By Nicky Adams, programme leader at The Centre for Addiction Treatment Studies, Action on Addiction

 

It takes energy, patience, specialist knowledge, skill and creativity to help people come to terms with their problematic substance misuse and adopt a new way of life in recovery.

 

Drug and alcohol practitioners carry out their professional and ethical responsibilities in busy, pressured environments, often working with limited resources. Their tasks are wide-ranging - from assessment, referral and treatment planning, to counselling, delivering psychosocial interventions and educating families and the wider community about addiction. Every day they are helping motivate clients to build the confidence and hope they need to engage in treatment and make life-saving changes.

It’s not surprising that, despite the level of dedication and passion addiction professionals bring to their work, they can be susceptible to burnout. They are at higher risk because addicted clients can be complex and potentially more demanding than other client groups; workers can also carry feelings of responsibility for their clients’ welfare (Baldwin-White, A, 2016). Burnout is a term covering a wide range of symptoms including exhaustion, feeling distant or cynical about work, and experiencing difficulty in concentrating; it may also be linked to other causes (Informed Health Online, 2017)

At Action on Addiction we support treatment staff to take care of their emotional, mental and physical wellbeing in a number of ways and in particular with clinical supervision – a regular process where practitioners meet with a supervisor (usually an experienced therapist) to reflect on their work. Supervision sessions provide the opportunity for staff to explore their ideas, share concerns and achievements, and learn how to improve their practice (Care Quality Commission, 2013, p4).

Addiction treatment is increasingly taking a ‘whole family’ approach when working with substance misuse disorders, recognising that addiction doesn’t occur in a vacuum but rather that individuals exist in a context – networks of relationships with family and friends. Family members and partners of addicts also need help. They face a number of worries and negative emotions including anxiety, financial trouble, domestic violence, guilt, anger, isolation and shame (the stigma of having an addicted family member continues to be powerful).

Working with individuals affected by someone else’s addiction can generate strong feelings in practitioners, which can mirror those felt by a family experiencing the impact of addiction (a phenomenon known as ‘parallel process’).

We have found that these feelings become even more heightened for teams delivering our Moving Parents and Children Together (M-PACT) programme, designed by Action on Addiction for children and young people affected by a parent’s substance misuse. Mental health issues, academic underachievement, behavioural problems, taking on a caring role at too young an age, the risk of developing alcohol and drug problems in adolescence and beyond – these are just some of the effects of parental substance misuse on children (Templeton and Velleman, 2016).

We know that the programme achieves remarkably positive outcomes and trained M-PACT workers do an incredible job of working with families in an optimistic manner, focusing on the strengths and resilience of each family. However, difficult feelings can emerge for them, particularly if their own family history begins to influence how they view other families. Unless understood and processed appropriately, these feelings can potentially have a negative impact on practitioners.

On 7 March I’ll be delivering a one-day training event for managers, supervisors and team leaders with some knowledge and experience of delivering supervision who would like to gain an understanding of the M-PACT programme and the issues that arise for practitioners when working with parental substance misuse.

For more information about this event and other training contact The Centre for Addiction Treatment Studies, email training@actiononaddiction.org.uk.

References
Baldwin-White, A, 2016. Psychological distress and substance abuse counselors: an exploratory pilot study of multiple dimensions of burnout, Journal of Substance Use, 21:1, 29-34
Care Quality Commission, 2013. Supporting information and guidance: Supporting effective clinical supervision. Available from: https://www.cqc.org.uk/sites/default/files/documents/20130625_800734_v1_00_supporting_information-effective_clinical_supervision_for_publication.pdf Accessed 06.01.19
Informed Health Online [Internet]. 2012: Institute for Quality and Efficiency in Health Care; Depression: What is burnout? Cologne, Germany [Updated 2017 Jan 12]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279286/ Accessed 06.01.19. Copyright © IQWiG (Institute for Quality and Efficiency in Health Care)
Templeton, LJ, Velleman, R. 2016. Impact of parents' substance misuse on children: an update. BJPsych Advances, Volume 22, Issue 2 March 2016 , pp. 108-117 Copyright: © The Royal College of Psychiatrists 2016 https://doi.org/10.1192/apt.bp.114.014449 Published online: 11 April 2018