Stories from family life: Living with problematic substance use and recovery in Norway

The research project is a small-scale, narrative study aiming to gain insight into problematic substance use (PSU) and PSU recovery processes from a family perspective. Exemplified with ethnographic participant observation and qualitative interviews, the research project shows how family members talk about their lives with PSU at different times and from the perspective of different family positions and roles. Such knowledge is essential for understanding the needs of families and supporting family participation in long-term recovery processes. The overarching research question is: How do people living in families with problematic substance use construct their family life through their stories? The following sub-questions elaborate on the main research question. 1. How do family members talk about their past, present, and future roles while living with problematic substance use? 2. How do family members assemble meaning about the impact of problematic substance use in their roles and relationships in the family? 2. How do family members voice their concerns and fears related to problematic substance use through their stories? The narrative approach was chosen as the main methodology. The findings, presented as stories, demonstrate how complex and multifaceted family members' stories are. "A story of love" and" A story of family ties" are about the importance of family life and relations. In contrast, "A story of fear and preparedness", and "A story of protecting other family members from PSU" are about experienced dangers and efforts to protect the family members. "A story about the unforgivable", "A story of doubt", and "A story about tough choices" provide insight into intolerable dilemmas related to life in families. "Stories difficult to tell", "Directing the stories", and "Stories with chaos" show how stories are told. This research project suggests that researchers and professionals need more awareness of acute tensions and paradoxes in families

Being a therapist - becoming a researcher: A collaborative autoethnography study

The aim of this study was to explore how four professionals who are both therapists and academics experienced the process of becoming researchers. Within the framework of collaborative autoethnography, and guided by a phenomenological approach, the authors sought to gain a collective understanding of their shared experiences (Ngunjiri et al., 2010). Data gathering involved a two-step process in which all four researchers produced autobiographical transcripts (datasets) in response to the question “What are your experiences of becoming a researcher?” Through the application of reflexive thematic analysis, four themes emerged: (1) “The tensions within academia as a hierarchy”, (2) “The struggle to become an academic”, (3) “Finding meaning and satisfaction in a new career”, and (4) “Evolving a new identity”. All four participants emphasised the hierarchical structure of academic institutions and the prioritization of research over teaching, resulting in conflicts and tensions. Participants also highlighted the demands and difficulties they encountered during the transition from professional practice to academic research: setting aside time for research was often at the expense of other activities, and issues of financial security also emerged. Describing research as “a landscape that is difficult to navigate and in which it is easy to feel overwhelmed”, participants stressed the importance of support from those with more experience in the research arena. However, participants welcomed the opportunity to apply their practical experience as therapists to their research activities and to communicate research findings to those still in practice. All four described gaining a new identity through making the transition. They valued the resulting self-development, which was seen as an ongoing process involving openness to learning new things and diving into new and unfamiliar waters.publishedVersio

An unknown invisible intrusion. Impact of an adult family member’s problematic substance use on family life: a meta-ethnography

Problematic substance use (PSU) has documented consequences for the person using substances and people close to that person. This meta-ethnography aims to provide insight into how families experience family life when adult family members PSU is present. The titles and abstracts of 24,423 retrieved studies were assessed against the inclusion and exclusion criteria. Fifteen qualitative primary articles, including 393 different family members experiences, were included. The included articles described families from different countries with various socioeconomic status. An unknown invisible intrusion was established as the overarching metaphor. This metaphor was accompanied by three main themes: Taking over the family life, Family survival, and An invisible family. The theme Taking over the family life reflects how PSU affected the family structures and how overwhelming the families experienced these problems. The theme Family survival reflects how family members tried to adapt to life with PSU, while An invisible family reflects how families experienced loneliness and lack of help. We suggest that professionals should move from a one-sided focus on PSU to understanding the consequences as a long-lasting intrusion into family life. This includes both disciplinary development and interventions that enhance family relational practices.publishedVersio

The Metamorphosis. The impact of a young family member’s problematic substance use on family life: a meta-ethnography

Purpose This meta-ethnography seeks to provide insight into the impact that a young family member’s problematic substance use has on family life. Background Problematic substance use (PSU) usually emerges in adolescence or young adulthood. Living with a family member with PSU is highly stressful. An understanding is needed of families’ experiences and their needs for adapted help and support, hence we have explored the impact of a young family member’s PSU on family life. Methods Systematic literature searches for qualitative research that explores the impact of PSU on family life and family relationships were conducted and the seven stages of meta-ethnography were used. Results Fifteen articles were included. The Metamorphosis was established as an overarching metaphor. Five main themes accompany this metaphor: stranger in the family; injuring chaos; no trust any more; family lock-up; and helpless societies. Conclusion The Metamorphosis reflects the all-embracing change experienced by families. Family members have felt powerless and helpless; often they wish to stay involved but do not know how. PSU at a young age can develop into lifelong chronic health challenges. Family-oriented help must be readily available in this phase as parents and siblings become deeply involved. Family involvement is seldom incorporated into routine treatment practices; such incorporation is therefore needed

