Family Empowerment Project provides therapy for substance use

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People in rural Australia experience a disproportionate level of physical and psychological harm related to drug and alcohol use than their urban counterparts. Comorbid substance use and mental health disorders can negatively impact family members - increasing their burden of care and family conflict. Yet, despite this, few drug and alcohol services provide support to family members. In 2022, only 8.1% of Australians receiving treatment or support for substance use were family or friends.

Community Reinforcement and Family Training (CRAFT) is an evidence-based talking therapy which works with the family and friends of people struggling with substance use. CRAFT utilises techniques from Cognitive Behavioural Therapy (CBT) and Motivational Interviewing (MI); teaching family members safe removal of positive reinforcement for problematic substance use behaviours while increasing positive reinforcement for non-using behaviours. Importantly, CRAFT also aims to increase the family members’ own social and emotional well-being.  

Despite extensive use of CRAFT in the United States of America, this program is not routinely offered in Australia. Thus, family members in Australia have few options available.  With funding from the Australian Government Department of Health and Ageing, we are providing online support to family members living in rural Australia through the delivery of the CRAFT program. Leading this project is Associate Professor Julaine Allan (Rural Health Research Institute at Charles Sturt University) who has extensive experience in drug and alcohol research. The CRAFT program has been renamed the Family Empowerment Program for this project.

To provide the Family Empowerment Program, psychologists from rural New South Wales and Victoria completed a two-day training course. Psychologists were guided through how to apply practical strategies including goal setting and achievement, developing pro-social behaviours to replace activities related to substance use, and encouraging improved relationships with family and peers. Participating psychologists are undertaking supervised practice to receive internationally recognised accreditation in the program.

To advertise the Family Empowerment Program, a recruitment campaign took place on Facebook and Instagram over three weeks during the Christmas period of 2023-2024 with 1,502 people clicking on the project information. This recruitment campaign will continue to run throughout 2024.

Currently, 99 people have requested to be included in the Family Empowerment Program. After completing eligibility screening, the program has accepted 45 active participants. Most participants are Caucasian woman, aged 45-65. Participants live throughout rural Australia and previously had not accessed any support services. Participants attend six online sessions over six weeks, with the opportunity to attend two additional sessions if required. Participants work through building motivation and self-care, positive communication, positive reinforcement, problem solving, natural consequences and helping their loved one to seek help. Throughout their involvement, participants will complete three questionnaires seeking to understand the effectiveness of the Family Empowerment Program.

Feedback from both psychologists and participants has been extremely positive. Psychologists have communicated the importance of caring for and involving families in the care of someone using drugs and alcohol. They have also reported how useful the sessions and new skills have been with some of them having a structure to address substance use problems for the first time in their practice.

This research project is the first of its kind addressing this underserviced area of need. Subsequent data will complement data from previous projects from Australia and the USA. Importantly, this research project can inform future health system policy by providing a clearer understanding of the importance of online care for rural families of people with substance dependance and mental illness.

Recruitment will continue until October 2024. If you’d like access to this program, please go to Family Empowerment Program - Rural Health Research Institute (csu.edu.au)

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