The Effectiveness of a Web-Based Individual Coping and Alcohol Intervention Program for Children of Parents with Alcohol Use Problems: An RCT
Presenter: Dr. Tobias Elgan
STAD, Centre for Psychiatry Research (CPF), Karolinska Institute & Region, Stockholm, Sweden
Time: Wednesday, 22nd January 2025; 14.00 UK Time, 15.00 Sweden, Germany; 16.00 Finland etc
Description:
Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Although many would benefit from support programs, only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children.
We developed and tested a novel digital therapist-assisted self-management intervention, targeting adolescents whose parents had alcohol use problems, aimed at strengthening coping behaviours, improving mental health, and decreasing alcohol consumption in adolescents. Only 24% (24/101) of the participants in the intervention group completed the intervention, and we found a small but inconclusive effect of the intervention. We will present these findings and discuss their implications of how digital interventions to reach a vulnerable, hard-to-reach group of adolescents could be taken further.
Registration: Click here to register
Practitioners wanting to know more/become trained
Training assumes that participants have competent basic counselling skills, so participants need to have these competencies in order to come on a course, or there needs to be a preliminary course training people in these counselling competencies. Practitioners must have access (either via a job which provides access or via other ways such as convening a self-help group) to affected family members with whom they can work and implement the 5-Step Method, once they have completed the training.
Training for Practitioners
The 5-Step Method should only be used by practitioners who have been trained. Training can be adapted to your organisation and be delivered face to face, or via zoom and can be a mixture of half day sessions and self learning. For training courses via zoom, please contact candf2021@outlook.com for application form. This covers 14 hours facilitated content; Training materials; Practitioner exercises; Comprehensive accreditation assessment for 5 steps.
Before training can take place we ask for sign-up (often in the form of a Memorandum of Understanding or MOU) from both the practitioner who is being trained AND from their organisation/line-manager. This agreement covers:
- Details of the training (and supporting resources etc.) and what is expected of each party.
- Commitment that all practitioners who sign up will complete the training.
- Commitment from each practitioner that, once trained, they will implement the intervention.
- Commitment from line-manager that each trained practitioner will be supported to use the intervention (e.g. time, room), and that an organisation will have the appropriate delivery framework in place to support use of the 5-Step Method (e.g. recording data, assessments, policies and procedures).
- A team or organisation will share (following the appropriate consent and data sharing procedures) basic anonymous client data (covering demographics and the Family Member Questionnaire outcome tool but no identifiable data).
Training for Managers and Supervisors
It is important for managers and supervisors to understand the 5-Step Method, even if they will not be practitioners themselves. We can offer a bespoke half day training course for managers and supervisors (this can be done face-to-face or online), which will support them in understanding the 5-Step Method, and what is expected of both practitioners who are trained to use the intervention and the organisations where it will be introduced.
Please contact us to find out more at 5stepmethod@gmail.com
Practitioner Skills and Accreditation
If you really want to develop your competency and ensure fidelity to the model while delivering the intervention, the best way is to become an 5-Step Method accredited practitioner. For organisations who want to ensure that there is high quality practice in place, accreditation and on-going supervision ensure this.
Everyone who has gone through accreditation says they have found the process very worthwhile - have a look at the Video Presentation and the Expert Panel Discussion.
To support the process, click on the following documents which are also located in the Guidance, Handbooks & Other Reading section:
- Template: Practitioners Competency Form
- Guidelines: Practitioners Accreditation
- Checklist: Practitioners Competency
- Guidance: Common Problems
We can provide you with expert guidance via a Zoom call. You will need to provide a tape for each Step that has been audio recorded with a Family Member (consent needs to be given for this) and self assess yourself using the Practitioners Competency Form. Accredited Assessors will then assess your tape using a similar Competency Form. You will receive a huge amount of high quality feedback to enhance your practice.
