11.05.15
Breaking the cycle of intergenerational substance misuse
Guest blog by Tim Vanstone, head of Breaking the Cycle
The impact of substance misuse tears families apart, disrupts communities and continues to be a burden on economies. There is a lot of evidence to show that children and young people can be influenced by their parents’ substance misuse and are much more likely to develop substance misuse problems themselves. Addaction’s ‘Breaking the Cycle’ project (BtC) was founded in 2005. Its purpose is to prevent the intergenerational transfer of substance misuse within families by working intensively and holistically with a range of services to enable change from within.
A decade on from its conception, Tim Vanstone, head of BtC, recounts how one simple but bold idea has evolved and what happened along the way.
The need for a unique approach
Breaking the Cycle (BtC) was conceived in 2005 as Addaction’s response to the government’s 2003 ‘Hidden Harm’ report. We recognised we needed to be more family-focused in our approach to providing drug and alcohol services.
Addaction knew parental substance misuse had a potentially long-lasting impact on the children and young people in their care.
We saw that children were more likely to develop dependency problems if they came from families where drug and alcohol misuse occurred.
It was important for us tackle the intergenerational cycle of substance misuse within the many families who used our services – and that’s where we started to see the breakthrough changes occur when BtC started.
Working holistically
Addaction decided to pilot the service in three areas: Cumbria, Derby and Tower Hamlets. Two BtC workers were placed in each area, attached to existing Addaction services. In these early days, and because the approach was new, staff had to work hard to create links with relevant stakeholders in each of the areas: social care, criminal justice services, drug and alcohol treatment, mental health, housing and education, to name a few.
Research shows that when families become chaotic, they remove themselves from contact with mainstream and statutory services. Much of the task for the BtC workers was to rebuild the relationships that had been broken with these services, advocating on behalf of the family and ensuring they were able to receive the support they needed.
Many of the professionals at that time had little knowledge of the issues facing families, as the approach was very focused on individuals. The main role of the BtC worker was to provide a coordinated approach to working with the family, ensuring that any plans made worked across disciplines and organisations.
Why evaluation and research is essential
During this pilot, we employed the University of Bath to evaluate our work. In 2009, the results were published and proved to be a catalyst to developing services further. The results we achieved at the time (and continue to achieve) were something to be really proud of.
During phases 1 and 2 of implementation and delivery, the three original pilot sites provided interventions for 251 clients and 465 family members. The results show significant and consistent outcomes:
- 83% of clients achieved some level of progress in working towards their treatment goals
- 81% of parents stabilised, reduced or stopped highly problematic substance misuse that was impacting negatively on their own as well as their family’s lives
- 81.7% of parents reduced their involvement in harmful behaviours including involvement in unresolved disputes, domestic violence and crime
- 84% of parents acknowledged the benefits of engaging in a meaningful occupation
- 87% of parents increased their efforts to prioritise their children’s healthy development
Award-winning partnership
The support that Addaction has received from Zurich Community Trust (ZCT) throughout the last 10 years has been phenomenal. Without a doubt, BtC would not be the success it is today without this. Not only have they provided the much-needed financial backing for the project to get off the ground, but also strategic leadership and guidance to enable us to develop and build on the good work undertaken during the pilot phase of the project.
Over the decade we have built a trusting, professional and supportive relationship between our two organisations, fuelled by the passion to deliver support to families where substance misuse is an issue.
My remit
Things have changed almost out of all recognition in the last decade. In 2005, drug and alcohol treatment was provided differently from the way it is now. The focus was on harm reduction, prescribed medication and no real belief that recovery was possible.
I joined in 2011 with the remit of rolling out BtC across Addaction services and beyond. This was aided financially by ZCT and over the next two years, and enabled us to grow to 25 services from Penzance to County Durham, turning us into a truly national service reaching many more families and children.
Important lessons
There are many lessons from our experience:
- It’s vital to be innovative even though in today’s austere climate, this is sometimes seen as a luxury.
- Always have external evaluation for any new project - this has been the key component of our success. The ability to build an evidence base and independently prove results has been invaluable.
- Secure partnerships because they are vital to success. BtC doesn’t work without operational partnership and likewise, our strategic partnership with ZCT has proven to be crucial.
- Have passion and determination as they are essential to any project or service under development – there will always be difficulties and challenges ahead. BtC and ZCT faced challenges with passion and determination and with a focus on finding solutions.
What does the recovery landscape look like now?
The main difference today is that there is a genuine recovery landscape. Within the drug and alcohol service sector, there is recognition that recovery can be achieved for individuals and families. Services can also be creative with how they provide opportunities for recovery. This doesn’t mean that reducing harm and accessing appropriate treatment is less important – it means it is part of a journey that people and families undertake to enable their potential to be fulfilled.
Addaction has recently undertaken a new piece of research – a follow-up study with some of the families we provided services for in the early days.
The key findings were that the BtC approach was effective during the intervention and also continues to be effective up to five years after discharge, and that intensively working with substance misuse and families really works.
Tim Vanstone
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