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Conversations for Change: supporting families affected by substance use

Continuing the conversation from their workshop at our Annual Conference, Circle’s Development Manager, Douglas Guest, reflects on research into lived and learned experience of addiction and substance use and looks to the future of ‘family inclusive’ systems.

Research published by Circle in Conversations for Change (click here to access) was based on words shared by families with lived experience alongside contributions from peer support workers and professionals. It reflected the challenging and ever-changing journey of living with the effects of a loved one’s substance use and how services In East Lothian can best support and care for those families.

What we learned first was that people with lived experience are very keen to have a voice, to be heard and taken seriously. Those with learned experience (professionals) struggle to challenge the status quo as they are caught up in the systems of status and employability/careers and too busy to share their views on what might not be working. Encouraging professionals with learned experience to be honest and share publicly was challenging for this research, however some were brave enough to do so.

What Conversations for Change told me is we need to collectively explore via safe spaces and in multiagency groups the barriers and enablers to system change. We need to codesign with equal power; lived experience and staff experience (from all sectors) alongside managers and power holders (of resources and culture).

Beyond stigma and shame

This needs to go beyond the management of individual cases to look at what’s not working and why across the whole system. It might be that some people get support because of the commitment of third sector charities advocating for change and public sector, values-driven practitioners on the ground, but we need a collective recognition that we are all system players now.

To move towards shared responsibility and cultural change, we need to stop and think about notions of blame and stigma. Anna Ross and her content on Stigma & Shame is a crucial must read (p.27 of Conversations for Change) We often move to blame and judge when we should instead seek to understand how others have lived and the intergenerational trauma they may have experienced. Conscious, unconscious and confirmation bias are inherent to our culture and our professions.

Looking to the future

How we engage with families is critical. Within Conversations for Change, Dave Gasparini, Manager, (Mid and East Lothian Drugs) says, “system change does not happen on its own, it requires the support and encouragement of everyone involved to develop and embed it within everyday practice.” He goes on to say, “it will require a vision of family inclusive practices and family rights to be shared with all adult treatment providers and related services and to call upon their dedication and professionalism.”

To get there, we need to find ways of:

  • Agreeing to co-produce solutions across service systems alongside families – hence the Promise school of co-design. Sounds obvious but how much time and resource do we have?
  • Having a guiding set of values, principles and assumptions to underpin family rights, family inclusive practice and whole family approaches. Imagine for a minute if we all saw ourselves as the same service and we quarterly met to discuss this, reviewing as equal multiagency partners. Not just managers and commissioners, and with family involvement central!
  • Living our values: dignity; respect; fairness; non-judgmental support; solidarity; going the extra mile and never giving up. This needs to be factored into workforce development and commissioning. Let’s go the whole hog and make these the measurements! Can we discuss regularly how you meet these values and where the system doesn’t and why not!

There are questions we need to continually ask ourselves and each other. Thanks to Lisa, Katie and Angela for writing this report and staying with it during the challenging times of the pandemic.

Click here to download Conversations for Change:

Based in Edinburgh, Circle is a registered charity working at the heart of communities across central Scotland. Circle works with families facing multiple disadvantages because of structural inequality, poverty, drug and alcohol use, imprisonment, physical or mental health, trauma, abuse, and loss.

Click here to find out more about Circle:

About the author

Douglas Guest is Development Manager at Circle

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Image in an illustration in pen and ink showing figures of a mother and father holding a child
Conversations for Change landscape image illustration by Ruby Tait

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