“You Don’t Get That from Professionals”: A Consumer-Led Peer Recovery Program for Families and Friends of Individuals with Alcohol and Other Drugs Use Issues in Darwin
Abstract
:1. Introduction
1.1. The Landscape of Substance Use
1.2. The Harm Caused by Substance Use
1.3. Stigma and Challenges Experienced by Families
2. Materials and Methods
2.1. Aims and Objectives
2.2. Evaluation Design
2.3. Sample and Recruitment
2.4. Data Analysis
3. Results
3.1. The Value of A Peer-to-Peer Approach
“At the start, I thought that I don’t…I can’t have this opportunity [to seek help for myself] because I have to support them …you always have to worry and…your priority is to help them.”(PP7)
“[I decided to] sign up to be a member of [the program] just to sort of keep in touch with what goes on in the world in regard to supporting people with lots of issues. My expectation was to learn and understand more about the issues…”(PP5)
“The peer connection and support [were] the most important. You felt safe. You felt that you were not alone…you knew that you could trust them… no judgmental and all that…it was the best thing that I [could] do for myself.”(PP7)
“100% satisf[ied], the contents being fantastic. You know, [it] touched on some really, really good themes…I can learn from peer people with shared experience and from conversations with people who have similar backgrounds and are willing to be vulnerable and open about their backgrounds and share what they know from a deep place of understanding, [which] is really valuable. You don’t get that from professionals.”(PP1)
“Darwin’s a small place; you may know people that come along…day one we had people coming in…[and] there was a [person] that I used to work with… [this person] got up and went outside… I guess it is the stigma that [this person] might feel and also that confidentiality… [this person] had an issue with trusting… it was just unfortunate… shame or stigma or trust.”(PP5)
3.2. Facing Challenges and Distress
“I felt incredibly isolated… and I didn’t really know where to turn for help…. I did not know what the future possibly could look like… And I think just probably like it an overall feeling of just being overwhelmed.”(PP4)
“…trying to explain it to family…this sort of shame and guilt and all the things that come around it… I just found it really difficult to talk to [them] about the situation… that was quite sort of distressing as well”(PP4)
“In the beginning, I wasn’t confident I was actually scared.”(PP6)
“I try to [have a break], then some days there are no breaks because you have to [be] there as a carer.”(PP1)
3.3. Adopting Self-Care Strategies
“No concept of [self-care] at all. And in fact, in the [Circles of Support] classes, we joke about how I’m learning about self-care now… Yeah, it was just the way life was. It was the way I was brought up. It’s the way things were. You just got on with it… I’ve learned that there are minor forms of self-care…That I’ve been practising, but nothing like I heard in the group from participants and the facilitators.”(PP3)
“I’m engaging with…[an] employee assistance program… So, I reach out, I know [how] to reach out….”(PP2)
3.4. Development of Valuable Skills
“The post-traumatic growth, which is something we all learned about in the Circle [of Support program], and everybody latched onto it. Wow, that’s fantastic. [one participant] was the only one who’s heard of it before because [they have] done classes with [the lived experience network]… And it’s something I knew intuitively and that it gives me the resilience that I have because I can keep taking the knocks and that they might knock me down for a day or two. However, then I’m back at it.”(PP3)
“Stages of change [for families]… as soon as I saw [it]..that is our family. That’s exactly…sort of what way we’re going through so…[it] was kind of revolutionary to me because it just suddenly very clearly mapped out the journey that we’ve been on, and I guess it’s comforting to know because it all just feels so chaotic when you’re in the middle of it. It was kind of comforting to know; Oh, there’s a psychology behind this as well. And that’s what we’ve all been through…”(PP4)
“Articulating that what’s within our control and outside of our control, which is about our thinking, was certainly a fundamental piece for me—and reinforcing that about the ways to think about the person who is mentally ill or dependent on alcohol. A lot of what they’re doing is entirely out of our control. And therefore, where we can focus our energy and attention on what aligns with our values…”(PP1)
