Psychosocial Interventions to Improve Psychological, Social and Physical Wellbeing in Family Members Affected by an Adult Relative’s Substance Use: A Systematic Search and Review of the Evidence

The use of alcohol and drugs is a significant public health concern and is prevalent in families. Over 100 million people are thought to be affected by a close relative's substance use, with many experiencing negative health and social consequences. Additional associated stressors, such as interpersonal conflict, financial issues, the burden of care, and family conflict, frequently increase the multi-dimensional impact of substance use. Moreover, there is evidence of a link between substance use and intimate partner violence and abuse, both in the offender and the victim, as well as a link between severe substance use and the severity of violence. Children are particularly sensitive to the consequences of a family member's substance use, especially if the substance user is their parent, with evidence of an association with a wide range of harms including abuse and neglect.

The aim was to examine the international literature for effective interventions to enhance the wellbeing of family members affected by an adult relative's substance use, using rigorous systematic techniques to seek and assess the evidence. The goal was to figure out what kind of treatments were utilised and what was known about their influence on their psychological, social, and physical well-being.

Following the systematic search and review strategy, the evidence was synthesised narratively by intervention type. 65 articles were found that met the inclusion criteria (from 58 different trials). For each database, a search strategy based on key words, thesaurus headings, Boolean, and proximity operators was developed and implemented.

The majority of intervention studies that are delivered exclusively or jointly to affected family members focus on reducing substance use. Families are typically included in therapy as a method of influencing change in the target user. These treatments fall short of meeting the requirements of the family and the multi-dimensional effects of substance abuse, including the long-term effects on the family's psychological and social well-being. An adult relative's substance use has a significant influence on the family. It is evident that treating substance use is a critical first step in the family's recovery.

As a result, behavioural treatments delivered in collaboration with the drug user and affected family members have been shown to improve the social well-being of family members (reducing intimate partner violence, enhancing relationship satisfaction and stability and family functioning). An adjacent individually targeted therapy intervention component may provide psychological benefit to affected adult family members. There is a need for research that develops and assesses therapies aimed at addressing the multiple multidimensional challenges that many families dealing with drug abuse face. More study is needed to evaluate the effectiveness of a multi-component psychosocial intervention that aims to help both the substance user and the affected family members, with equal focus upon their needs.