Supporting addictions affected families effectively (SAFE): a mixed methods exploratory study of the 5-step method delivered in Goa, India, by lay counsellors

Aims: To explore the effect of the relatives’ drinking on their family members, and the preliminary impact of the 5-step method intervention on the adverse effect of the relatives’ drinking on their family members. Methods: In-depth interviews were conducted with eligible Affected Family Members (AFMs) (n = 30) to understand the effect of the relatives’ drinking on their family members. Subsequently, a different group of consecutive eligible AFMs (n = 21) received the five-step method from lay counsellors, with outcomes measured at baseline and 3 months after delivery of the first session, to examine the impact of the intervention on AFMs. Findings: In the in-depth interviews, the perceived impact of the relatives’ drinking on the AFM included substantial physical/emotional abuse, financial difficulties, shame, poor health, impaired interpersonal relationships and change in the AFM’s role in the family. In the case series, for AFMs who received at least one session of the intervention, there was significantly increased engaged coping, increased stress and increased professional social support; and in those who completed the intervention, there was significantly increased engaged coping, increased strain, and increased informal social support. Conclusions: Compared to developed countries, stresses experienced by AFMs in our study are somewhat qualitatively different. The impact of an un-adapted five-step method intervention is less helpful than found elsewhere; hence an adapted version of the five-step method which is responsive to the realities of the cultural context may be better suited to Indian settings.