“I get stuck on [with self-care activities]… what that looks like, and you think I just have a warm shower or go for a walk and just forgetting that… [however] there’s a lot of other things that you can do to nurture yourself so that looking at that list [we received in the program] and picking some of those things out and seeing what works on a daily basis…one size doesn’t fit all, so it’s just working out what will work for me.”(PP5)
“I have a really troubled way of communicating with one of my [children], and we seem to buttheads no matter what we do, it always ends in an argument… So I think, you know, really looking at that communication with [them] and how I could change that… stopping and reflecting and having a good look at myself and how I communicate, not just putting it all on [them] and [their] addiction, but you know how I possibly become part of the problem when trying to have this communication.”(PP5)
“……if you are a rescuer, then…you blur the boundaries because you wanna fix…you wanna help, but actually you’re making it worse because you’re increasing the dependency. So, the work in boundary setting and communicating the boundaries [are very important] so that you get what you need out of life.. Every day, they need to be set and set and set.”(PP1)
“If times get tough again with my [child] that, I will know how to reach out…. Particularly to the lived experience network. I think that’s really that was a key learning I think… finding out that some people can support navigate the system…[and] understanding about rights and responsibilities and things like that within the system that we, we have to negotiate… I’ve felt a bit more empowered in that, and so when we were going through the [service] stuff recently, it was just incredibly, you know, people can be very patronising to [my child] and ignore [my child’s] right…. Advocating for [my child] and making sure that is [treated], you know, with respect.”(PP4)
“[the facilitators] worked hard on the values piece…and aligning our behaviours, oursel[ves], gratitude with our values…once you know that your values are aligned…[your] thinking blinds up. You experience that tension when you’re going away from values, so they worked hard with that, creating the boundaries.”(PP1)
4. Discussion
Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Tari-Keresztes, N.; Smith, J.; Gupta, H. Follow-Up Evaluation of the Peer-Led Education Pilot in Darwin; Menzies School of Health Research: Darwin, Australia, 2021. [Google Scholar]
- Tari-Keresztes, N.; Armstrong, N.; Smith, J.; Gupta, H.; Goding, S.; Endemann, S.A.; Mulholland, K. Supporting Family Members’ and Friends’ Individual Recovery with a Locally Co-Designed Peer-Led Recovery Program in Darwin; Flinders University: Darwin, Australia, 2022. [Google Scholar]
- National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol; National Health and Medical Research Council: Canberra, Australia, 2020.
- Australian Bureau of Statistics. Alcohol Consumption; ABS: Canberra, Australia, 2020–2021.
- Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2019; AIHW: Canberra, Australia, 2020.
- Smith, J.; Livingston, M.; Miller, P.; Stevens, M.; Griffiths, K.; Judd, J.; Thorn, M. Emerging alcohol policy innovation in the Northern Territory, Australia. Health Promot. J. Aust. 2019, 30, 3–6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Department of Attorney-General and Justice. Northern Territory Wholesale Alcohol Supply 2010 to 2017; Northern Territory Government: Darwin, Australia, 2018.
- Smith, J.; Whetton, S.; d’Abbs, P. The Social and Economic Costs and Harms of Alcohol Consumption in the NT; Menzies School of Health Research: Darwin, Australia, 2019. [Google Scholar]
- AIHW. National Drug Strategy Household Survey (NDSHS) 2016—Key Findings. Available online: https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-key-findings/contents/summary (accessed on 3 February 2023).
- Lander, L.; Howsare, J.; Byrne, M. The impact of substance use disorders on families and children: From theory to practice. Soc. Work Public Health 2013, 28, 194–205. [Google Scholar] [CrossRef] [PubMed]
- The Role of the Family in Alcohol & Other Drug Treatment. Available online: https://www.sharc.org.au/wp-content/uploads/2021/02/The-Role-of-the-Family-in-AOD-Treatment.pdf (accessed on 24 January 2023).
