Whole Family Approach: rapid review of literature

1. Introduction

Research undertaken with people with lived experience of problem alcohol and drug use and their family members indicates that harms extend beyond the person using alcohol or drugs (see Ask the Family). Family members are often involved in providing support to their loved ones who use substances, trying to keep family life going or even keeping the family together, while also being affected by an array of intersectional harms themselves.

Ms Sturgeon, in her role as First Minister, announced a national mission to reduce drug related deaths and harms in January 2021. This is supported by an additional investment of £250 million over the next parliament, with £18 million of this being made available through four funds. Of these, the Children and Families Fund has allocated £3 million to improve support and access to services for children, young people and families affected by substance use. It focuses on community-based organisations delivering frontline services with significant experience in supporting children and families affected by substance use. This fund is intended to help these organisations to sustain, stabilise or increase capacity; extend or improve services; and/or address identified gaps in service provision.

In December 2021, the Scottish Government published a framework for the implementation of Whole Family Approaches (WFAs) and Family Inclusive Practice (FIP) in Scotland: Families Affected by Drug and Alcohol Use in Scotland. This was developed through a multi-agency Whole Family Approach/Family Inclusive Practice Working Group. The Scottish Government has provided Alcohol and Drug Partnerships (ADPs) with an additional £3.5 million per year over the life of the Parliament to implement this framework locally.

As part of the working group's action plan to implement a Whole Family Approach (WFA) to address alcohol and drug-related harms, a rapid review of the evidence and best practice examples of WFAs in the context of substance use was conducted. This will support the development and delivery of Family Inclusive Practice (FIP) learning and skills development in the workforce.

This report presents the findings of the evidence review, focussing on examples of best practice in terms of family support to inform an understanding of existing WFA interventions in the context of substance use. It identifies the overarching themes and gaps in the existing literature on FIP by exploring key concepts, identifying evidence of good practice and the implications this has for the training and learning development of substance use practitioners and wider workforce.

It should be noted that whole family support, while being present in a small number of areas in Scotland, has not been embedded in local state services in the majority of areas (Scottish Government, 2021: p.33). The literature consulted therefore predominantly makes reference to work undertaken in England, Wales and Northern Ireland, as well as internationally where relevant, These are consulted with relevance to the Scottish context in terms of exploring 'what works' in discussing examples of best practice and implications for workforce development.