Intervention

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A Guide to Interventions

If someone you care about is facing addiction or a possible substance use disorder, you may be able to intervene and help compel that person to seek treatment. This intervention guide will show you how.

As you know firsthand, addiction doesn’t just affect those with the addiction; it affects their whole community, including family, friends, colleagues, and community members. That’s why it can often take those very same people to help someone recognize their addiction and accept treatment.

Often, people struggling with substance addiction are in denial of their problem or its negative effects on others around them. Or, they are aware of these things but are unable or unwilling to do anything about it. Sometimes, simply talking with people openly and honestly about their problem can be enough to prompt them to recognize and address it. Other times, a more organized effort may be needed. In such cases, an intervention could provide the motivation that a simple heart-to-heart could not.

Some types of addictions and substance use disorders that may call for an intervention include:

• Compulsive eating
• Compulsive gambling
• Prescription drug abuse
• Street drug abuse
• Alcoholism

What Is an Intervention?

An intervention is a structured and focused process of helping users recognize and acknowledge their problems with substance use and helping motivate and guide them to seek appropriate treatment and care.

In an intervention, you typically rally others to join forces with you in helping users confront their problem. Those others could be close family and friends, doctors or clergy known to the individual, licensed addiction counselors and other substance use professionals, or some combination of these. Oftentimes, an intervention professional, or interventionist, will direct the intervention with close family and friends present.

The Goal of an Intervention

An intervention is designed to lessen problematic behaviors that lead to persistent substance use and lower the risk of harm from that substance use. In general, its intent is to:

• Prompt action that reduces risk factors surrounding substance use disorder
• Support factors that protect the individual using substances recurrently
• Provide continued services as necessary

The intent of a specific intervention for a specific individual, however, is based on factors unique to that individual’s substance use and circumstances. This includes their consumption patterns and consequences of substance use and the setting in which the intervention takes place.

Types of Interventions

There is no single way to deliver interventions. Different intervention approaches are more appropriate for different people and situations. Most interventions fall into one of four basic types:

1. Simple intervention – This is a one-on-one conversation with a loved one, sometimes with a professional mediating.
2. Classic intervention – This is the most commonly known form of intervention in which those concerned about a person’s welfare gather together to confront users on their addiction and encourage them to seek support.
3. Family system intervention – This is similar to a classic intervention except that planning and participation are restricted to just relatives of the individual, with or without a professional’s help.
4. Crisis intervention – This is an impromptu intervention that occurs during or immediately following a moment of crisis involving users and their addiction.

Integrated Intervention Approaches

One example of a more comprehensive and integrated means of intervention is called SBIRT, which stands for screening, brief intervention, and referral to treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) promotes this as a public health approach to providing early delivery of intervention and treatment to people with substance use disorders and those at risk of developing them.

The SBIRT approach incorporates:

• Quick screening to assess the severity of a person’s substance use and determine the appropriate type(s) and degree of treatment
• Brief intervention concentrating on building awareness and insight into a person’s particular substance use patterns in order to drive them to change those behaviors
• Treatment referral for those requiring more extensive or specialty care

What Takes Place During an Intervention?

When an intervention occurs, participants gather to confront users about their addiction or substance use and its consequences. Participants also encourage users to accept help for their problem. In a typical intervention, you’ll give users:

• Specific examples of their destructive behaviors and the ways they’ve negatively impacted you, others, and themselves
• A pre-designed treatment proposal detailing goals, guidelines, and steps for recovery
• Consequences from each person present if users reject treatment and persist with their current pattern of use or abuse

How to Hold an Intervention

An effective intervention is a carefully planned and executed process that includes all of the following steps.

1. Planning

One or more people close to the individual suggest that an intervention is in order and enlist others in planning it. In this initial stage, it can help to consult with an appropriate professional for guidance, such as a:

• Qualified counselor
• Addiction expert
• Psychologist
• Mental health counselor
• Social worker
• Interventionist

With their help, you can begin organizing an intervention more likely to be effective with the given individual. Remember, interventions can be highly emotionally charged and may lead to any number of unwanted results, like resentment, anger, or a feeling of betrayal.

This is why thorough planning is essential for the best chances of success. Poor planning, by contrast, can cause an intervention to only exacerbate the problem and potentially lead users to feel attacked, isolate themselves, and further resist treatment.

2. Information Gathering

The members of the planning group discuss the extent of the individual’s problem, learn about the person’s condition, and investigate potential treatment options. At this stage, you may even begin arranging for the individual to enroll in a particular treatment program.

