design and implementation of web-based support for passive drinkers
DESCRIPTION
Design and Implementation of Web-based Support for Passive Drinkers. by Akan Ibanga, Alex Copello , Jim Orford , Lorna Templeton and Richard Velleman. The Riddle. - PowerPoint PPT PresentationTRANSCRIPT
Design and Implementation of Web-
based Support for Passive Drinkers
by
Akan Ibanga, Alex Copello, Jim Orford, Lorna Templeton and Richard Velleman
The Riddle
“If I do not drink (or my drinking is so inconsequential it would go unnoticed), but will still be feeling the effects of a hangover long after it has worn off the binge drinker, Who Am I ? “
More importantly “Is There Help For Me?”
Society Larger SocietyFriends
Friends
Family
Family
Individual
The Ripple Effect
Out of court settlements
Should Affected Others be the Focus?
Cross cultural evidence
Behaviour of individuals with a drug problem
Impact is irrespective of age or gender
Difficulty to cope in ways that makes life more manageable
Taking Census: of passive drinkers?
Current Treatment focus
Focus almost solely on issues of screening, identifying, and intervening briefly or otherwise, with the individual alcohol and drug misuser.
Only involve the family members, to encourage or provide support to the user for entry into and retention in treatment (Velleman & Templeton,
2002, Copello and Orford, 2002).
When considering brief interventions for alcohol or drug problems, this gap in service provision for family members is much wider
Theoretical failureTheoretical failure•Individual ModelsIndividual Models
•Critical, pathologising Critical, pathologising modelsmodels
•Ambiguous modelsAmbiguous models
•Partial modelsPartial models
Practical failurePractical failure
•Attitude of SDA workerAttitude of SDA worker•In working with FNMIn working with FNM
•To enlist family and To enlist family and network support network support
for changefor change
FAILURE TO INCLUDE FAMILY AND NETWORK
Stress-strain-coping-support model.
Stress –living in a family where someone misuses alcohol or drugs is commonly very stressful
Strain- Family members who are concerned are likely to show signs of strain including physical and psychological ill-
health
Coping-Family members will seek to understand what is going on and what to do about it
Support from others -These members can be help or hindered depending on how other people react
ADF Perspective
Contrast with other Models
• Family/affected others are seen differently
• Places affected others, and not the substance user at the center of interest
• Focus on present circumstances and actions
• Focuses on the needs of the affected others
• Provides a model of intervention
Copello, Templeton et al. (5-STEPS) – Copello, Templeton et al. (5-STEPS) – family member focusedfamily member focused
Step 1Step 1
Step 2Step 2
Step 3Step 3
StepStep 4
Step 5Step 5
Listen non-judgmentally
Addresses fears and misunderstandings
Explores responses and coping mechanisms
Examines available social support
Probes further help and referral
Our Work So Far• Face-to-face delivery where the various health professionals (Gps,
Health Nurses, Counselors) were trained to delivery of intervention evaluated.
• Delivery to special populations (BMEs) was evaluated
• Whole teams/ organisations were trained and supported to make changes in delivery of services to include or be more focused on the affected other.
• Self-help manual was later developed, a version of which was
tested in a clustered randomized trial in primary care. Encouraging results were obtained at each of these stages
Is this intervention currently
accessible to family members?
www.alcoholdrugsandfamilies.nhs.uk
Advantage of a web-based approach
• It would provide an approach to intervention that is currently not readily available.
• It would be accessible to much wider number of family members.
• It could be accessed by anyone anywhere in the world.
• Accord a level of privacy for family members and their relations.
• Would empower individuals.
• The timing is flexible enough to fit each individual’s program.
Self-Help (SH)Manual
TransformationOf SH into
Web Format
Review
World Wide Web
Outcome evaluation
Pilot /Limited Access
Ease
Usability
Analysis
Data Collection
Appropriateness
Outcome evaluation
Outcome Measures The Family Member Impact (FMI) scale This is a 16 item scale
that measures the perceived impact that alcohol and other drug use by a relative is having on the family as a whole.
Coping Questionnaire (CQ) Assess ways in which family members have over the previous 3 months been coping with the problem drinking or drug taking relative.
Symptom Rating Test (SRT) Consist of 30 questions used to assess the extent of physical and psychological ill-health experienced each of them within the past 3 months
www.alcoholdrugsandfamilies.nhs.uk
Enter your username and the password that was sent to your email box.
Then click on the login button
Self- Help Programme
Patient information sheet, privacy policy, informed consent, Demographic questions, Assessment battery, registration
Registration
Step 2
Introduction
Exercise 4
More Information on Alcohol/ Drugs
Exercise 5a Exercise 5b
Recap
Step 3
Introduction
Exercise 6
Ways of Responding
Exercise 7
Recap
Step 1
Introduction
Examples of Stress
Exercise 2
Health Experiences of Family Members
Exercise 3Recap
Step 4
Introduction
Exercise 8
Kinds of Support
My support
Exercise 9a, b, c
Exercise 10
Recap
Introduction
Related Issues
Exercise 12
Recap
Getting Additional Help
Exercise 13
REVIEW
Step 5
Variable %GenderMaleFemale
11 (15.9%)58(84.1%)
Age of Family Member Mean=44.64 (10.07)
Age of User Mean=39.09 (13.29)
Relationship with UserFather/MotherSpouse/PartnerBrother/SisterSon/DaughterOther
4.347.85.8
27.514.5
Gender of UserMaleFemale
58(84.1%)11 (15.9%)
Main Substance Consumed by UserAlcoholDrugsBoth
62.317.420.3
Duration of Problem< 1Year1-2 Year3-5 Years6-9 years10 years
4.310.1
21.713.050.7
Demographics for WWW participants
”The programme helps challenge me to think about the specifics of what I think or feel about the issues. Providing answers to questions asked in the programme caused me to pause and think how I might feel or put into words. It is kind of difficult to put into words but it was generally positive”.
”It was a therapeutic experience online for me”.
“It makes you feel supported that somebody knows what you are going through”
”The programme is quite easy to use, intuitive and the instructions and pretty straight forward”.
”This (web-programme) makes available so much needed social support that is just not always available with every door being closed on you wherever you go. Just knowing that there is something out there is helpful”.
”In using this site you get the feeling that you are not alone that someone understands what you are going through. Further more that, the site went into how you feel and really makes you open up, it is nice to let it all out. It does not present you with a ‘yes’ and ‘no’ situation but ask you questions and requires you to think further than this, which is actually quite revealing”.
”It helped me to see that as a person I needed help”.
”Having it online is obviously the way to go as many things are now available online and people search the net for a lot of things, and as many more people are having access to the internet finding a way to provide that on the internet is a way forward”.
”It made you feel you were still a person…that you have rights….that you have a life to live as well”.
Include Social Networking, & Dating Functions?
The results of this work so far points to the fact with slight modifications to this web-based programme, one can conclude; as stated by one of the family members that:
“Having this (support) online is obviously the way to go”
ADDICTION AND THE FAMILY (ADF) GROUP
• The University of Birmingham/Birmingham and Solihull Mental Health NHS Trust Substance Misuse Service
Akan IbangaAlex CopelloClaire HampsonJim Orford
• The University of Bath Mental Health R&D Unit/Avon & Wiltshire Mental Health Partnership NHS Trust
Lorna TempletonRichard Velleman
and other colleagues who have been part of this group over the years.