- Hill, T.; Thomson, C.; Raven, M.; Wong, M.; Cass, B.; Yeandle, S.; Buckner, L. Carers and Social Inclusion: Summary Report; Social Policy Research Centre, UNSW Australia: Sydney, Australia, 2016. [Google Scholar]
- Sanders, R. ESSS Outline: Carer Mental and Physical Health; Iriss: Glasgow, UK, 2020. [Google Scholar]
- Mental Health Carers NSW. Carers with Alcohol & Drug Misuse Issues. Distinction between Carers of a Person with Substance Misuse Issues and Carers with Substance Misuse Issues, Position Statement; Mental Health Carers NSW: Sydney, Australia, 2018. [Google Scholar]
- Centre for Change Governance; NATSEM University of Canberra. Caring for Others and Yourself: The 2021 Carer Wellbeing Survey; Carers Australia: Canberra, Australia, 2021.
- Marshall, O. Associative Stigma among Families of Alcohol and Other Drug Users; Edith Cowen University: Western Australia, 2013. [Google Scholar]
- Corrigan, P.; Watson, A.; Barr, L. The self-stigma of mental illness: Implications for self-esteem and self-efficacy. J. Soc. Clin. Psychol. 2006, 25, 875–884. [Google Scholar] [CrossRef]
- Ogunmefun, C.; Gilbert, L.; Schatz, E. Older female caregivers and HIV/AIDS-related secondary stigma in rural South Africa. J. Cross Cult. Genterology 2011, 26, 85–102. [Google Scholar] [CrossRef] [Green Version]
- Goffman, E. Stigma: Notes on the Management of Spoiled Identity; Simon & Schuster: New York, NY, USA, 1963. [Google Scholar]
- Mehta, S.; Farina, A. Associative stigma: Perceptions of the difficulties of college-aged children of stigmatised fathers. J. Soc. Clin. Psychol. 1988, 7, 192–202. [Google Scholar] [CrossRef]
- Mak, W.; Cheung, R. Affiliate stigma among caregivers of people with intellectual disability or mental illness. J. Appl. Res. Intellect. Disabil. 2008, 21, 532–545. [Google Scholar] [CrossRef]
- Koschorke, M.; Padmavati, R.; Kumar, S.; Cohen, A.; Weiss, H.A.; Chatterjee, S.; Pereira, J.; Naik, S.; John, S.; Dabholkar, H.; et al. Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India. Soc. Sci. Med. 2017, 178, 66–77. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Quinn, D.; Chaudoir, S. Living with a concealable stigmatised identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. J. Personal. Soc. Psychol. 2009, 97, 634–651. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Heitz, D. Caregiving at What Price? Coping with Drugs and Alcohol While Taking Care of Mum or Dad. Available online: https://skywoodrecovery.com/caregiving-at-what-price-coping-with-drugs-and-alcohol-while-taking-care-of-mom-or-dad/ (accessed on 27 January 2023).
- Bradshaw, S.; Shumway, S.T.; Wang, E.W.; Harris, K.S.; Smith, D.B.; Austin-Robillard, H. Hope, Readiness, and Coping in Family Recovery From Addiction. J. Groups Addict. Recovery 2015, 10, 313–336. [Google Scholar] [CrossRef]
- McArdle, E.; Stull, L. Anxiety and Depression in Family Members of People Struggling with Addiction. Mod. Psychol. Stud. 2018, 23, 10. [Google Scholar]
- McCann, T.V.; Lubman, D.I. Help-seeking barriers and facilitators for affected family members of a relative with alcohol and other drug misuse: A qualitative study. J. Subst. Abuse Treat. 2018, 93, 7–14. [Google Scholar] [CrossRef] [PubMed]
- Carers NSW. 2020 National Carer Survey: Summary Report; Carers NSW: Sydney, Australia, 2020. [Google Scholar]
- Carers NT. Carer Gateway Services. Available online: https://www.carersnt.asn.au/services/carer-gateway-icss/ (accessed on 16 January 2023).
- Beales, A.; Wilson, J. Peer support–The what, why, who, how and now. J. Ment. Health Train. Educ. Pract. 2015, 10, 314–324. [Google Scholar] [CrossRef]
- Australian Health Ministers’ Advisory Council. A National Framework for Recovery-Oriented Mental Health Services: Guide for Practitioners and Providers; Commonwealth of Australia: Canberra, Australia, 2013.
