What do we already know? our whole family evidence bank: report

Summary of evidence collated as part of the Ask the Family engagement project. The full detailed report can be found below.

1. Constantly Just Holding It Up and Together

What Is This?

This study was carried out by John Holleran (Families and Communities Manager at Scottish Families) as part of a Masters in Contemporary Drug and Alcohol Studies at the University of the West of Scotland. It aimed to address the gap in understanding about family members' experience of support in Scotland, including life with substance use in the family, routes to support, and the impact of support. The research was based on qualitative interviews with ten family members, all of whom were accessing evidence-based family support.

What Did Families Say?

Families only reached support as a last resort after many years, when they could no longer cope. Family support was described positively, a "safe place" which reduced isolation and developed knowledge and skills. Families found new coping and response strategies, improved self-care, reduced risk, and improved communication and family relationships:

"At the time it was just survive-survive-survive. …You're worried [husband] is going to die,in your daily list of things that are gonna happen you're like… oh shit, he's gonna die today & it's constantly on your list of things toconsider in today's shopping list-husband's dead!…Constantly just holding it up & together."

"As you grow through it, you grow in the knowledge of it and youre cognise that person has the right to live their lives the way they want to and accepting that is very difficult to get to but it does come. … I can be there but I can't change him and I can do the best I can with the support I have and the information I've got and its hows up that side of things to you and it makes it easier to deal with it all."

"She [worker] helped me visualise the scenarios and prepare for how I might be if the worst of my fears happened…. She said, 'when you go into the hospital and when he says that,when he says eff off–just get up and say I'll come back at a better time' and just leave… It helped bolster me from becoming totally, totally over whelmed and destroyed with the amount of chaos and sadness that was around so it was a really helpful too l and it worked."

Three Take-Home Messages

1. Health, care and other services are missing opportunities to reach and support families until the point of crisis, leaving the onus on families to find support.

2. Many families give the impression everything is fine due to shame, guilt, fear and anxiety, and (where there are children involved) to avoid statutory intervention.

3. This research demonstrated that evidence-based family support for adult family members improves outcomes for the whole family.


Holleran, John (2020) Constantly just holding it up and together. Exploring family support in relation to problem substance use in Scotland, Scottish Families. https://www.sfad.org.uk/constantly-just-holding-it-up-and-together


Email: alcoholanddrugsupport@gov.scot

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