The experiences, challenges and coping strategies of concerned significant others living with a partner with a substance use disorder : informing guidelines for social work intervention

Abstract

The pandemic of alcohol and drug abuse continues to ravage families, communities and societies placing many households, even communities, under siege. For persons living in an addictive home it is like living in a whirlwind where a family member’s substance use disorder (SUD) turns homes into sporadic unpredictable and out-of-control environments. The partner or concerned significant other (CSO) of the partner with the SUD becomes so engrossed in the latter, that they sacrifice their own time, needs, energies and resources to manage the whirlwind, even adopting maladaptive coping skills to survive. When partners with SUDs begin treatment, its modalities primarily focus on treating the partner with the SUD. The non-abusing CSO-partner is mostly conceptualised as an adjunct treatment collaborator for partners with a SUD and therefore instrumental to a successful treatment outcome. The CSO-partner’s own needs for professional treatment go unattended while they themselves seldom receive specialised treatment to heal and recover from the many and varied scars caused by the whirlwind of a partner’s SUD. They are thus deprived of a service to which they are entitled in their own right. This explains a lacuna in home-grown treatment which falls within the ambit of social work for a CSO-partner. Utilising a qualitative research approach, and the collective instrumental case study and phenomenological research designs complemented by an explorative, descriptive and contextual strategy of inquiry, I explored the experiences, challenges and coping strategies of CSOs living with a partner with a SUD with the view of informing guidelines for social work intervention from 12 CSO-partners and their partners with a SUD. These guidelines were informed by their suggestions for social work support. To live with a partner with a SUD was for all the CSO-participants an overall negative and stressful experience in which they felt isolated and trapped. Feelings of anger and frustration; sadness; embarrassment; shame, humiliation; despair, and hopelessness were experienced causing some of them to emotionally disengage from their partners. Their partners’ SUD-related behaviour had a negative effect on them; their relationships and the relationships with their children. The partner’s argumentative attitudes; intimate

partner violence; lack of responsibility; erratic, reckless behaviour, manipulation and threatening relapse were highlighted as some of the challenges experienced. A mix of coping strategies that can be categorised as both adaptive and maladaptive, or enabling behaviours, were employed to mitigate and manage the challenges experienced. The CSO-participants also employed external sources of motivation to convince or force their partners to enter treatment. Admitting to the fact that their SUD’s had affected the CSO-partners negatively, both the partners with the SUDs and their CSO-partners offered suggestions for social work support for the CSOs of partners with a SUD. Topics to be covered during social work interventions to support to CSOs included providing information about drugs and its effects; setting of boundaries and personal safety; rebuilding self-esteem; anger-management; relapse management; and parenting and marriage counselling. Ways in which to provide such social work intervention and support suggested was through couple counselling; family counselling and support groups, and a tailor-made programme catering specifically for the CSO-partners. Based on the research findings, guidelines were formulated as recommendations for social work intervention directed at social work practice. Additional recommendations for education and training; continuous professional development, and ideas for future research were also suggested.