There is a cost to this as it can take an Accredited Assessor up to 15 hours to complete this process. The cost will vary depending on the type of organisation and how much support is needed. Please contact 5stepmethod@gmail.com
Competency Skills Framework
The competency framework is an essential resource for 5-Step Method training and practice. It covers 35 skills which ensure that trained practitioners can become, and remain, competent and confident users of the 5-Step Method – these are summarised in the diagram below and in the video presentation. Please see the Template and Guidance in Guidance, Handbooks & Other Reading
Click here for the Practitioner Competency Form
5-Step Method Competency Framework
© The Competency Skills Framework is copyrighted to AFINet – it cannot be reprinted, reproduced, photocopied, altered or utilised in any form or by any electronic, mechanical or other means invented, without prior permission in writing from AFINet. The skills framework should not be used by, copied or shared with people who have not been trained to use the 5-Step Method – an exception would be the person who is supervising or managing your work if they are not themselves a 5-Step Method practitioner.
There are variations to the skills framework for some of the different versions of the 5-Step Method that are available – you will have been given the correct one for whichever version[s] of the intervention you are using. These different versions of the skills framework will be added to the website in due course.
Practitioner Accreditation Process
We recommend that trained practitioners become Accredited (by AFINet) 5-Step Method Practitioners. The steps of the accreditation process are given below. Practitioners have told us that they find this process extremely useful and that it has helped improve their skills and overall 5-Step Method practice. Certificates (different to the certificates that are given after completion of the training) are awarded to each practitioner who successfully passes the accreditation process and Professional Development points have been gained in various countries (depending on country and profession requirements). Accredited practitioners can go on to become accredited trainers and accredited assessors if they wish.
5-Step Method Practitioner Accreditation Process
Practitioners should self-assess themselves against the competencies in the skills framework and only apply for accreditation once they assess that they are competent. We suggest that practitioners do not apply for accreditation with the first family member that they work with, but that they do so within 3-6 months of training (depending on the volume of 5-Step Method practice that they have been able to do).
The documents required for the accreditation process are listed below. These documents should not be used by, shared or copied with people who have not been trained to use the 5-Step Method unless they are directly supporting the work (such as a manager or supervisor). RESTRICTED ACCESS PERMISSIONS NEEDED FOR THE LIST BELOW
© All of the documents that support the 5-Step Method Practitioner Accreditation process are copyrighted to AFINET. They cannot be reprinted, reproduced, photocopied, altered or utilised in any form or by any electronic, mechanical or other means invented, without prior permission in writing from AFINet.
- InstructionSheet for Scoring
Competency Assessments for Self/ Peer/ Expert and How to become an
Accredited Practitioner
This gives you all the information to assess your own or other practitioner’s competency. It also provides information on the accreditation process.
- 5-Step Method Competency
Assessment Form
This is designed so you can self-assess how well you meet each of the 5-Step competencies. The same sheet is also used in the accreditation process by the Accredited Assessor.
This is the document that must be completed and submitted along with audio recordings of sessions for each practitioner who wishes to become accredited.
- 5-Step Method Competency
Checklist
This is similar to the competency sheet but in a handier checklist format. This is useful to use while you are facilitating the session - this helps you to ensure you remember all the competencies for each Step. This can also be used after the session and by peers/supervisors.
- 5-Step Method Example of
Good Practice in Completing the Assessment by Accredited Assessor
This will also help guide you in completing your own self- assessment.
- 5-Step Method Competency
Assessment. Examples of Common Problems and Feedback Statements
This summarises common problems that practitioners may experience in each step. It also gives useful tips and guidance. It is particularly helpful in giving examples of useful phrases to use when providing feedback when rating either someone else’s session or reflecting on one’s own competency.
To find out more about the accreditation process, including costs, please contact your 5-Step Method nominated person or contact us at fivestepmethod@gmail.com
Outcome Measurement (the Family Member Questionnaire)
To support therapeutic 5-Step Method practice, and to continue building the global evidence base for the 5-Step Method, we have developed the validated Family Member Questionnaire (FMQ). This is primarily for use with family members affected by a loved one’s alcohol, drug or gambling problem. The FMQ is the best way for practitioners, organisations, commissioners, and family members themselves, to assess whether the 5-Step Method has helped family members.
We want to emphasise that if the FMQ is presented and used in the right way, AFMs value this element of the support, and can often welcome it as part of the help that they are receiving.
The FMQ should be completed by each family member before they start the intervention (ideally as part of an assessment or very early in the first session) and then again towards the end of Step 5 (ideally after the review of Steps 1-4 has been completed). If possible, we also suggest that the FMQ is completed on a third occasion, perhaps as a 3-month follow-up.
