Supporting and including families in professional care for alcohol use

This chapter states that the family, or certain members, are central to all aspects of ethical practice for the treatment of alcohol problems. This is because people’s alcohol-related behaviour will have many effects on others in the family and because family members may be involved in the help that an individual may seek or receive, related to their drinking. Therefore, we consider that it is both unhelpful and unethical to take an individualistic perspective which treats the drinker in isolation from her/his context. Instead, we consider that it is effective practice, both to support family members who are affected by a relative’s alcohol use and to include at least some family members in the person’s treatment journey. However, such involvement sometimes creates complex ethical and practical dilemmas, which are explored within the chapter. Further, involving the family necessitates that professionals take account of cultural differences around family involvement, raising further competing ethical dilemmas. We consider both the why and the how of family involvement in the various stages of someone’s ‘treatment journey’. There is overwhelming evidence favouring a range of evidence-based family-based interventions. Engaging family members can improve the chances of someone with an alcohol problem entering, engaging and completing treatment. Family involvement also helps with improving the overall health and wellbeing, relationships and other aspects of life, of both the drinker and of family members. Implementing evidence-based interventions is of particular importance in ensuring that family members’ health and social care needs are met, particularly in contexts where family members have limited options for care.