- Department of Health. The Fifth National Mental Health and Suicide Prevention Plan; Department of Health: Canberra, Australia, 2017.
- Self Help Addiction Resource Centre (SHARC). Annual Report 2021–2022; Self Help Addiction Resource Centre: Melbourne, Australia, 2022. [Google Scholar]
- Wellways. Annual Review; Wellways: Melbourne, Australia, 2022. [Google Scholar]
- Family Drug Support. Annual Report 2019–2020; Family Drug Support: Leura, Australia, 2020. [Google Scholar]
- Tari-Keresztes, N.; Smith, J.; Gupta, H.; Aanundsen, D. Evaluation of the “Professionalising the NT Peer Workforce and Expanding Peer Supports for Territorians Who Experience Mental Health Challenges” Project; Flinders University: Darwin, Australia, 2022. [Google Scholar]
- Tari-Keresztes, N.; Christie, B.; Gupta, H.; Wallace, T.; Stephens, D.; Caton-Graham, P.; Smith, J. Evaluation of a Peer-Led Education Pilot for People with Psychosocial Support Needs in Darwin, Northern Territory; Menzies School of Health Research: Darwin, Australia, 2020. [Google Scholar]
- Northern Territory Mental Health Coalition. 2018–2019 Mental Health Peer Support Workforce Needs Assessment. Report to NT Primary Health Network; NT: Darwin, Australia, 2019. [Google Scholar]
- Primary Health Network. Peer Workforce Role in Mental Health and Suicide Prevention. Available online: https://www.health.gov.au/resources/publications/primary-health-networks-phn-mental-health-care-guidance-peer-workforce-role-in-mental-health-and-suicide-prevention?language=en (accessed on 18 January 2023).
- Rowe, C. Family Therapy for Drug Abuse: Review and Updates 2003–2010. J. Marital. Fam. Ther. 2012, 38, 59–81. [Google Scholar] [CrossRef] [PubMed]
- Hayes, L. Effective, Evidence-Based Psychosocial Interventions Suitable for Early Intervention in the National Disability Insurance Scheme (NDIS): Promoting Psychosocial Functioning and Recovery; The Centre for Mental Health, Melbourne School of Population and Global Health: Melbourne, Australia, 2016. [Google Scholar]
- Health Workforce Australia. Mental Health Peer Workforce Study; Health Workforce Australia: Adelaide, Australia, 2014.
- Tari-Keresztes, N.; Girdler, X.; Gupta, H.; Clarke, B.; Christie, B.; Smith, J.; Armstrong, N.; Harris, V. ‘Like a family in the end’: Improving mental health Recovery skills through Peer-to-Peer communication in Darwin, Australia. Health Soc. Care Community 2022, 30, e5336–e5345. [Google Scholar] [CrossRef] [PubMed]
- Australian Bureau of Statistics. Disability, Ageing and Carers, Australia. Available online: https://www.abs.gov.au/statistics/health/disability/disability-ageing-and-carers-australia-summary-findings/latest-release%20Accessed%20June%202021 (accessed on 11 January 2023).
- Australian Institute of Health and Welfare. Australia’s Health 2018: In Brief; Cat. no. AUS 222; Australian Government: Canberra, Australia, 2018.
- Braun, V.; Clarke, V. Thematic analysis. In APA Handbook of Research Methods in Psychology, Vol. 2. Research Designs: Quantitative, Qualitative, Neuropsychological, and Biological; American Psychological Association: Washington, DC, USA, 2012. [Google Scholar]
- Corbin, J.; Strauss, A. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory; Sage Publication: Sauzendeoaks, CA, USA, 2014. [Google Scholar]
- Tari-Keresztes, N.; Gupta, H.; Smith, J. Evaluation of the Two Ways Workforce Mentoring Program; Menzies School of Health Research: Darwin, Australia, 2022. [Google Scholar]
- Tedeschi, R.G.; Calhoun, L.G. Posttraumatic Growth: Conceptual Foundations and Empirical Evidence. Psychol. Inq. 2004, 15, 1–18. [Google Scholar] [CrossRef]
- Family Drug Support. The Stages of Change for Families. Available online: https://www.fds.org.au/ (accessed on 9 January 2023).
