Family members affected by a close relative's addiction: The stress-strain-coping-support model

Abstract

This chapter outlines the stress-strain-coping-support (SSCS) model which underpins the whole programme of work described in this supplement. The need for such a model is explained: previous models of substance misuse and the family have attributed dysfunction or deficiency to families or family members. In contrast, the SSCS model assumes that having a close relative with a substance misuse problem constitutes a form of stressful life circumstances, often long-standing, which puts affected family members at risk of experiencing strain in the form of physical and/or psychological ill-health. Coping and social support are the two other central building blocks of the model. Affected family members are viewed as ordinary people faced with the task of coping with such stressful life circumstances. It is an assumption of the model that, difficult though the coping task is, family members need not be powerless in maintaining their own health and helping their relatives. Good quality social support, in the form of emotional support, good information, and material help, is an invaluable resource for affected family members, supporting their coping efforts and contributing positively to their health. The 5-Step Method, to be described later in the supplement, is based on the SSCS model. It can be seen as a way of increasing the positive social support available from professional sources.

Bereavement Following Substance Misuse

“…The stress of living with the person's substance misuse may have already impaired family relationships and ravaged the well-being of family members (Orford et al, 2010). In particular, the breakdown of a relationship in which so much has been invested has been found to involve grief at losing the person they once knew and loved to their addiction.…”

Families that Live with Disorders Related to Substances and Addiction

“…Next, family disorganization commonly occurs: The family members may take on strict, predictable roles and serve as facilitators to drug use. Therefore, while attempting to solve the problems, commonly severe, the families may take on the responsibility for attitudes that are originally the user's, who, consequently, misses the chance of realizing the consequences of his or her behaviors [24]. The inversion of roles and functions is also commonly observed.…”

“…They may also face other difficulties such as financial issues, arguments, lack of boundaries between generations, role inversion, enhanced family myths, secret loyalty in face of disorder and inadequate conduct, and ambivalent communication [15,23,24].…”

“…This represents an important possibility of accessing, even if indirectly, the user, besides of directly contacting the family member who, not uncommonly, is suffering [6, 24,25]. It is known that interventions in the family system may favor changes in the family and in the individual (user) [6].…”

The development, dissemination and evaluation of a psychoeducational parenting program for use within the adolescent drug and alcohol treatment field

“…Parents being able to talk openly about their situation within a larger group of parents in similar situations is often noted by parents as a very helpful and cathartic experience, providing much needed support (e.g. Orford et al, 2010a). A group-based intervention provides a cost-effective and easily transportable avenue for this process to occur effectively (Bamberg, Toumbourou & Marks, 2008;Sanders, Kirby, Tellegen & Day 2014; …”