Living with it: a grounded action on family involvement in compulsory treatment for severe addiction
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This grounded action research sought to first understand the involvement of family and whānau in the process of committing a whānau member for compulsory addiction treatment under the Alcoholism and Drug Addiction Act 1966 (ADA Act) and second to develop an action plan to address the issues identified. Although several reviews have been undertaken there is little known about the impact of this Act on the people whom it directly affects. The aims of the research were to: (1) identify the process occurring in this situation and produce a grounded theory to explain what is happening for family as they seek to place their family member, who is experiencing the severe effects of addiction, in compulsory treatment; and (2) develop a grounded action plan to address the concerns identified in the theory. Data were collected using semi-structured interviews with 11 participants involved in placing a family member under the ADA Act, addiction practitioners, reviewing court reports and conducting informal conversations with key informants. Data were analysed using constant comparative analysis and coded using open, selective and theoretical coding. Analysis using memoing and theoretical sampling was also used to generate a substantive grounded theory and further comparative analysis was undertaken using the theory components to develop a cohesive systemic action plan. The theory ‘living with it’ was identified as the families’ key strategy for managing living with and supporting a family member with severe addiction. ‘Living with it’ is an interactive system comprised of the main categories; ‘fracturing relationships’, ‘working it out myself’ and ‘holding my breath’. These categories and their properties that tell the story of a profound lack of professional support for families seeking help. The grounded action plan resulting from this theory includes: influencing the proposed wording for the revised legislation so family are recognised in this process, improving the responsiveness of the workforce through training in the use of evidence based models of family inclusive practice and building families’ resilience using a website redesign (www.kina.org.nz) that specifically provides tailored information and support for family members. These activities will contribute to a change in practice for addiction practitioners to enable them to effectively engage and support family who are ‘living with it’.