- Covey, S. 7 Habits of Highly Effective People; Free Press: New York, NY, USA, 1989. [Google Scholar]
- Mind. How can Supporting Someone Else Affect Your Mental Health? Available online: https://www.mind.org.uk/information-support/helping-someone-else/carersfriends-family-coping-support/your-mental-health/ (accessed on 3 February 2023).
- Lee, K.M.; Manning, V.; Teoh, H.C.; Winslow, M.; Lee, A.; Subramaniam, M.; Guo, S.; Wong, K.E. Stress-coping morbidity among family members of addiction patients in Singapore. Drug Alcohol Rev. 2011, 30, 441–447. [Google Scholar] [CrossRef] [PubMed]
- Orford, J.; Copello, A.; Velleman, R.; Templeton, L. Family members affected by a close relative’s addiction: The stress-strain-coping-support model. Drugs Educ. Prev. Policy 2010, 17 (Suppl. S1), 36–43. [Google Scholar] [CrossRef] [Green Version]
Variable | Frequency (%) |
---|---|
Gender | |
Male | 25.0 |
Female | 68.75 |
Other | 6.25 |
Age Category | |
18–24 yrs | 6.3 |
25–34 yrs | 6.3 |
35–44 yrs | 25.0 |
45–54 yrs | 31.3 |
55–64 yrs | 18.8 |
65+ yrs | 12.5 |
Country of birth | |
Australia | 75.0 |
Other | 25.0 |
The main language spoken at home | |
English | 100.0 |
Other than English | 0.0 |
Aboriginal and Torres Strait Islander | |
No | 87.5 |
Aboriginal and Torres Strait Islander | 12.5 |
Highest level of education | |
Less than Year 12 | 0.0 |
Year 12 or equivalent | 18.8 |
Vocational education | 25.0 |
Diploma course | 6.3 |
Bachelor’s degree | 37.5 |
Postgraduate degree | 12.5 |
Employment | |
Employed | 62.5 |
Self-employed | 12.5 |
Student | 6.3 |
Unemployed | 0.0 |
Unable to work | 0.0 |
Retired | 6.3 |
Other | 12.5 |
Relationship status | |
Single | 43.8 |
Relationship | 0.0 |
Married/de facto | 50.0 |
Other | 6.3 |
Number of children | |
0 | 25.0 |
1 | 12.5 |
2 | 31.3 |
3 | 18.8 |
4 | 12.5 |
Relationship with the person they care for | |
Partner | 25.0 |
Parent | 31.3 |
Child | 12.5 |
Sibling | 25.0 |
Other | 6.3 |
Caring for more than one person | |
Yes | 25.0 |
No | 75.0 |
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Tari-Keresztes, N.; Armstrong, N.; Smith, J.A.; Gupta, H.; Goding, S.; Endemann, S.-A. “You Don’t Get That from Professionals”: A Consumer-Led Peer Recovery Program for Families and Friends of Individuals with Alcohol and Other Drugs Use Issues in Darwin. Int. J. Environ. Res. Public Health 2023, 20, 5514. https://doi.org/10.3390/ijerph20085514
Tari-Keresztes N, Armstrong N, Smith JA, Gupta H, Goding S, Endemann S-A. “You Don’t Get That from Professionals”: A Consumer-Led Peer Recovery Program for Families and Friends of Individuals with Alcohol and Other Drugs Use Issues in Darwin. International Journal of Environmental Research and Public Health. 2023; 20(8):5514. https://doi.org/10.3390/ijerph20085514
Chicago/Turabian StyleTari-Keresztes, Noemi, Noelene Armstrong, James A. Smith, Himanshu Gupta, Sam Goding, and Sal-Amanda Endemann. 2023. "“You Don’t Get That from Professionals”: A Consumer-Led Peer Recovery Program for Families and Friends of Individuals with Alcohol and Other Drugs Use Issues in Darwin" International Journal of Environmental Research and Public Health 20, no. 8: 5514. https://doi.org/10.3390/ijerph20085514