medium for the delivery of this intervention for family members. The implications of these findings are further discussed with suggestions for future research
Implementation of the “unplugged” school-based prevention programme in Nigeria: Results of process evaluation
No full textProcess evaluation can improve the quality of program implementation and the achievement of program outcomes. This paper aims to describe the fidelity of implementation of the school-based prevention program 'Unplugged' in Nigeria, i.e., the degree to which the intervention was delivered as intended, and the satisfaction of teachers and students. The program aims to prevent tobacco, alcohol, and substance use and consists of 12 standardized units, one-hour each, delivered by class teachers. Sixteen schools implemented the program. Eleven schools, 33 classes, 27 teachers, 993 students provided process evaluation data. Eighty-two percent of classes implemented the entire program, with lower rates of activities implementation at the beginning and at the end of the program. Each unit took on average 55 minutes. More than 90% of teachers perceived high students' interest for units 1, 4, 5, 8, and 9, high interactivity for units 1, 2, 8, and 9, and declared high comfort in implementing most units. About 80% of teachers reported an improvement in knowledge, teaching skills, and relationships with students due to the program. More than 75% of students declared the program changed their way of seeing themselves, was helpful to answer questions about themselves, and improved their relationships with mates and teachers. About 95% of students reported an increase in knowledge of the consequences of substance use. Students declared Unplugged educative, informative, helpful, impacting on change, interesting and suggested the program should be spread to other schools
The economic community of West African states intervention in the Liberian Civil War: its implication for West Africa, 1998
No full textMore often than not, when regional powers involve themselves in a country where conflict is present, there is always the implication that intervention can: (a) buttress an otherwise fragile regime; (b) assist in neutralizing threats; (c) allow a regime to consolidate power; (d) help rejuvenate the state; (e) extend the conflict; and (f) bring conflict to an end or quickly reduce its scale. The purposes of intervention vary depending on the interests of the regional powers and the strengths and motivation of contending groups engaged in civil conflict. This study demonstrates that the economic community of West African State's initiative brought an end to the Liberian civil war and helped forge regional unity among West African States. Since the creation of modern Liberia in 1821, the country has experienced repression, denial of basic rights, and socioeconomic inequalities. These conditions set the stage for the military takeover of April 12, 1980 led by Master-sergeant Samuel K. Doe who overthrew the William Tolbert regime. Doe's continuation of his predecessors' policies and administrative style, combined with his own lack of experience in governance, and dismal performance, promoted discontent among the Liberian majority, such as the Krus Krelles, Grebo, and Gbande. On December 24, 1989 civil war broke out. This study identifies internal factors leading to civil war such as Liberia's historical legacy, the nature and basis of the Liberian government, its policies, and the means and effectiveness with which the Liberian government enforced its authority. Hoping to resolve the Liberian conflict, the Economic Community of West African States (ECOWAS) formed a monitoring group, Economic Community of West African States Monitoring Group (ECOMOG), to intervene and bring the war to an end. The study's conclusion is that ECOMOG has the potential to bring peace, stability, economic growth and good governance to Liberia, and help forge unity among West African states. The war has created an enormous refugee problem and economic hardship for Liberia, and has threatened the health, security, and stability of the West African region. This study recommends that the gap between the impoverished masses and the elite in Liberia be bridged
The experiences of affected family members:a summary of two decades of qualitative research
No full textThis article is based upon the collective findings of a number of studies conducted in a number of countries during the past 20 years. Female partners and mothers are the family members who have been most represented in the study samples, but the latter also included sizeable numbers of male partners, fathers, sisters, brothers and adult sons and daughters. Citing examples taken from the studies, the article describes some of the most prominent elements of the stressful experience of living with a relative who is drinking or taking drugs excessively, notably: the relationship with a relative becoming disagreeable and sometimes aggressive; conflict over money and possessions; the experience of uncertainty; worry about the relative; and home and family life being threatened. The reasons why family members may put up with substance misuse are described, and the ways in which family members may either withdraw and gain independence or stand up to substance misuse, as alternative ways of coping, are outlined. Examples of the strain experienced by family members are given. The kinds of social support valued by family members are explained, as is the finding that good quality social support for family members is often lacking. The article concludes by offering an integrated view highlighting the disempowered position in which family members usually find themselves and the importance of good social support for family members in their coping efforts. Although the picture is coloured by factors such as sociocultural group and the ages and genders of family members and their relatives, we believe the core experience for affected family members is a universal one
