Drug and alcohol services - improving holistic family support

Annex B

The principles of Whole Family Approaches across Scotland – what families think about what needs to be done

The Ask the Family work has powerfully shaped the approach and content of the values that should drive the development and expansion of family support services. Their voices urge public services to work together and commission services at local level that can meet the needs of families and a common set of outcomes, making the best use of local resources as well as new investment.

The Ask the Family work gives us crucial insights into what families are looking for from their support workers, including showing their human side, honestly challenging them, and being "invested in helping" (see figure 1). The need for our workforce development approach to invest in, grow and sustain this skilled and confident group of staff across the country is one of the most important drivers that requires our attention – as is the need to recognise lived experience as a key qualification to complement other skills and abilities.

Family support services need to offer safe spaces where people can connect with each other and share peer to peer support. Family inclusive practice across all services needs to find ways of addressing the negative experiences of families in relation to their inclusion in their loved one's care and treatment. As one participant reminded us:-

"As a person in recovery from addiction, I can see the benefits of having a strong family support network around you to get support. This is only possible when the families of addicts are also supported to recover."

One significant aspiration picked up throughout Ask the Family was the need to address the issue of visibility and speed of response of family support, given the often huge delays in both seeking and receiving help for families affected by substance use. The need to have grounded, relationship-based and asset-based services which modelled inclusion, hope, respect and a non-judgemental approach was a constant area of focus.

Figure 1

Overarching Principles

• Free from stigma and judgement
• Help and support is available to individual family members in their own right
• Fosters hope and positivity
• Children's rights
• Family rights
• Connecting with others with the same experience; peer support
• Visible family support and recovery
• Included in loved one's treatment and care (family inclusive practice)

Workforce

• Able to work holistically with the whole family
• Driven by positive family values and a positive inclusive ethos
• Need to understand trauma
• Listen (take time and show interest)
• Friendship; be like a friend; relatable; use everyday language
• Honesty and openness (e.g. being blunt, direct, brave, assertive, challenging)
• Helping; "invested in helping"
• Be yourself; show your human side; open up about yourself
• Humour
• Empathy (not sympathy); understanding of the person's experience
• Kindness; consideration; caring; nurture
• Workers openly demonstrate and share knowledge and skills
• Team approach with family; "a two way street"

Services

• Focus on people's individuality, strengths and assets
• Swift and responsive; continually improve accessibility and availability; "there when I need it"; "no postcode lottery"
• Collaborative multi-agency approaches; "Joined up thinking"
• Empowering families to "reach in" for support, not just be referred by others
• Holds on until a family feels sufficiently ready to move on; "stickability"; "never gives up"
• Providing respite/ relaxation/ escape
• Choices and options (including how we are supported and by whom)
• Help and support as soon as you need it (early intervention)
• Help to navigate other areas of family stress, e.g. school, social work
• Support outside of the family; independent of the family
• Lived experience as a qualification/ Learning from lived experience

Models of Whole Family Practice

• Trusted relationship
• Holistic approach; "Look at the whole person"
• Offer access to other supports such as food, financial
• Engaging the voice of families at every stage
• Mutual respect
• Offer consistent support for woman (parents) where children have been removed
• Safe space to talk and open up
• Leads to change in my life; makes me feel better
• Time and Patience (going at our pace); recognise change can be hard work for families
• Support families to have fun
• Support to grow knowledge and skills
• Goal setting and structure; solutions-focused
• Support to build confidence and self-esteem; reassuring
• Support me to advocate and make decisions for myself
• Equality between family and worker (on the same level)
• Love and belonging; feeling valued and worthwhile