It can be extremely painful to watch a close friend or family member with a substance use disorder continue to engage in destructive behaviors and act as if nothing is wrong. For many, it is a serious quandary to decide whether to try and intervene, or sit back and wait for the individual to come to their senses.
An intervention occurs when close friends or family members of a person with the substance use disorder confront the person in a nonthreatening manner and attempt to convince them that help is needed. The intervention is often the first step to getting the person with the substance use disorder assistance.
Most often, interventions are organized and performed by close family members, very close friends, and perhaps coworkers of the individual. The intervention process has been popularized by the media and on television as a form of coercive or caustic confrontation where demands are made on the person who is the subject of the intervention. Although these types of interventions do occur, and there are formal outlines for them, they are not the most successful approach. There are various types of interventions, and professional assistance with the process can ensure realistic and appropriate goals are set, helping to ensure the best chances of success.
When Should an Intervention Be Performed?
There is no hard-and-fast rule to decide when an intervention should be performed. Certainly, if two or more family members are concerned over an individual’s substance abuse, this situation could be enough evidence to suggest that an intervention may be an alternative way to approach that person. In many cases, one concerned individual could conceivably stage an intervention (see below).
In addition, family members and friends often find that they are met with sharp resistance, and even angry and aggressive behavior, when they mention their concerns to a person who may be struggling with substance abuse. Thus, they may feel safer in approaching the person as a group. When this type of situation occurs, it is almost certain that an intervention may be the only viable option to discussing the person’s substance abuse with them.
Who Should Be Involved in the Intervention?
The core members of an intervention team should have close personal relationships with the person in need. Only close family members and close friends or coworkers who are directly affected by the target’s behavior should be involved in the intervention. There should not be any casual acquaintances or friends of friends. Interventions should not have concerned onlookers who are not going to formally participate. Including these groups of individuals in the process can only diminish the effectiveness of the intervention. In most cases, small children are not appropriate to include, but there may be exceptions to this. It is best to confide in someone who has experience in interventions regarding this choice.
The one exception regarding only having individuals close to the target involves recruiting either a mental health professional who specializes in addiction treatment or a professional interventionist (a person trained in organizing and performing interventions) to be part of the process. Interventions will run much smoother if a professional organizes and plans the intervention. In addition, this person will ensure the event runs smoothly, acting as a sort of supervisor.
Basic Types of Interventions
There are several basic types of interventions:
- Simple intervention: Sometimes, just one concerned person, such as a family member or close friend, will just meet with the individual, and this is known as a simple intervention. Depending on the situation, this type of intervention may be the best course of action. For example, an individual who has few close friends, who is normally shy or not very social, or who may become embarrassed if a crowd of people confronts them could be more responsive to this type of more intimate intervention. Before attempting a simple intervention, it might be useful to talk with a professional mental health care worker or interventionist, and get some tips on how to approach the individual.
- Classic intervention: The most familiar form of intervention is the classic intervention strategy. In this approach, a group of concerned family members, friends, or coworkers confront the individual and explain how that person’s behavior is affecting them and their concerns. The types of individuals who should be part of this type of intervention are discussed above. This type of strategy will be more successful if a professional interventionist or addiction counselor is included and if there is an initial planning stage before the intervention is actually performed. All of the individuals who will be at the intervention need to meet together, discuss the goals of the intervention, discuss their personal input and role in the intervention, and work with the organizer to keep the process running smoothly.
- Family Systems intervention: Some interventions may be targeted at more than one person, such as several family members who are in dysfunctional relationships that either feed into the addiction of one member or into addictive behaviors of several family members. When an intervention is focused at a family or part of a family, it is a family systems intervention. The process used for organizing these is the same as in a classic intervention, except having a treatment professional present is mandatory.
- Crisis intervention: It is always preferable to plan the intervention ahead of time; however, this may not always be realistic. In some cases, individuals with substance use disorders engage in behaviors that need immediate attention, such as engaging in abusive behaviors, having accidents, showing up intoxicated or high in the wrong place, etc. A type of intervention that can be used in these emergency type situations is a crisis intervention. The intervention is performed on the spot, the individual is confronted by people who are in the immediate environment, their concerns are explained, and the goal is to get the person to admit they have a problem and they need treatment. Crisis interventions are typically more confrontational than the other aforementioned types due to the nature of their implementation. However, people involved should still emphasize their concern for the person in question.
