The effectiveness of psychosocial interventions for family members impacted by another’s substance use: a systematic review of the last 10 years

Background: Substance use disorders (SUD) negatively affect both the person using, and their families, however the harm to family members is frequently overlooked. A summary of the contemporary literature evaluating interventions to support families in their own right is pertinent. This review examines the effectiveness of psychosocial interventions for affected family members.

Methods: A systematic review was conducted of randomised, non-randomised, and pre-post studies published between 2010-2020 examining the effectiveness of group or individual interventions for affected family members. Five databases were searched (PubMed, PsycINFO, Medline, Web of Science, Cochrane Library). Outcomes included psychological functioning, quality of life, physical health and substance use, and general functioning (family functioning and coping). Study quality assessed using the Effective Public Health Practice Project’s Quality Assessment Tool.

Results: Nineteen studies were included. Ten were deemed weak methodological quality. Ten were appropriate for meta-analysis. Meta-analysis of three studies found that individually administered interventions significantly reduced depression (standardised mean difference [SMD] = .50, 95% confidence interval [95%CI] = .21, .79) and distress (SMD = .28, 95% CI = .03, .54). Pooled effects from two single-arm studies indicated improvements in family functioning (d = .51, 95%CI = .28, .73) and coping (d = .43, 95%CI = .24, .61). Pooled effects of five studies found that group interventions significantly reduced depression (d = 50, 95% CI = .17, .82) and distress (d = .44, 95% CI = .13, .75), and improved coping (d = .81, 95% CI = .29, 1.33).

Conclusion: Both individual and group psychosocial interventions demonstrated favourable outcomes for affected family members. The strongest evidence indicated reductions in depression and distress with individual interventions. This review provides a summary of the emerging literature evaluating interventions for family members in their own right. However, small sample sizes, lack of standardised measurement, and methodologically weak-quality studies limit conclusions.