Engaging Affected Family Members in Substance Use Disorder Care: Knowledge, Attitudes, and Behaviors of Addiction Care Teams

Background: Engaging affected family members (AFMs) of individuals with substance use disorder (SUD) has the potential to improve treatment outcomes across the continuum from identification of substance misuse to treatment initiation, harm reduction, and recovery. Although family and social support improves outcomes for people with SUD, current care models often do not include AFMs in care. This study aimed to understand SUD care team members’ behaviors, attitudes, training, and knowledge regarding engaging AFMs, and evaluate whether attitudes and receipt of related training are associated with clinical practices. Methods: This is a cross-sectional study of interdisciplinary SUD care team members at a large, urban, safety-net hospital. Surveys assessed providers’ current clinical practices around including AFMs, related attitudes, prior training and desired support about family engagement, and a knowledge assessment. Results: Few providers (30%) reported regularly including AFMs in SUD despite most feeling it is helpful for families to be frequently or very frequently involved (68%). Providers more frequently provided education to AFMs about SUD (72%) and treatment (70%) than overdose prevention and naloxone (38%). Only 26% of providers had received any training on strategies to include AFMs and other social supports in SUD care, and the knowledge assessment revealed prevalent inaccurate and potentially stigmatizing beliefs about the involvement of AFMs in care. Conclusions: Although most SUD care team members recognize the benefit of social support in recovery, a minority regularly involve AFMs in their clinical work with individuals with SUD. Addressing these barriers and improving provider access to training may create opportunities to improve engagement of AFMs and outcomes for individuals with SUD.