Tolerate, engage or withdraw: a study of the structure of families coping with alcohol and drug problems in South West England and Mexico City


  • Jim Orford,

  • Guillermina Natera,

  • Jill Davies,

  • Adriana Nava,

  • Jazmin Mora,

  • Kate Rigby,

  • Colin Bradbury,

  • Nadia Bowie,

  • Alex Copello,

  • Richard Velleman5


Aims. To explore the structure underlying individual differences in the ways family members cope with drinking or drug problems. Design. Cross-sectional interview and questionnaire study of a series of family members in two contrasting socio-cultural groups. Setting. Mexico City and South West England. Participants. Two hundred and seven family members from separate families, three-quarters women, one-quarter men, mostly partners or parents. Data. Long semi-structured interviews; the Coping Questionnaire (CQ). Findings. Factor and subscale analyses of the CQ data and textual analysis of the interview reports were used to test the hypothesis that the underlying structure to coping could be described in terms of eight or nine coherent and distinct ways of coping. Neither form of analysis gave strong support to this hypothesis. Conclusions. It is concluded that the structure of coping can best be described in terms of three broad coping positions: tolerating, engaging and withdrawing. These conclusions challenge some previous assumptions about functional and dysfunctional ways of coping with excessive appetitive behaviour in the family.