Supporting addiction affected families effectively: a feasibility randomised controlled trial of a psychosocial intervention delivered by lay counsellors in Goa, India

• Published in: Global mental health 2022, Vol.9, p.448-459
• Main Authors: Bhatia, Urvita, Velleman, Richard, Velleman, Gill, Garber, Alison, Catalano, Alexander, Nadkarni, Abhijit
• Format: Article
• Language: English
• Subjects: Addiction; Addictions; Addictive behaviors; Alcohol; Alcohol use; Coping; Councils; Counseling; Domestic violence; Drug addiction; Drug use; families; Families & family life; Feasibility; feasibility randomised controlled trial; India; Intervention; intervention development; Interventions; Medical research; Original Research Paper; psychosocial intervention; Questionnaires; Social support; Substance abuse; Supervision; Word of mouth advertising
• ISSN: 2054-4251; 2054-4251
• DOI: 10.1017/gmh.2022.41

Despite evidence of the burden of alcohol use on families, there is a lack of adequate and targeted support. We aimed to examine the feasibility, acceptability and impact of Supporting Addiction Affected Families Effectively (SAFE), a brief lay counsellor-delivered intervention for affected family members (AFMs). Parallel arm feasibility randomised controlled trial [1:1 allocation to SAFE or enhanced usual care (EUC)]. The primary outcome was mean difference in symptom score assessed by the Symptom Rating Test and secondary outcomes were difference in coping, impact and social support scores measured by the Coping Questionnaire, Family Member Impact Questionnaire, and Alcohol, Drugs and the Family Social Support Scale. Process data examining feasibility and acceptability were also collected. The primary analysis was intention to treat at the 3-month endpoint. In total, 115 AFMs were referred to the trial, and 101 (87.8%) consenting participants were randomised to the two arms (51 SAFE arm and 50 EUC arm). Seventy-eight per cent completed treatment, with the mean number of sessions being 4.25 sessions and mean duration being 53 min. Ninety-five per cent completed outcome assessment. There were no statistically significant differences between SAFE and EUC on any of the outcome measures, except for the between-group adjusted mean differences for social support scores (AMD -6.05, 95% CI -10.98 to -1.12, = 0.02). Our work indicates that it is possible to identify AFMs through community networking, and have high rates of participation for lay counsellor-delivered psychosocial care. Nevertheless, there is a need for further intervention development to ensure its contextual relevance and appropriateness.