Local caregivers such as psychiatric service providers, mental health welfare workers, and nursing-care staffhave a major role to play in the long-term support of survivors of the Great Eastern Japan Earthquake of March 11th, 2011.
 Alcohol-related problems often cause various problems mentally, physically, economically, and socially.Alcoholics tend to show violent behavior,deny their own alcoholism,cause codependency in significant others,and occasionally relapse.Local caregivers bear the burden of caring for them and feel responsible for their relapse. This leads to exhaustion and discomfort with caring for them. In order to provide continuous and effective support for people with alcohol-related problems,it is important for caregivers to know the nature of the illness, the means and stages of recovery, effective support strategies, and how to enjoy providing support.
 A Leadership Training course on “Mental Health First Aid（MHFA）”was held in November 2011 for caregivers in Iwate Prefecture.MHFA provides help for people suffering from a mental health problem or in a mental health crisis, developed in Australia by Betty A. Kitchener and Anthony F. Jorm. In 2006, the MHFA-Japan（MHFA-J）Project Team translated the program and modified it to fit Japanese culture.The action plan consists of 5 part : 1）Approach the person,assess and assist with any crises, 2）Listen non-judgmentally, 3）Give support and information, 4）Encourage the person to get appropriate, professional help, 5）Encourage other support/self-help.
 During the leadership training course, MHFA for anxiety disorder, depression, suicidal thoughts, and alcohol-related problems was introduced, as well as how to train caregivers in experience-based and participatory approaches.
 The session for alcohol-related problems focused on the process of recovery, including how to deal with relapse, how to listen, how to motivate patients, and how to enjoy being a caregiver. There was also a role-play with two different scenarios : one with a confrontational interview and one with an MHFA-styled interview using a motivational approach. In February 2012, two other seminars focused on alcohol-related problems among the elderly and how to organize a case conference to incorporate requests from participants of the leadership training course.
 In order to provide long-term support to local caregivers, it is important to convey strategies that focus on caring for others comfortably.