The FMQ, together with guidance for its use, scoring and interpretation, can be found in the FMQ box: see link The Family Member Questionnaire (FMQ) Please contact your 5-Step Method nominated person to ensure that you have the correct administrative version of the FMQ for your team/organisation.
© The FMQ is copyright to AFINET. It should not be revised or altered in any way as this will affect its validity although it can be adapted to be administered online. The FMQ can be added to organisational IT systems that are used for the purpose of holding client data.
We are happy to work with organisations to support your analysis of the FMQ data that you collect – for example, by providing a spreadsheet that you can use to collate and analyse your FMQ data.
As part of your agreement with AFINet to use the 5-Step Method, we ask that you (with the appropriate consent and data sharing practices) share anonymised FMQ data with us (along with some basic, non-identifiable demographic information about family member clients). The data that you share with us will be used to build and promote the global evidence base of the 5-Step Method, and can be used at local, regional, country and international levels to promote policy and practice change that is required to ensure that more affected family members receive the help that they so badly need.
Other versions of the 5-Step Method use different outcome questionnaires or have other ways to assess the impact of the intervention. For example, Steps to Cope uses the READ (Resilience Scale for Adolescents). Please contact your nominated 5-Step Method person or contact us at 5stepmethod@gmail.com to find out more.
5-Step Method Publications and Other Resources
A large number of peer reviewed academic articles and other publications (such as books and book chapters) have been published about both the Stress-Strain-Coping-Support model and the 5-Step Method. For a full list of publications, click here
Richard’s document is excellent and I know it’s kept updated. Not sure of the best way to present it on a revised website though. Perhaps in addition to having all publications in one document that someone can download etc., we need to list publications (in their sub-sections) on this page – so a list of headings that someone can click on to get the list of publications in that topic. We also need to ensure that we list books/chapters, publications not in English, and perhaps also highlight any open access publications.
Richard to work on what will be on this page and how it will be laid out/presented.
Developing a Self-sufficient 5-Step Method Service
We can support an organisation or a country to become self-sufficient in their use of the 5-Step Method. For example, a country wide scheme has been introduced in the Republic of Ireland and similar schemes are being introduced in New Zealand and the Netherlands.
Developing a self-sufficient 5-Step Method service is achieved by providing training in four areas.
- Accredited Practitioners This involves submitting audio-recordings of sessions carried out with consenting family members. Practitioners self-assess themselves against key competencies and only submit once they assess that they are competent. An accredited assessor then listens to the recordings and rates the practitioner against the same key competencies. Irrespective of whether they meet the competency thresholds, a numeric score and useful feedback to improve competency is given for each Step. Practitioners have told us that they find this very useful and it has really helped improve their skills. Certificates are given on completion and Professional Development points have been gained in various countries (depending on country and profession-requirements).
- Accredited Trainers A 2-day course or on line zoom course in 4- half days, followed by the participants running and video-taping their own 5-Step Method training. The video-tapes are then assessed against a the Trainers Competency Framework. Accredited Trainers can then go on and run 5-Step Method training which will allow participants to follow the process described above to become Accredited Practitioners. Ideally, accredited trainers should already be accredited practitioners but there can be exceptions to this.
- Accredited Assessors Accredited Practitioners/Trainers (with some exceptions to this) are trained to assess others to become Accredited Practitioners via Assessors Competency Framework and repeated feedback until trainee assessors reach the same standard as existing Accredited Assessors. Accredited Assessors can then support the work of their own organisation (or organisations elsewhere in their country or in other countries) to assess whether other practitioners have reached the competency requirements to become accredited practitioners.
- Additionally, we support organisations to have a system in place for collecting, collating, analysing and interpreting data collected using the FMQ. We also agree the means by which anonymised FMQ data can be shared with AFINet (as per the MOU that will be in place).
