Richard Velleman

University of Bath | UB · Department of Psychology

Aims: To estimate the prevalence of family members affected by addictive disorders (FMA) with regard to various types of addictive disorders, and self-rated health and depression in the general population. Design: Cross-sectional general population survey. Setting: The "German Health Update" study GEDA 2014/2015, a nationally representative pa...

Objective To evaluate the feasibility and acceptability of a mobile-based brief intervention (BI), generate preliminary estimates of the impact of the BI and fine-tune the procedures for a definitive randomised controlled trial. Design Parallel three-arm single-blind individually randomised controlled pilot trial. Eligible and consenting participa...

Background Tele-psychiatry is an increasingly acceptable and feasible platform to deliver mental health care with the potential to increase access to care in low-resource settings. We aim to examine the acceptability and preliminary impact of the delivery of assisted tele-psychiatry services in primary healthcare settings in Goa, India. Methods Be...

Introduction: Stigma towards alcohol use disorders is prevalent in India and can lead to social exclusion and hamper treatment access and outcomes. Family members of individuals with dependent drinking are often their primary caregivers and play a key role in decisions around help-seeking, treatment and recovery. The nature and role of stigma in c...

Background Alcohol use is typically established during adolescence and initiation of use at a young age poses risks for short- and long-term health and social outcomes. However, there is limited understanding of the onset, progression and impact of alcohol use among adolescents in India. The aim of this review is to synthesise the evidence about pr...

Background We investigated the feasibility, acceptability, safety, and preliminary effectiveness of the Counselling for Alcohol Problems (CAP) psychological intervention delivered by non-specialist health workers (NSHW) to participants with alcohol use disorder (AUD) and comorbid depression in primary care. Methods We used data from a single blind...

Of all the potentially modifiable influences affecting children’s development and mental health across the life course, none is more important than the quality of parenting and family life. In this position paper, we argue that parenting is fundamentally linked to the development of life skills that children need in order to achieve the United Nati...

Background The treatment gap for alcohol use disorders (AUD) in India is the highest among all mental health and substance use disorders. Despite evidence of the cost effectiveness of brief interventions (BIs) for hazardous drinking, implementation in low- and middle-income countries (LMICs) is rare due to several human resource–related barriers. T...

Internet gaming disorder (IGD) is a condition in which the individual is preoccupied with playing online video games and unable to regulate this behaviour, resulting in adverse physical and psychological consequences. Although there is some debate about whether IGD is an addiction or a coping mechanism, global evidence indicates that the condition...

Background: Although crystal methamphetamine (‘ice’) use is a large and growing worldwide problem, few research studies have explored the impact of crystal methamphetamine use on affected friends and family members. In order to inform the development of a Family and Friend Support Program for those affected by someone else’s use of ice, the experie...

Zusammenfassung. Fragestellung: Angehörige von Suchtkranken stellen eine belastete substantielle Gruppe dar, die in Forschung und Versorgung unzureichend repräsentiert ist. Es liegen bislang keine wissenschaftlichen Zahlen zu den Auswirkungen der durch die Covid-19 Pandemie verursachten sozialen Einschränkungen auf Belastungen und Versorgungsangebo...

Introduction and Aims Of the Indian population, 2.7% have alcohol dependence, the most severe of alcohol use disorders. Alcohol use disorders have previously been found to be correlated with a range of negative economic outcomes, but dependent drinking has yet to be causally identified as a poverty trap. We use qualitative data as the first step to...

Background: The Coping Questionnaire measures affected family members’ responses to their relatives’ substance misuse related problems. The Coping Questionnaire examines three main coping strategies: engaged, tolerant-inactive, and withdrawal coping. Objectives: The aim of the current study was to compare competing conceptual measurement models acr...

Hazardous drinking (HD) is a major public health problem in India. However, healthcare access is limited by the shortage of healthcare professionals. Extensive global evidence demonstrates the effectiveness of technology-delivered BIs in reducing alcohol consumption. Our study aims to increase healthcare access for HD, by designing a contextually-a...

Despite the increasing burden of alcohol dependence, treatment resources in low- and middle-income countries such as India, are concentrated in poorly accessible tertiary care facilities. The aim of our study was to examine the feasibility and acceptability of lay health worker delivered home-based packages of care for alcohol dependence. We conduc...

