Table 4.

Themes From Those Attending First Time Family Meeting

Themes	Examples
1.  Psychoeducation     a.  Education about what is addiction,       what are realistic recovery       expectations- offer statistics	“(I’d like to know) Here are the numbers. And it amazed me it’s not something right up front, it’s just, you just got to know…. If you’re here, what we’re seeing is, if the family does this, this, and this, the chances of relapse are far less… But to use the statistics”
i.  Chronic illness orientation,          ‘long haul of it’, ‘there is          no long-term quick fix’          with recognition of relapse          as a possibility	“We didn’t have enough information on what could possibly happen. We thought, gee, this is great, he’s done now, and he’s going to be fine. And that was so naïve on our part… I think some of these things have to be addressed about what we can expect, what might happen”
ii. Signs that the patient is          about to relapse or          relapsing	“… what the signs are that we were falling off course; things that would give us some indication that plan might not be working or that plan needed to be adjusted”
b.  Overview of key success factors       that work for people trying to       maintain abstinence (AA/NA,       medication-assisted recovery,       therapy)	“… What has been successful to the majority of folks who’ve gone through this, I mean there are obviously lots of ups and downs in the process following the release from a program, but I’d like to know what are those key success factors… that have worked for people”
c. Overview of treatment options for      addiction recovery- levels of care	“It’d be really helpful to have a real presentation about the AA programs, NA programs, and the value of those programs” “(It would’ve been helpful) if I was given more resources to research on my own”
2.  Advice- specific and concrete action items    for the family      a.  How can the family support the        patient with maintaining recovery?	“…What is the correct next step? What do we do in the short-term? What do we do when they get out of here? What is their treatment plan? What medicines are they going to come out with? Should they be going home?”
b.   Stress the importance of aftercare,        consistent care, and coordination        with all treatment providers	“I think the importance of aftercare and consistent care and the communication of the plan to the other health care providers, I think is important.”
c.   Self-care and support/ counseling        for the family- recommend        attending multiple times for full        benefit	“…going to a family meeting for the first time, what would have been the best thing for me to hear on my first family meeting is to get myself support and start to educate myself how to deal with something that’s not going to be cured in three days”
3.  Aftercare Planning- Short-term      a.  What follows the current level of        care? –recommendations for next        treatment program and the        rationale      b.  Include multiple program options      c.  DO NOT create the discharge plan        without consulting the family	“I don’t get the flow. I still don’t get the flow. I’ve been listening to it for seven months. I’d like to see it spelled out…. How come PHP is the choice for my daughter?… I’m not a clinician… but I do want to know why somebody is saying that this is going to be the treatment of choice.”
4. Referral     a.  Family support groups, self-help,       family counseling or case       management services, individual       therapy- depending on assessment       of family situation	“By going to family support meeting…it’s almost prepared me for when the relapse did happen and how should I react to it… I think that (it) is important to learn those buzzwords to get you and your loved one through the situation and perhaps that loved one back into recovery and to stop using” “I would have liked it early on if there was a professional (recommending) go to a lot of meetings. Here’s a pile of different types of meetings”
b.  Reading list, resource guide,       website information	“I think there should be a resource, a written guide or book or some kind of pamphlet that comes right at admission about what to expect, about what is treatment, what has been tried” “Information in handouts, a website, videos; so (much) information to grasp…”