A service framework for interventions for rural families affected by a relative’s substance use disorder

Abstract

The devastating impact of substance use on families of a person with a Substance Use Disorder (SUD) has been documented. However, services to support such families are under-emphasised as interventions primarily focus on the person with the SUD, while the family has to take on added family responsibilities to deal with the substance-related problems within the family. This is particularly the case in rural areas in South Africa due to, among others, socioeconomic conditions and the lack of infrastructure, family values and cultural influences, and the availability and supply of substances in rural communities. South African policies and legislation recognise the impact of SUDs on families, and provide guidelines emphasising the need for support services to both the person with a SUD and their families. Despite these guidelines, families are often overlooked when services are provided. Therefore, this study aimed to develop a service framework for interventions for rural families affected by a relative’s SUD. For this, a critical engagement was required to determine their lived experiences, challenges and coping strategies. It also required an exploration of the perspectives of social workers working in the field of substance use in rural areas.The strengths-based approach and the family resilience and ecological systems theories served as the theoretical framework that underpinned this study. From a functional pragmatic paradigm, this researcher employed the convergent parallel mixed methods approach utilising the survey, contextual and narrative research designs. The population consisted of families and registered social workers in rural areas of the Western Cape Province in South Africa. Non-probability purposive and snowball sampling were employed to identify 25 family members affected by a relative’s SUD, and 17 registered social workers working in the field of substance use in the Cape Winelands and Overberg Districts of the Western Cape. A survey was used to collect the quantitative data, and semi-structured interviews with family members and online focus groups with social workers to collect the qualitative data. The IBM Statistical Package for the Social Science Sciences (SPSS) were used to analyse the quantitative data, and qualitative data analysis was done according to the framework provided by Maguire and Delahunt (2017).