Introduction: The World Health Organization's (WHO) Alcohol Use Disorders Identification Test (AUDIT) is used extensively across the world, with cut-off scores recommended by the WHO. We reviewed the use and validity of AUDIT cut-off scores in low- and middle-income countries as cultural contexts are expected to influence the detection of alcohol...

Aims To examine the feasibility, acceptability, and preliminary cost‐effectiveness of a lay counsellor delivered psychological treatment for men with alcohol dependence in primary care. Design Single‐blind individually randomized trial comparing Counselling for Alcohol Problems [CAP] plus Enhanced Usual Care [EUC]) versus EUC only. Setting Ten pr...

Background The current study explored the temporal pathways of change within two treatments, the Healthy Activity Program (HAP) for depression and the Counselling for Alcohol Problems (CAP) Program for harmful drinking. Methods The study took place in the context of two parallel randomized controlled trials in Goa, India. N = 50 random participant...

Introduction The aim of this review is to provide the first consolidation of the policy environment surrounding alcohol-related societal harm in India giving researchers and policy-makers a clearer base for future reforms. This review is also an important adaptation on the scoping review method for policy reviews in low-resource settings that may s...

Introduction: Despite the large burden of a relative's drinking on their family members, the latter's perspectives and experiences are largely neglected. The aims of this article are to assess the coping strategies used by affected family members (AFMs) in Goa, India, and to examine the nature of the support they have for dealing with their drinki...

Aims: To explore the effect of the relatives’ drinking on their family members, and the preliminary impact of the 5-step method intervention on the adverse effect of the relatives’ drinking on their family members. Methods: In-depth interviews were conducted with eligible Affected Family Members (AFMs) (n = 30) to understand the effect of the relat...

Background The Healthy Activity Programme (HAP), a brief behavioural intervention delivered by lay counsellors, enhanced remission over 3 months among primary care attendees with depression in peri-urban and rural settings in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of HAP over 12 mon...

Background Counselling for Alcohol Problems (CAP), a brief intervention delivered by lay counsellors, enhanced remission and abstinence over 3 months among male primary care attendees with harmful drinking in a setting in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of CAP over 12 months,...

Cost-effectiveness acceptability curve: Willingness to pay per remission achieved via counselling for alcohol problems from a health system perspective. (DOCX)

Description of serious adverse events over 12 months by arm. (DOCX)

Mediation results examining patient-reported readiness to change at 3 months on mean standard ethanol consumption at 12 months (n = 151). Beta estimates (β) are unstandardised. Multiple linear regression models controlled for baseline AUDIT score, baseline PHQ-9 score, where the intervention was delivered (primary health centre) and who delivered i...

Interaction effect of readiness to change, expectations of treatment, and drinking severity (AUDIT score) at baseline on the effect of CAP on primary outcomes. (DOCX)

Intervention effect on outcomes at 12 months (complete case analysis and random effects). 1Among those with observed data at 12 months. 2Number of participants for whom AUDIT and Alcohol Timeline Followback were available. 3Including imputed outcome data for those with missing data. 4Analysed with a zero-inflated negative binomial model that fits 2...

Means and 95% CIs for key variables used in mediation analyses. (DOCX)

Study protocol. The effectiveness and cost-effectiveness of lay-counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India: PREMIUM study protocol for randomised controlled trials. (PDF)

Cost-effectiveness planes: CAP plus EUC compared to EUC alone per recovery achieved. (DOCX)

Secondary outcomes at 12 months. (DOCX)

Baseline characteristics of completers of outcome evaluation and those lost to follow-up. 1Includes those who completed the 3- and 12-month evaluations (n = 305) and those who completed only the 12-month evaluation (n = 11). 2Includes those who completed only the 3-month evaluation (n = 31) and those who dropped out before the 3-month evaluation (n...