Living with siblings’ drug use. Bereaved siblings’ family stories

Family members’ problematic drug use is challenging for siblings affecting their well-being and their relationships within the family. Research about siblings living with brothers or sisters’ problematic drug use and research on bereaved siblings’ experiences indicates that life situations and support needs for both minor siblings and adult siblings can easily be overlooked, both in practice and in research. This article contributes to this knowledge gap by examining how siblings provide meaning to their sibling’s drug use problem and how they position themselves and other family members accordingly. Qualitative semi-structured interviews were used for data collection, and fourteen bereaved siblings were interviewed. A narrative thematic analysis was chosen, and four themes were generated. These four themes, (1) Surviving difficult family life, (2) The relationships in continuous change, (3) It’s worse for the parents, and (4) “We”, as a synonym for the family, are presented in this article. Our findings demonstrated how complex and multifaceted siblings’ stories about living with their brothers or sisters’ ongoing drug use are. This study calls for more attention to siblings’ situations. Siblings’ lives are affected by their brothers or sisters’ problems, and siblings should also be involved in routine support and treatment practices

An unknown invisible intrusion. Impact of an adult family member’s problematic substance use on family life: a meta-ethnography

Problematic substance use (PSU) has documented consequences for the person using substances and people close to that person. This meta-ethnography aims to provide insight into how families experience family life when adult family members PSU is present. The titles and abstracts of 24,423 retrieved studies were assessed against the inclusion and exclusion criteria. Fifteen qualitative primary articles, including 393 different family members experiences, were included. The included articles described families from different countries with various socioeconomic status. An unknown invisible intrusion was established as the overarching metaphor. This metaphor was accompanied by three main themes: Taking over the family life, Family survival, and An invisible family. The theme Taking over the family life reflects how PSU affected the family structures and how overwhelming the families experienced these problems. The theme Family survival reflects how family members tried to adapt to life with PSU, while An invisible family reflects how families experienced loneliness and lack of help. We suggest that professionals should move from a one-sided focus on PSU to understanding the consequences as a long-lasting intrusion into family life. This includes both disciplinary development and interventions that enhance family relational practices

"Hun var jo bare en rusmisbruker." Stigmatisering av etterlatte etter narkotikarelaterte dødsfall.

Artikkelen belyser hvordan etterlatte ved narkotikarelaterte dødsfall opplever møtet med hjelpeapparatet, og hvordan fagfolk som møter de etterlatte, kan bidra til å øke eller minske den opplevde stigmatiseringen av dem. Bakgrunnen for artikkelener at det hvert år dør ca. 300 mennesker av overdoser og narkotikarelatert død i Norge. Bak tallene sitter mange sørgende etterlatte tilbake. Likevel mangler det generaliserbar kunnskap om hvilke konsekvenser narkotikarelatert død har for nære etterlatte, og hvordan de møtes av hjelpeapparatet. Studier fra andre former for unaturlig død viser at etterlatte ofte ikke får den hjelpen de trenger, dersom ikke hjelpeapparatet har en proaktiv og empatisk tilnærming til de rammede. Artikkelforfatterne er knyttet til prosjektet «Etterlatte ved narkotikarelatert død i et recoveryperspektiv» (END-prosjektet) ved Høgskulen på Vestlandet. Artikkelen er teoretisk med empiriske eksempler som bygger på forfatternes egenopplevelser som etterlatte, og klinisk arbeidserfaring. Erfaringene knyttes til teori om stigmatisering, sosial interaksjonisme og kommunikasjonsteori for å belyse hvordan samhandlingen kan fortone seg, sett fra et etterlattperspektiv. Artikkelen viser at stigmatisering kan prege samhandling og kommunikasjon mellom etterlatte ved narkotikarelatert død og ansatte i hjelpeapparatet, og kan legge stein til byrden for de etterlatte. Det er viktig med kunnskap om komplekse stigmatiseringsprosesser i hjelpeapparatet

Professional helpers’ experiences of assisting the bereaved after drug-related deaths: A knowledge gap

Background and aims: Drug-related death (DRD) is a major public health concern in the Nordic countries, in the rest of Europe and in the US. After a DRD, approximately 10–15 next of kin will be left behind. People bereaved after sudden and unexpected deaths have a documented higher risk of reduced quality of life, daily functioning, and early death. It is important to know the resources professional helpers have available to them, the barriers and possibilities they face in their work, and how they can respond to the needs of the bereaved. This knowledge can help prevent severe health and social consequences of bereavement following a DRD. In this systematic review, the aim was to explore knowledge regarding professional helpers’ experiences of providing assistance to people bereaved after a DRD. Methods: Inclusion criteria were empirical studies of professional helpers’ first-person perspectives on meeting the bereaved after a DRD. Quantitative, qualitative, and mixed-method studies were included. Results: The results show that there are no studies addressing professional helpers’ experiences of providing assistance to the bereaved after a DRD. Conclusion: There is a vital need to develop more knowledge of professional helpers’ perspectives. This knowledge is important not only to improve education and the quality of health and social services, but also to help raise awareness of the bereaved after a DRD