Patterns of family conflict and their impact on substance use and psychosocial outcomes in a sample of young people in treatment

The influence of family environment on adolescent substance use is well established, but little is known about its impact on outcomes for young people in treatment for substance use disorders. This study aimed to investigate the impact of family conflict and its resolution on substance use and measures of well-being among adolescents in treatment. Eighty young people (aged 16-21 years) were recruited from youth-specific alcohol and drug community and residential treatment services in Melbourne, Australia, and interviewed at baseline and 18 months. Analyses were conducted examining family network variables, as well as their relationship to substance use, risky behaviours and satisfaction with health and quality of life. Overall, the treatment cohort showed reductions in both severity of substance use and improvements in general life functioning following engagement in specialist substance use treatment. Young people who reported higher levels of family conflict at baseline and at follow-up reported more severe substance issues, as well as poorer social functioning, greater psychological distress and lower life satisfaction. In contrast, those who reported reductions in family conflict reported the greatest improvements in their global risk scores for substance use (as measured on the WHO ASSIST instrument). Family conflict is associated with severity and complexity of substance use and wider life issues in young people early in and following specialist alcohol and drug treatment; however, it is not a constant factor. Although our data do not permit us to draw causal conclusions, they have important implications for the structure and targets of treatment delivery, as well as the role of family members in supporting change in young people's substance use and well-being.