Professionals' evaluation of the '5-step method' for helping family members of substance misusers in the context of the Italian Health Services

Background: A feasibility study of an intervention aimed at helping and supporting family members, affected by a relative's alcohol or drug problems, was undertaken in an Italian health services context. Aims: To assess professionals' (Italian general practitioners and community addiction staff) views about the usefulness and applicability of a 5-step intervention for helping family members affected by someone else's substance-misuse problems. Method: Analysis of professionals' written reports following each of 52 interventions, plus analysis of focus-group discussions with these professionals. Findings: Forty-one professionals within southern Italy (18 Italian GPs and 23 community addiction staff) were trained and 23 of them (10 and 13 respectively) went on to recruit at least one affected family member and undertake an intervention with them. These 23 staff worked with 52 affected family members (mean, 2.3 treatments/ professional). Analysis of the staff-completed intervention reports following each intervention, and of focus-group discussions with the professionals, showed that professionals rated the interventions as being effective and helpful, especially the giving of space to individual family members to discuss their problems in relation to their relative's alcohol or drug dependence. Many positive changes were noticed in families being helped, as well as some difficulties being reported by the professionals related to them using this method. A number of differences between staff from different settings were found, with community addiction service staff being more likely to consider that this intervention would be easy to incorporate into routine practice, and with Italian GPs finding the focus on the family members (as opposed to the substance misusing relative) to be more problematic. Conclusions: The large majority (79%) of professionals from both services stated that they were planning on utilizing the 5-step intervention again. It may be feasible to implement this intervention more widely within Italy.