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Abstract
Background: Family members of people with serious alcohol or drug problems are negatively affected by the behaviour and problems of their substance misusing relative.
Aims: Conduct a feasibility study, testing whether a intervention successful in the UK, aimed at helping family members of people with alcohol or drug problems (the 5-Step Intervention), would also be applicable in Italy.
Method: Feasibility study.
Results: It is feasible to deliver this intervention in Italy. Materials were successfully translated and back-translated and were deemed relevant for an Italian context; different health services organizations and their staff were recruited to participate; 52 family members were recruited and received the intervention. Before-and-after comparisons of these family members' physical and psychological symptoms, and their coping methods, showed that major and significant changes were made during and following the intervention.
Conclusions: How family members cope with living with a relative with alcohol or drug problems is important. Issues related to the generalizability of the intervention are discussed, including the transferability of therapeutic interventions within Europe at a time of greater trans-European mobility, and the generalizability of the possible intervention to other contexts.
Declaration of interest: There are no conflicts of interest.
Notes
1 IGP – Italian General Practitioners: general doctors, working within a primary care setting. Unlike (e.g.) the UK situation where there are “walk-in centres”, IGPs are the first reference for all medical problems, and for all referrals on to more specialist services. Furthermore, in order for pharmaceutical prescriptions to be paid for (partially) by the health system as opposed to privately, all medical prescriptions must come from IGPs. The IGP therefore is very strongly connected to all aspects of patient care. Each IGP has a limited caseload (ranging between 700 – 2000). In Italy, all IGPs are self employed and all work as sole practitioners (there are no partnerships of a number of doctors, nor any “health centres”, nor any ancillary staff: they work with no nursing staff, health visitors, or other practice staff; and have no computerization). They refer into the more specific public health service (maternity, psychiatric and other hospital services) but are not part of the hierarchies or organizations which run these systems. IGPs have no appointment systems: people just attend and wait their turn; which contributes to the short average time that IGPs see their patients for.
2 The local addiction services Ser.T (Servizi per le dipendenze), is the only state-run addiction service at the local level across Italy. Ser.T utilizes a multi-professional team (as in the UK) comprising doctors, psychologists, nurses and social workers, who interact in work groups and who organize access to various types of treatment. Ser.T is the focal point: Ser.T staff sometimes offer treatments, but also through them people are directed to various other services as appropriate. The types of help and treatment on offer include methadone supply, day services and community treatments; but there are no specific interventions oriented towards or directed at family members, neither preventive programmes or intervention ones.