Working with teams and organizations to help them involve family members
No full textIn this article we describe our work in trying to influence whole service teams to move their practice towards greater involvement of affected family members. Work with five teams is described. The process varied but in all cases it included recruitment of the team, training, continued support and evaluation of results. Use of a standard questionnaire for assessing attitudes towards working with affected family members showed significant changes in team members’ knowledge, confidence and team support for working with family members. Records of all project events and meetings suggested that change takes time but that a ‘cultural change’ can take place whereby earlier misgivings are dispelled and positive attitudes towards involving family members become embedded in a team's approach. Diary audit indicated that the frequency of involvement of family members in sessions can be increased three- to five-fold, with teams beginning to carry out work with a diversity of family members, in diverse ways and with diverse positive outcomes. In a number of cases, teams were encouraged to institute new family-friendly procedures, for example changes to appointment letters, assessments and design of waiting and counselling rooms. Lessons have been learnt, including the need to accommodate different levels of initial experience of working with family members, and the need to be clear about project aims and objectives. Sustainability of change remains an issue. A general conclusion is that the capacity of services to take on work with family members affected by substance misuse of close relatives varies greatly. Where organizations already have a mission to involve family members, capacity is good. Where alcohol and drug services have previously been focused on individuals who are misusing substances, change is difficult but can be achieved. For most non substance-specialist organizations, such as primary care health centres and most non-statutory organizations, capacity is very limited. In addition to training and continued support for practitioners, explicit commissioning of work with family members combined with management support is necessary
The 5-Step Method: Future directions
No full textThe final contribution to this special supplement of Drugs: Education, Prevention and Policy draws together some of the points that have been made in the other contributions regarding future directions which are needed in the further development of the 5-Step Method. These include: more detailed theoretical developments; testing the suitability of the method for particular groups of affected family members, including young people and those experiencing particularly complex problems including domestic violence; further study of different ways of delivering the intervention including those that are web based; new research with larger samples and longer follow-up; the inclusion of types of families missing from the studies so far, including reconstituted families, gay and lesbian families, and families with more than one substance misuser; and further investigations of the costs associated with the family impacts of alcohol and drug problems, as well as cost-benefit studies of the 5-Step Method. Although much remains to be done, the programme of research carried out to date in the UK, Mexico and Italy has only strengthened our commitment and passion for this area of work. We believe the evidence accumulated in support of approaches such as the 5-Step Method is already sufficiently compelling that they should be implemented without waiting for further detailed research evidence
Increasing the involvement of family members in alcohol and drug treatment services: The results of an action research project in two specialist agencies
No full textAn evaluation of a two-year project that aimed to move the practice of two specialist substance misuse treatment teams towards greater involvement of family members. Success was evaluated using a combination of: detailed process notes of all project meetings and events, collection of practice case examples, an inventory of new team procedures, individual interviews with team members, end of project focus groups, a final auditing of the involvement of family members, and completion of the attitudes to addiction-related family problems questionnaire (AAFPQ) before and after the project. Audit and AAFPQ data were also obtained from comparison teams. The conclusion is drawn that the project was successful in changing team practice in the desired direction: by the end of the project both teams were capable of acting as demonstration sites for family-oriented alcohol and drug problems treatment. The paper includes details of the family work conducted and its perceived benefits. Also discussed are the initial barriers to family involvement, a number of issues that remained unresolved, and the question of whether such changes are sustainable