- Confrontational interventions: Some types of interventions are more confrontational than others. In these interventions, some coercion is used to force the person into treatment by making demands on them and setting forth conditions that will occur if the target does not agree to enter treatment. Using coercion and confrontation during an intervention may be necessary in some cases, but as an approach, it is least likely to be successful. Some of the best-known types of confrontational interventions include:
- Tough Love intervention: This is pretty much what its title implies. Individuals explain their concern for the individual, make demands on them regarding the need to get treatment, and if the person doesn’t get treatment, they enforce those demands.
- Love First intervention: The members of the intervention team meet prior to the intervention, discuss the goals of the intervention, and each member writes a letter directed at the subject of the intervention. At the actual intervention, each member reads the letter to the person, and after the letters are read, demands are placed on the individual regarding getting treatment.
- Johnson Model intervention: An intervention model that has been popular for many years is the Johnson Model. The intervention follows the course of the classic intervention model, but during the planning stage, the members also agree on at least three different treatment options to present to the subject at the end of the intervention. This treatment model has demonstrated some success and is nonconfrontational in nature.
- ARISE intervention: A formal organization that trains intervention specialists, the Association of Intervention Specialists, has developed a specialized intervention model, the Albany – Rochester Interventional Sequence for Engagement (ARISE), that is quite comprehensive in its conceptualization. There are numerous planning sessions, numerous intervention meetings, and a final meeting that takes place only if the subject has not agreed to treatment after being exposed to all levels of planning and intervention stages. The individual is invited and encouraged to attend all of the planning sessions, intervention meetings, and the final meeting. In order to be implemented effectively, it requires the participation of a professional intervention specialist trained by the organization.
Things to Keep in Mind
A successful blueprint for an intervention should attempt to follow this specific plan:
- Get at least 3-4 people together and discuss the prospect of doing the intervention. See if anyone has spoken to the individual in question about entering treatment and what the person’s reaction was. Then, discuss other people who are appropriate for the intervention and who can help to produce a positive outcome. Contact these people and see if they are willing to get involved.
- Find a professional addiction counselor, interventionist, or family mediator, and enlist their help in planning the intervention.
- Before performing the intervention, everyone should meet to plan the event and make preparations.
- In the planning session, everyone who will attend the intervention should outline what they plan to say to the target. Everyone’s function in the intervention should be clearly defined so each participate knows what is expected of them.
- When planning what to say to the individual in need, it is important to only include specific details and facts. Stay away from inferring things that are not known. Each individual should discuss the person’s behavior, how it affected them, and the consequences of the behavior. This should be done in a nonconfrontational way, and each person should avoid arguing with, challenging, or accusing the person. Tell the person how much you care for them, what is happening, why it is concerning to you, and why you think they should consider changing. If possible, do a trial run without the subject of the intervention present.
- When discussing treatment, have several specific options available for the person. Make sure these options are doable. Do not offer treatment options that are unrealistic for the target, such as attending a treatment retreat in Switzerland if the person is unable to travel there. In addition, don’t overwhelm the individual with too many choices; aim for 2-3.
- If there are going to be consequences associated with the person not agreeing to go into treatment, try and make these clear with the least amount of coercion possible.
- If possible, choose a neutral setting for the intervention. Choose a place that offers privacy and that can accommodate everyone in the intervention party. Do everything possible to get the person to the intervention once this is arranged.
- Follow through with the intervention. Many times, interventions do not go past the initial planning stages. Obviously, the intervention cannot be successful if it is not implemented.
What Happens after the Intervention?
If a group of individuals are concerned enough to perform an intervention, they should also be willing to offer support during the recovery process. When defining the roles of the people participating in the intervention, some people should be designated to assist the subject in getting to treatment, helping the person get involved in treatment, and following up with the subject throughout treatment.
If a group of people just perform an intervention and then leave the person alone, chances are that little will actually be accomplished regarding getting the person into an active treatment program. Many individuals initially need quite a bit of coaxing to get them to consistently attend treatment. This may include actually taking them to treatment and even participating on some level.
It is very interesting to note that a large number of people who go into treatment for substance use disorders are typically forced in some way to attend treatment. This includes being directed into treatment by the legal system, by family members, by work, as a result of experiencing negative physical or mental health issues due to the substance use, or as a result of some other sanction or push that has occurred as a result of the substance use disorder.
It is not as common, although it does happen, for an individual to voluntarily enter treatment for a substance use disorder without some external condition encouraging or forcing them into treatment. It is important to keep this in mind and follow up with the target. Give them support and assistance, so they realize that they are not alone. With ongoing support and encouragement, recovery is more likely.