The Seven Methods of Substance Abuse Intervention
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There are seven methods of intervention that are widely used and condoned as the most professional ways of managing addicted patients.
Most interventions fall into the direct intervention category, but there are other forms known as indirect interventions and forcible interventions, too. Direct interventions are primary types in which family members, friends, and loved ones confront the addict with the help of a support professional or interventionist. The reality television show, aptly titled Intervention, has brought much fame to the direct intervention model in recent years, and the show boasts an impressive 71 percent success rate, according to the Daily Beast.
These interventions don’t allow for much input from the addicts themselves. Rather, decisions are made ahead of time for them, and an entire treatment plan is set up in advance in hopes that they’ll agree to it. These types of interventions are quite helpful for those who may struggle with wanting help but are fearful of asking for it or taking the first steps required to get there. Sometimes taking the pressure off them is all they need to agree to treatment, whether that treatment is as intensive as an onsite residential program or they are still able to live at home with outpatient treatment.
Indirect methods involve preparing the family to interact with a substance abuser so that the addict’s environment is more conducive to healing. While interactions with therapists or support specialists are open not just to the family but to the addict, too, some addicts will relentlessly refuse to get help. In these situations, the indirect intervention still assists the family as long as they’re willing to seek help. Forcible interventions are carried out by professionals with the purpose of having an individual committed against their will. Interventions may be formal with an interventionist present or informal, lacking a professional present. Across the board, formal interventions are more effective.
Sometimes a standalone intervention, the crisis intervention is primarily direct in form. These interventions are highly important for those who find themselves in emergent situations where time is not a luxury. Crisis interventions are suitable for addicts, people suffering from mental health breakdowns, or those dealing with both. Approximately 50 percent of people who have severe mental health disorders are also substance abusers, Helpguide reports.
Sometimes, if a crisis is emerging and the addict is still not willing to accept help, an intervention professional may be able to get the person evaluated for commitment to hospitalization or treatment involuntarily, an action that makes it no longer a direct intervention, but a forcible one. This is especially true in cases where the addict may harm himself. While substance abuse is known to increase the risk of suicidal attempts, mental health disorders pose an even bigger threat, with the National Alliance on Mental Illness reporting some 90 percent of people who die from suicide are mentally ill.
A crisis doesn’t have to be aligned with mental stability though. It could be legal or financial troubles, or even homelessness. The Substance Abuse and Mental Health Services Administration notes 13 percent of all admissions to addiction treatment centers in 2004 were homeless people. Other times the effects of substance abuse may be bleeding into the lives of others. For example, an alcoholic mother may be neglecting her children due to her addiction. Crisis interventions work best when family members and support persons are involved.
The process is much like a direct intervention carried out by family. Loved ones need to gather around the addict at this time and show support and concern. Simultaneously, this is the time to tell the addict in your life how her behaviors are affecting you and others she cares about. Given that a crisis isn’t planned, getting this kind of intervention together on short notice can be difficult, and it is advisable that you seek professional help when dealing with any addict who may be a threat to others or their own well-being.
A “tough love” intervention can be direct or indirect in nature and is the primary go-to intervention for those who have had a difficult time saying no to the addict in their life. The tough love approach is perfect for family members and loved ones who want to stop enabling the addicted party and see that he gets the help he needs. If you’ve come to a point of no return where you’ve tried everything without results, this may be your best bet. This method often scares loved ones, because there’s always a possibility of it not working and potentially pushing the addict further away from you. Thus, professionals in the field urge that it be used as an absolute last resort.
As commonplace as the tough love terminology is, this isn’t something you should attempt without the help of a professional interventionist. Tough love is more than just making veiled threats; it’s following through with them, too. If you can’t take another day watching your grandchildren suffer through life with an addicted parent, it may be time to take legal action and pursue custody. Pacific Standard Magazine reports more than 8.3 million children in America are living with an addict.
If your adult child is an addict who still lives in your home, tough love means it’s time to cut those ties and insist she seek treatment before she can return home. You must limit all resources an addict has when applying tough love strategies, so loaning her money, paying her bills, doing her laundry, and managing her problems are out of the question. When an interventionist is present for this type of intervention, the interventionist can act as a support person for the addict, who will likely feel like everyone else has turned against her. This in turn benefits everyone if the addict yields to the pressure she feels and turns to the interventionist for help.
