Whole Family Approach: rapid review of literature

Reviews the evidence on Whole Family Approaches to family support, focussing on examples of best practice in the context of substance use and implications for the training and learning development of substance use practitioners and wider workforce.

3. Policy Background

One of the Scottish Government's core public health priorities is to reduce the harms from alcohol and drugs, with a particular emphasis on reducing drug-related deaths (Public Health Scotland, 2020). Rights, Respect and Recovery (RRR) and the Scottish Government's National Mission to reduce drug related deaths and harms place a specific focus on the needs of children, young people and families affected by substance use. Outcome 6 of the National Mission Plan 2022-26 recognises that a loved one's substance use can cause hardship and trauma to families and that dedicated support is required to empower and enable them to support the recovery of their loved one.
The Scottish Government's National Principles for Holistic Whole Family Support sets out that support should address the needs of the entire family while being underpinned by children's rights. It should be tailored to the respective needs of individual families, non-stigmatising, timely and sustainable, empower the service use and build on existing strengths within the family and their wider community. Finally, it should be delivered collaboratively and seamlessly by a skilled and supported workforce that is able to promote the approach in a way that is accessible and understandable to families. These principles echo the ten driving principles underpinning intensive family support outlined in The Promise, itself a pledge to support families to stay together in a safe and loving environment, and reduce the number of children who are taken into care.

The prioritisation of a WFA within RRR and the National Mission aligns with the commitments established in The Promise and its focus on expanding family support so that it is consistently available for all families across Scotland. Central to this is around providing holistic support that addresses the needs of children and adults within a family at the time of need rather than at crisis point. Delivering on the Promise requires wholesale change in the way current child, adult and family-based services operate, with a central focus on valuing families, providing long-term support beyond the established norm, building trusting relationships. It emphasises the need for services to move beyond set risk-based approaches to child protection to keep families together by sustaining meaningful and loving interpersonal relationships within families and identifying, interrupting and addressing intergenerational causes of trauma. It also highlights the importance of collaboration between alcohol and drug services and statutory children's services, and requires services to prioritise the needs and safety of both children, parents and adults affected by substance use.

These aims and principles are captured by a number of strategies across the Scottish Government. Getting Our Priorities Right (GOPR) – the Scottish Government guidance for services working with children, young people and families affected by substance use – recommends that children and adult services in Scotland adopt a whole family approach when assessing the needs of families affected by substance use.

GOPR sits within the context of Getting It Right For Every Child (GIRFEC)'s[1] national practice model[2], with professionals in the Team Around the Child and Family working together to coordinate support through a Child's Plan[3]. GIRFEC is founded on an integrated, relationship-based, co-ordinated approach that emphasises that support is effective when it works with the strengths of individuals and whole families, alongside providing professional support in an open, collaborative and dignifying way.

This approach is supported through the Children and Young People (Scotland) Act 2014 Part 3, regarding Children's Services Planning and the associated part 3 statutory guidance, which identifies a number of tasks and duties over each three-year planning, delivery and reporting cycle. The local Children's Services Plan (CSP) outlines how partners will collaborate to deliver services, support and improvement activity that addresses national and locally-identified priorities in improving outcomes for children, young people and families. It is not limited to children but encompasses services that support adult parents or carers and young people in the transition between children and adults services. The CSP considers the need of all children and young people living in the area as well as the specific needs of certain groups. It includes local provision of holistic whole family support where the impact of alcohol and drug use is a factor. Along the Child Protection Committee, the Alcohol and Drugs Partnership is key to ensuring that a holistic and joined-up whole-system approach is in place that includes prevention, early intervention and targeted support in the development and delivery of each area's CSP.

There is an overarching desire to work collaboratively within and across agencies with families and communities, to develop and redesign services to better support families in protecting children and those affected by substance use in respectful, trauma-informed and rights-based ways (Gentile and Clapton, 2021). This trend within the Scottish context also sits within a broader shift towards the UK's 'Think Family' agenda (see Thoburn et al, 2013; Bunting et al, 2017; Gentile and Clapton, 2021).


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