I hope everyone has had a good week.
The Vesta Approach is based on a brilliant programme, the Parents and Carers Training programme. It was created by Phil Harris, and this week’s guest blog is all about where it came from, how it supports families and why it will work for you.
My name is Phil Harris. I have worked in the substance misuse field for over 27 years now. I began as a volunteer in frontline services, and then went on to become a manager and director of front line services. For the last 16 years though, I have been an independent consultant, designing treatment services in substance misuse and mental health services across the UK and internationally.
Tell us about the programme and why you created it?
I first began working with concerned others in the early 1990s. At this time, they were almost wholly ignored by professional services but I could see that they had “substance misuse issues” in their lives, even thought they were not using substances themselves. It was not until 2004 I was asked to design a dedicated service for families in South Wales. I suggested that a key aim of the service would be to show families how to motivate unmotivated problematic users into treatment through their family. People were unsure of this but I was confident it could be done for two reasons. Firstly, was my own experience. And secondly was the research on treatment entry.
When we look at the number one reason why people enter into a substance misuse service the biggest single factor is family pressure. Studies show that 80% of people sought help for drug and alcohol problems because of family pressure to do so. Families are a central force that drive change.
How does the programme work?
The programme works in a number of ways. It is based on key ideas in behaviourism. Behaviourism is interested in how we meet our needs through interacting with the world around us. For example, if we are hungry, we might go to a cafe to eat. If the food is good and it is good value, we will return. If the food is poor and expensive we will avoid it. So, our experience of the cafe has changed our behaviour in some way. Human behaviour is shaped by the world around it. Environments have a big influence on us, in ways we do not realise. For example, big supermarkets have limited windows so people lose track of time and spend longer in the shop. Whilst fast food restaurants will use bright lights and hard seating to get you out more quickly. These shape our behaviour without us even realising it.
Now, a concerned other often has a great deal of influence, not over the problem user, but the environment that they share. The Parents and Carer’s Training (PACT) programme really teaches the concerned other how to change the environment to shape a loved ones behaviour in the same way. They can use this influence to make non-using behaviour more rewarding and using behaviour more uncomfortable. For example, after an argument, the loved one will storm off and use. They will probably use heavily, knocking back the drinks or drugs. They will avoid the negative emotions and blame the concerned other for “driving them to it” at the same time. By teaching simple communication skills, conflict can be reduced and in doing so, the subsequent use is reduced.
Can a family member really stop a drug or alcohol user using?
This can be further enhanced. Most conflict from the concerned other’s point of view is actually driven by fear or concern for the loved, one though tends to be voiced as anger and criticism. Helping concerned others convey the more authentic feelings becomes a very powerful expression of love and concern. This is much harder for a loved one to negate. In this way, the programme looks to strengthen the relationships between the two, not divide it. We then let the negative consequences of use occur without reducing them, where it feels safe to do so. In this way, the concerned other becomes the ally and the use becomes the adversary.
Most problem users recognise on some level that their use is out of control. Whilst their use is causing them difficulties, they may see it as the only way of coping with these difficulties. As such, they have mixed feelings regarding change. By shaping the consequences around them it can help tip the balance of change towards seeking help. The PACT programme has lot of tools that help concerned others make this change. They do not have to use them all. Just the ones likely to tip the balance.
withdrawing yourself from your loved one’s company when they use, is one of the four key principles of the programme. If we think about this, your loved one is used to taking their drugs or drinking, a lot of attention from you (even negative) and your company as a bonus. Taking yourself away from the situation in a calm manner teaches them that you will not react when they use, they have nobody left to blame for their use and also, they lose out on your company (even if you are ignoring them!).
How does the programme help concerned others/family members?
The programme also works for the concerned other in other ways. After what might be years of battling with the loved one and the incredible toll this can take, it is a huge relief to share this with someone who is prepared to understand and not judge. It can help remind them of their own needs and sense of self and a long period of self-neglect. And perhaps, most importantly, it allows them to regain a sense of control over their own lives that they may have felt was eroded a long time ago. In short, I guess it helps concerned others remember that they are a human being in their own right.
What outcomes have you seen for concerned family members?
To allay these fears, I designed PACT and we set up a trial with the DAFs service in Newport, South Wales. One family practitioner would have 12 PACT clients and 12 general counselling clients. In the general counselling approach, 2 concerned others got their loved one into treatment as opposed to the PACT programme where all the concerned others got a loved one into treatment. Furthermore, the two concerned others who had got their loved one into treatment had been so stuck in general counselling, that the practitioner had used elements of the PACT programme in these cases.
Based on this success, the programme was then rolled out across five counties in south Wales. We sought feedback from concerned others in every session and this information helped us develop the programme even further. One review found that over 85 per cent of concerned others experienced the highest rates of improvement to their lives. Whilst 70 per cent motivated their loved one into treatment. The same results were achieved in other areas such as a group work version programme delivered in Somerset and a project delivering 1-to-1 sessions in Bristol. Look at the evidence here.
What are your top 3 pieces of advice for people living with a loved one’s substance use?
- Try to remember that your loved one has been “hijacked” by a powerful substance. This can help take the emotions out of dealing with the problem and help you stay focussed.
- Addictions love conflict. The more conflict there is, then the more people will use. Think about what is it is that is making you feel angry, frustrated or anxious in a given situation. How can you communicate honestly? Rehearse it if necessary.
- You are not alone. For every problematic substance user in the country, five people are negatively affected. As 2 million adults would meet the criteria for alcohol dependence in the UK alone, that is at least 10 million people in the same situation as you, if you are UK based. Living with a problematic drug or alcohol users is the country’s best kept secret. It is a not your fault that the loved one uses, but you can influence their use.
Why should people join the Vesta Programme?
When living with a problem user, it is really difficult to get time for yourself. This is especially true if you have sought sanctuary from home life in work or other commitments. Vesta offers the flexibility, ease and convenience to give you the help you need at a time and place that is best for you, using an evidence based programme of support. Research shows the being supported through the internet is as effective as seeing someone in person. No matter where you are, there will be a skilled professional to offer you proven practical skills and a compassionate listening ear to help you manage what feels unmanageable.
To contact Phil
For more information and courses people can contact me though my website at www.philharris.online
Thank you to Phil for a wonderful piece about the history of the Vesta Programme. I hope you enjoyed reading this as much as I did. I am very excited and honoured that Phil has allowed me to use his evidence based programme to support you. No matter who you are or who your loved one is, I can help.
How to get help
My service, The Vesta Approach, supports families affected by a loved one’s substance use.
If you are worried about a loved one’s drinking or drug use, join my closed group, Vesta Confidential, a safe space for you to talk about your situation with others and to find out more about the Vesta Programme.
Sign up to my mailing list here and get my free 10 Steps to Family Recovery download.
See you next week,