Mean costs (2015 international dollars) and QALYs gained per person over 12 months. (DOCX)

Counselling for Alcohol Problems (CAP) manual. (PDF)

Statistical analysis plan for the PREMIUM randomised controlled trials of the effectiveness and cost-effectiveness of lay-counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India. (DOC)

Cost-effectiveness acceptability curve: Willingness to pay per QALY gained from HAP from a health system perspective. (TIF)

Cost-effectiveness planes: HAP plus EUC compared to EUC per remission achieved. (A) Health system perspective; (B) societal perspective. (TIF)

Comparison of participants who were followed up and those lost to follow-up at 3 and 12 months. (DOCX)

Results of t test and descriptive statistics for change in mean primary outcome score between the 3- and 12-month endpoints by trial arm (complete case n = 438). (DOCX)

Interaction effect of baseline depression severity, sex, length of depression, and expectations of treatment on the effect of HAP plus EUC on scores for depression symptoms (BDI-II outcome). 1Adjusted for PHC as a fixed effect and PHQ-9 baseline score. (DOCX)

Secondary outcomes at 12 months. (DOCX)

Effect of HAP plus EUC on scores for depression symptoms, disability, suicide behaviour, and intimate partner violence over 9 months, based on complete case and random effects. 1Adjusted for PHC as a fixed effect and PHQ-9 baseline score. ***Not previously specified in trials protocol but specified in published analysis plan. #Suicidal thoughts ove...

Statistical analysis plan. (DOC)

Serious adverse events and medication use by arm in the last 3 months. (DOCX)

Mediation results examining the effect of patient-reported activation levels at 3 months on 12-month depression outcomes. *Beta estimates are unstandardised. Multiple linear regression models controlled for baseline PHQ-9 score, participant age, and PHC. *p < 0.05. **p < 0.01. ***p < 0.001. c′, total effect; a × b, indirect effect. (DOCX)

Mean costs (2015 international dollars) and QALYs gained per person over 12 months. (DOCX)

Aim: To review the literature on psychosocial interventions for addiction affected family members in Low and Middle Income Countries (LMIC). Methods: A systematic review with a detailed search strategy focussing on psychosocial interventions directed towards people affected by addiction without any gender, year or language specifications was con...

Gambling has been a popular pastime in ancient and colonial India, and continues to be in modern India. Problem gambling is an important public health issue because of its prevalence, increased risk to certain vulnerable groups and its numerous adverse consequences to the gambler, his/her family and the wider society. In this paper, we present an o...

: Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psychological treat...

Background: Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psycholo...

: Although structured psychological treatments are recommended as first-line interventions for depression, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of a brief psychological treatment (Healthy Activity Program [HAP]) for deli...

Despite the potential advantages of community detoxification for alcohol dependence, in many countries the available resources are mostly focused on specialist services that are resource-intensive, and often difficult to access because of financial or geographical factors. The aim of this systematic review is to synthesise the existing literature a...

Aims: Overdoses contribute disproportionately to drug-related deaths (DRDs) in the UK, yet little is known about the experiences and needs of those who are bereaved by such deaths, and how their experiences and needs might differ from other bereavements associated with substance use. Methods: An interview study with 32 adults in England and Scotlan...

Background Deaths associated with alcohol and/or drugs belong to a category of ‘special’ deaths due to three characteristics: traumatic circumstances of the death, stigma directed to both the bereaved and the deceased, and resulting disenfranchised grief experienced by the bereaved. These factors can impede those who are bereaved in this way from b...

We review how research over the past decade both supports existing knowledge about the risk factors that children in the UK affected by parental substance misuse face, and adds to our knowledge about the protective factors, protective processes and evidence of resilience which can reduce the likelihood that children will experience poor outcomes. F...

How to promote compassionate care within public services is a concern in several countries; specifically, some British healthcare scandals highlight poor care for service users who may readily be stigmatised as ‘other’. The article therefore aims to understand better the relationship between stigma and compassion. As people bereaved by a drug- or a...

Background Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Couns...

Psychological treatments delivered by lay therapists, with little or no previous mental health training, have been shown to be effective in treating a range of mental health problems. In low resource settings, the dearth of available experts to assess therapy quality potentially leads to a bottleneck in scaling up lay therapist delivered psychologi...

Background: The leading mental health causes of the global burden of disease are depression in women and alcohol use disorders in men. A major hurdle to the implementation of evidence-based psychological treatments in primary care in developing countries is the non-availability of skilled human resources. The aim of these trials is to evaluate the...

Aims: To describe the development of a questionnaire for assessment of the perceived functional social support needs of family members who have relatives with substance-related problems. To present preliminary evidence of its reliability and validity, thus completing the set of measures required to quantitatively assess the Stress-Strain-Coping-Su...