To discuss how your organisation or country could become self-sufficient in the 5-Step Method and the associated costs please contact us at 5stepmethod@gmail.com
5-Step Method: Contacts
Contact:
Contact your 5-Step Method nominated person or contact us at . canddf2021@outlook.com
or for the southern hemisphere, contact steve.staunton@outlook.co.nz
For Steps to Cope programme of work then please contact info@ascert.biz or 5stepmethod@gmail.com
5-Step Method: Copyright & Acknowledging 5SM and AFINet
© The 5-Step Method, and all materials and resources associated with it, are copyrighted to AFINet. Nothing can be reprinted, reproduced, photocopied, altered or utilised in any form or by any electronic, mechanical or other means invented, without prior permission in writing from AFINet.
There are two exceptions to this.
- First, a trained practitioner can copy and share some or all of the self-help handbook with affected family members themselves.
- Second, a trained practitioner can share the handbooks with the individual who is supervising or managing your work, but that person should adhere to the copyright rules and not share them in any way with anyone else.
Please also discuss with us about how to acknowledge/reference AFINet and our published 5-Step Method research in your organisation (e.g. on websites, in marketing materials, or in reports to commissioners or funders). We will agree the best solution for your needs, and put in place an MOU (Memorandum of Understanding) or other form of contract as appropriate.
5-Step Method: Costs
Many of the materials are free to access, although some require you to have completed a 5-Step Method training course (which has a cost attached to it) or to be an AFINet member. However, watching videos and reading materials will not make you a skilled practitioner - practice, feedback and supervision are the best way to develop your 5-Step Method practice.
If you want to become a 5-Step Method practitioner then you will need to complete a training course and this can be done in a variety of ways. We can also support professionals to become accredited 5-Step Method practitioners. Costs for training and accreditation vary and depend on your needs. Similarly, we can support 5SM accredited practitioners to also become assessors and trainers.
Please contact us to discuss any costs: 5stepmethod@gmail.com.
Your Feedback
This website is in development and your feedback is welcome on any aspect of this 5-Step Method site.
Please email: 5stepmethod@gmail.com
Training Slides
These slides are your template for training and can be adapted as needed depending on how you are running your training.
Addiction
Using the word addiction can be controversial and emotive, to both practitioners and affected family members (AFMs), as it can imply only extreme problems and this can mean that some AFMs do not seek support. For AFINet, we are using the word as a short-hand: the issue for AFINet is whether AFMs feel they have been affected by somebody else's use of alcohol and/or other drugs, gambling or other excessive behaviours. So, the focus is on the AFMs experience and not the nature and severity of the problem.
We are in progress of developing how to use this as a self guided package. The essential items in such a package are
- To read the Handbooks and the Competency Framework.
- To view two of of the Powerpoint Presentation Videos: 5-Step Introduction, Research & Model; and Core Counselling.
- Then view all the Powerpoint Presentation Videos for Core Competencies, Family Member Questionnaire, Step 1,2,3,4,5 and then the associated Video Demonstrations.
- If you want to become competent and join our world-wide network of accredited practitioners, assessors and trainers, you need to attend a training course, and then gain feedback on your sessions and have good supervision. All of this is available and you can become Accredited.
- If you are already a practitioner who has attended a course, the videos (particularly the Expert Panel Discussions) will provide a refresher.
- Some of this site is restricted and you will need to be an AFINet member or have been trained to access some of the materials.
AFMs
As well as family members, we also include carers, colleagues, friends etc, but we use the term AFM for simplicity.
Interactive Exercise
You can rate any of the demonstration sessions using: Framework: Practitioners Accreditation Competency Self Assessment. (See Guidance, Handbooks & Reading). This will help you reflect on the competencies being shown and think about the skills you need to demonstrate.
Links
There is lots of detailed information about this step in the Handbook: For people trained in 5SM. There are also exercises for family members in Handbook: Self Help for Family Members. See link in GUIDANCE, HANDBOOKS & READING
Core Counselling Links
Each country is likely to have a national association for counselling.
In the UK, there is a wealth of information on British Association for Counselling and Psychotherapy www.bacp.co.uk.
For a general counselling book, the key reading is Velleman, R. and Aris, S. (2010) Counselling and Helping: Psychology in Action. London: Wiley Blackwell / British Psychological Society. ISBN-10: 1405106107; ISBN-13: 978-1405106108
For practitioners working in the alcohol area, the key reading is Counselling for Alcohol Problems (Therapy in Practice) by Richard D B Velleman | 18 Jan 2011