Families are experts in their loved one’s needs, and must be included in systems of care.

An article has been written showcasing the integral role that families have in providing ‘essential insider expertise’ and why it is so important that a shift towards family inclusive care happens.

About the author:

Stephanie is a professor at Vancouver Island University teaching child, youth and family counselling. Through her small private counselling practice, she works with families impacted by substance use and people involved with substances. In 2017, Stephanie lost her younger brother to stigma and drug poisoning. She fulfills her role as his big sister through research advocacy and social justice work

“I have learned from my research and practice that families often hold important understandings of past and present, essential insider expertise and deep investments in the long-term well-being of their loved ones. Within the enduring and escalating drug poisoning catastrophe, families have become first responders, social justice advocates and critical links to harm reduction resources, treatment pathways and care.

Despite their importance, family members are not always recognized and engaged as core team members in a loved one’s care. Nor do they always have access to the resources they need to support their own health and longevity as carers.” – Stephanie McCune, RCC, PhD

Summary of findings:

  1. Hitting Walls
    • Families often describe encountering walls and barriers when accessing resources for and alongside, a loved one involved with substances.
    • These walls are structures of stigma built on a complex foundation that includes:
    • politically-informed drug legislation, including criminalization of people who use drugs
    • individualistic biomedical treatment approaches
    • inaccessible and expensive resource pathways, including privatized treatment programs
      • When treatment approaches ignore the richer context around the person (including the family) families are at an increased risk of distress affecting mental and physical well-being, financial hardship, isolation and secrecy
  1. A way through for families
    • A broader definition of families is required to dismantle the walls shaped by social, cultural and political norms and lenses.
    • Such lenses influence ideas about: who is family, who might help a loved one and who is recognized as impacted by substance use.
    • A narrow lens based solely on biological relations overlooks the influence of others who play caring roles in an individual’s daily—and pivotal—life experiences.
    • Families must be understood as a wide circle that includes both biological and chosen family.
    • Family can be the people in a loved one’s circle of care who contribute love, connection, and closeness.
    • Families can include loved ones in parenting roles, siblings, aunties, uncles, Elders, children, street sisters/brothers/parents and even pets.
    • By advocating for recognition of broader circles of support, those named as family can be more easily identified as important contributors to care and can play a pivotal role in service provision and the impact of this care on families can be acknowledged.
  1. Updating standard practice
    • Family inclusion must become standard practice
    • Including families in early treatment interventions can impact loved ones by increasing engagement in substance use programming, contributing to higher program completion rates and reducing rates of relapse.
    • Updating standard practice requires organisational commitment to broad cultural shifts.
    • Such shifts would mean expanding from individualistic practices to a wider “relationship-centred” lens that sees and seeks families as their loved ones access care
    • Family inclusion is a necessary means to foster wellness for loved ones accessing services:
      • Inclusion helps with resourcing authentic sources of support and safety (e.g., making interventions more accessible, available, and culturally meaningful, with therapeutic, family-specific support groups).
      • Family inclusion also proactively addresses the intergenerational impacts of substance use (e.g., exposure to fatal and non-fatal drug poisoning).
  1. Help for Carers
    • The ability for families to connect with others, including formal helping professional and people with living experiences is emotionally supportive.
      • Family members experience a safe, meaningful way to receive non-judgment, encouragement, and recognition.
    • When family members are heard, without directives or advice, families can be valued for their unique ideas, wishes, beliefs and responses to substance use
    • Spaces, places, offices and offerings for families to address the impacts of substance use are a necessary component of a robust system of care that positively enhances capacity, ability and resilience.
  1. Some concrete steps towards making families ‘insider experts’:
  • publicly-funded access to family and couples counselling
  • publicly-funded and supported outreach to family homes
  • programs for children affected by substance use, including fatal and non-fatal drug poisonings
  • publicly-funded, family-informed treatment programs, including aftercare and post-treatment support
  • individual and group counselling for family members impacted by substance use
  • follow-up with people and loved ones after non-fatal drug poisoning events, including hospitalizations
  • access to culturally-informed, harm reduction–based and trauma-informed programs that centre diverse perspectives on substance use
  • family-centred policies that address barriers in the areas of funding, consent, confidentiality, transportation, childcare, hours of operation and program philosophies, to name a few

“For many families, the reality of the roller coaster can be ongoing. However, with family-informed, relevant and accessible support, families can get help to hold on—and hang on to hopefulness. They sense they will have the capacity to react and respond at each point. For me, this has often come through powerful moments of connection and care held by people with shared experiences, To be seen, heard and recognized as mattering is the medicine to the suffering that all too often comes from isolation.

I cannot overstate the importance of a broad cultural shift towards family inclusion. Organizations, programs and direct service experiences should centre relational, strengths-based and capacity-focused ways of working with, and alongside, those in family roles. Families affected by substance use must be viewed as insider experts, invaluable carers and voices to be heard.” – – Stephanie McCune, RCC, PhD

Article sourced online Here to Help Vision Journal, reprinted from the Families, Friends and Substance Abuse issue of Visions Journal, 2024, 19 (2), pp. 8-10

To read the full article go to: https://shorturl.at/rH026

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