Open Dialogue in Alcohol Services

open dialogue

I have recently started once again to supervise substance misuse services in Kent. The services I supervise are based on a harm reduction model and not the 12 step ethos. I am all too well aware that the commissioning of substance misuse services in the last decade has resulted in cuts in funding. These cuts have resulted in a considerably reduced service and a lack of therapeutic input in provision. Services now employ generic drugs workers who offer a range of interventions including day programmes, group work, mindfulness, criminal justice work and prescribing. They however no longer employ therapists/counsellors because their qualifications would require them to be paid on higher bandings than other workers, so they are the staff that are cut first. Subsequently therefore the local community services in Kent also no longer offer family work as there are no staff that are qualified to deliver this. There now exist no workers in substance misuse services who have had even a basic training in family work. This includes the BFT 5 day , NICE compliant family therapy training which is the minimum requirement for the implementation of a family therapy focused service.

In the recent past and with the 12 steps programme there is was an emphasis on involving the family and al-anon appears to be a growing organisation whose presence until recently was not in my opinion given as much consideration as it deserves. Al -anon services appear to be expanding and offer support to the families of those effected by the individual’s alcoholism. There are in addition family work programmes incorporated in the services provided by the majority of residential rehabilitation facilities as they now recognise the importance of this work.

Although over a decade ago when I was originally working in substance misuse services we regarded the family as part of the services users problem we have in more recent times started to see the family as part of the solution.The family (or peer group) will in most cases be the longest remaining and most substantial source of support to the individual.They will know the individual and their strengths and weaknesses far more comprehensively than the drug worker. The family should therefore be utilised to assist the client in his recovery and relapse prevention planning and it is the family who will recognise difficulties that could result in substance use.

I think it is important that those who commission substance misuse services reflect on the importance of family involvement for individual and family recovery. I also feel that for meaningful service provision and substantive recovery additional money for Open Dialogue training for substance misuse workers should be factored into their calculations.

Author Bio: Jane Hetherington, Principal Psychotherapist at KMPT and an employee at Early Intervention Services in Kent, has completed Open Dialogue course and will be a part of the new Open Dialogue Course. She is trained as an integrative psychotherapist and has experience working in primary care, substance misuse, and psychosis services. Here, she writes about a few psychotherapeutic theories.

open dialogue
rong>Author Bio: Jane Hetherington, Principal Psychotherapist at KMPT and an employee at Early Intervention Services in Kent, has completed Open Dialogue course and will be a part of the new Open Dialogue Course. She is trained as an integrative psychotherapist and has experience working in primary care, substance misuse, and psychosis services. Here, she writes about a few psychotherapeutic theories.

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