Barriers and enablers to implementation of family-based work in alcohol services: A qualitative study of alcohol worker perceptions

Abstract

Aims: Despite research evidence and clinical guidelines, family work is rarely delivered systematically in community alcohol services in the UK. This study explored clinicians’ perceptions of implementation of family-based approaches in community alcohol services and included the investigation of factors that clinicians perceived to either impede or enable family work.

Method: Participants were recruited from seven community alcohol services within the UK. A total of 18 clinicians participated in semi-structured interviews using an adapted version of the theory-based implementation interview which were audio-taped, transcribed and used for analysis.

Findings: Analysis of the interviews identified barriers and enablers to family-based work at three different levels: clinician; problem drinker and family; and the organization. Clinician perceptions of family-based work were identified as enabling or impeding depending on the clinician's interpretations of family-based work.

Conclusions: The study demonstrated the importance of challenging narrow perceptions of family-based work so that it included more flexible interpretations of it (i.e. brief low intensity family interventions as well as more formal family therapies). This would help to increase family-based work; more accurate measurement, and help reduce resistant attitudes in clinicians towards family work.