Supporting the supporters: Helping families navigate substance use

Sally’s daughter was drinking daily, often to the point of blacking out. Sometimes the calls came in the middle of the night. Sometimes they came during work. “Mum, I need you.” Sally was constantly juggling her job, worry for her daughter’s safety, and the complex relationships with people supplying drugs and alcohol. She felt responsible—but had no idea how to manage the chaos. When she finally reached out for support, she was told there wasn’t any help for her—that it was her daughter’s problem. She was stunned that the impact of her daughter’s drinking on her own mental health and wellbeing went unseen.

The Hidden Toll on Family and Friends

Sally’s experience is far from unique. Family and friends of people with problematic substance use – often called Concerned Significant Others (CSOs) – carry enormous emotional and practical burdens. They live with stress, worry, financial strain, disrupted family relationships and often develop symptoms of anxiety or depression as they try to cope with the uncertainty of their loved one’s behaviour.

Where Practitioners Make the Difference

Health and community practitioners play a vital role in recognising and responding to the needs of families and friends. The Community Reinforcement and Family Training (CRAFT) intervention equips practitioners with tools to help family and friends care for themselves, reduce the emotional burden, and gently encourage their loved one toward treatment.

A recent Australian CRAFT study conducted at the Rural Health Research Institute, Charles Sturt University, trained and accredited six psychologists to deliver the program, including online sessions for rural families. Families felt supported and gained strategies they could use immediately:

I’ve got so much out of this. And it’s because it wasn’t just talk. It wasn’t just me talking. It was like “Okay. Have you thought about this technique?” or “Try this thing and then we’ll circle back and we’ll see how you’re going.” So that’s what I found useful. – Jane, participant

The Power of Skilled Practitioners

Practitioners delivering CRAFT emphasised the importance of practical, structured skills that give families something they can actively use:

And using that positive kind of reinforcement as well. And understanding their strengths. And building up their own self confidence and their own self-esteem, through going “Yeah. I’m capable,”…I think that’s just so powerful. I think it’s around shifting perspective of how people see their loved ones. – Amanda, Practitioner

[What] stood out consistently was learning how to communicate in a clear, concise way – Leah, Practitioner

For many practitioners, the most rewarding moments came when participants realised they could change their approach and regain a sense of control:

They’d (the participant) come in and say “Yeah. I didn’t think it was going to work but I just thought I’d have a go.” And then “Oh, wow, this is so much more and so much better than I expected. This is so good.” And when, at the end of the session, they’d go “Oh, wow, this was great. I’ve got something to work with here,” that was so satisfying for both of us – Christina, Practitioner

Real Change for Families

CRAFT gives families like Sally’s hope, direction, and relief, and gives practitioners the confidence to support them effectively.

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