3. Forming the Team

The planning group may or may not be the same set of people personally participating in the intervention. They may include a range of people.

Members of the Person’s Community

Close friends and family are essential parts of the team as they can provide personal insights into users and their effects on others. It can also help to have non-family members on the team, such as coworkers, employers, teachers, trusted clergy, or community members. These members can help keep the conversation focused on the facts of the situation and potential solutions available. They can also help avoid intense emotional reactions.

Addiction or Intervention Professional

Some sort of substance use or recovery professional can be invaluable to your planning team. This could be a professional interventionist or a:

• Licensed alcohol and drug counselor
• Social worker
• Psychologist
• Psychiatrist

These professionals can help guide you into forming an intervention that may be most effective. They will take the individual’s unique circumstances into account and propose the best intervention process accordingly. They will also help you navigate the various treatment options and follow-up processes most likely to benefit this individual. If you don’t have an appropriate location to conduct the intervention, the professional may even have an office you could use.

Once the team is formed, its members must then schedule a specific date and time for the intervention to take place and devise a structured plan for its execution that conveys a specific, consistent, and practiced message.

Avoid letting the subject of the intervention know any of this planning is taking place.

4. Determining Consequences

There must be clear consequences presented to users if they refuse to acknowledge the problem or accept treatment. Every participant in the intervention must therefore decide ahead of time what they will do if the person resists and refuses help. The participants must commit themselves to telling the person this and following through with it if the person doesn’t cooperate.

5. Outlining Speaking Points

Each participant must also list the specific instances when the person’s addiction or substance use caused a problem or issue. Plan what you’re going to say when it’s your turn to speak, including the toll the individual’s behavior has taken on you personally. Be sure, as well, to express your care and concern for the person, your desire to see a change, a need to see your relationship heal, and your belief that the person can change.

6. Holding the Intervention Meeting

Without letting on what users are walking into, bring them to the appointed location at the appointed date and time. There, the other members of the team will be waiting to begin the intervention.

Everyone will take their turn sharing their experiences, concerns, and support. After everyone’s spoken, users are presented with treatment options. The participants then ask them right then and there whether they will accept those options.

Participants will lay out what changes they will make if the person ignores their pleas. Only mention consequences, however, with which you’re prepared to follow through as the person may not comply. Sometimes, you may have to institute those consequences before the person finally recognizes the seriousness of the situation.

Should an Intervention Professional Attend the Intervention?

While the presence of an addiction or intervention professional is not required to hold an intervention, having a professional present could be helpful in keeping the intervention focused and on track. In certain circumstances, a professional may be particularly beneficial or, even, necessary, such as if the individual has:

• A history of violence
• Been diagnosed with a serious mental illness
• Shown suicidal behavior or ideation
• Been taking mood-altering drugs

You may also want a professional present to help steer you away from responses and reactions that may trigger the individual’s addiction or cause the user to withdraw rather than show support and non-judgment. The goal is to encourage users to reach out.

It’s also a good idea to have a professional present at an intervention if you believe the individual might react self-destructively or violently.

Who Not to Include

As important as certain attendees are to the intervention, it’s at least equally important that certain people do not attend. These include people who:

• The individual hates or dislikes
• Have their own unmanaged substance use or mental health issues
• May not “stick to the script” and, instead, speak in ways that don’t help and could even hinder the intervention
• Might intentionally sabotage the intervention

If there are people you think need to participate in the intervention for it to be effective but you’re concerned about them attending, you could suggest they write a letter that someone else could read aloud at the intervention.

7. Following Up

An intervention doesn’t end when the intervention meeting ends. On the contrary, this final stage of following up is perhaps the most important and enduring stage of the intervention. The final stage of any intervention requires participants to keep an eye on the users and see whether they’re following through with treatment and avoiding relapse.

Participants may also have to make changes in their own patterns regarding users to help make it easier for users to avoid their destructive behaviors. You may offer to join the person in counseling, if appropriate, or seek therapy or recovery support on your own to help provide the best support for both the individual and yourself. It can also help to arm yourself with knowledge of what to do if the person does relapse.

If you are planning an intervention or are interested in helping a loved one get into treatment for addiction, help is widely available. You can reach out to a local treatment center for tips and information. Many treatment providers also employ or work closely with a professional interventionist and other addiction specialists that can help you take the next step.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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