Confrontational model of intervention
The traditional confrontational model of intervention is as direct as it gets and involves firmly challenging the addictive behaviors by pointing out undesirable behavior and consequences caused by the addict, as well as laying expectations of recovery on the addict’s shoulders. Years ago, this model of intervention was harsh by today’s standards and involved using indirect force — even forms of manipulation — to usher the addict into some form of treatment and rid him of his substance abuse behaviors, which were viewed then more as character flaws than an illness. The core of confrontation in the mid-1990s was placing blame on the addict and focusing on punishing him until he changed his ways.
Today, confrontation is still highly used among interventionists, but it handled with more care. Generally, addicts respond far better to confrontation when it isn’t overtly negative in nature. Often carried out in television shows and films, confrontations that involve chastising the addict and pointing out everything he does wrong without offering him support and compassion are not typical today, and for good reason — they aren’t effective. According to a published study in the Journal of Consulting and Clinical Psychology, intervention methods for 42 problem drinkers were successful in reducing drinking by 57 percent after six weeks; however, drinking was proven to be more frequent, and one-year reports weren’t as successful among those who were treated in a directive-confrontational manner by their therapist.
Most confrontational interventions only happen one time, following closed meetings the family and interventionist used to organize the event. If the addict accepts help during the intervention and enters treatment, the rest of the family members and loved ones go on with their lives during treatment. If the addict resists treatment, there may be consequences, such as their family cutting off all contact with him.
Johnson model of intervention
Stemming from the confrontational intervention model, the Johnson Model of intervention focuses on educating a caregiver, such as a spouse or parent, on how to confront the addict and encourage her to seek help for her substance abuse problem. Blame is avoided in the modern-day confrontational intervention models, and concentration is directed toward ways to treat the addiction with therapy measures.
This method typically involves a handful of closed meetings with a professional who preps the caregiver for confrontation with the addict in a way that will subtly ease the addict into conversation instead of motivating a defensive reaction. The American Psychological Association reports that an overwhelming portion of social networks — 70 percent — do not carry out the Johnson Model of intervention, despite research that touts its efficacy against other methods.
The love first approach to intervention
Another direct form of confrontational intervention is the Love First approach, which occurs on neutral territory, such as the family home. This method encourages family members to provide love and compassion to the addict and continue with such sympathy throughout and after treatment. In the beginning, family members will begin to refute excuses the addict makes, but do so in positive ways. For example, if the addict insists she can’t seek treatment because she has children to care for, let her know that you have already arranged for alternative care for them with a trusted family member they enjoy being with. It may help to point out that this is a temporary situation, but one that she wouldn’t want to make permanent. The American Grandparents Association reports that 44 percent of the 4.9 million children who are being raised by their grandparents in this nation are because of parental substance abuse.
It is vital that all participants of the Love First method stay calm during this period and understand that the premise is to avoid the tension, conflict, and defensiveness that arguing and hostile moods bring to the table. Even when an addict erupts or loses her cool, everyone else must remain calm. The trademark of this intervention technique is that every participant writes a letter to the addict detailing how they feel, including memories that bond them, and ending with supportive reinforcements.
In addition to the letter that each loved will read aloud to the addict during the main event, each participant will prepare a list of consequences for the addict should she choose not to get help. These consequences include anything from a parent cutting off financial resources to a spouse filing for divorce and custody of the kids. The Love First approach allows for support and compassion that balance the more aggressive confrontational aspects of other intervention models.
The systematic family model of intervention
Family members often have a larger influence over addicted love ones than they perceive. Typically, their point of view may be skewed merely because the addict hasn’t responded to their efforts thus far, but the right tools and language, that an intervention professional can provide, can make all the difference. Some addicts won’t be willing to help themselves no matter how much damage their substance abuse has inflicted on their life, but many will seek help after hearing how much their behaviors have damaged the lives of others that they care about.
In fact, family involvement is one of the primary reasons many end up seeking treatment, as well as one of the biggest factors in preventing substance abuse altogether. The National Center on Addiction and Substance Abuse at Columbia University states that teenagers with weak ties to their family are nearly three times more likely to have experimented with alcohol and four times more likely to have used cannabis than their peers with stronger family bonds.
This is the typical intervention most people are accustomed to hearing about. It centers on bringing the family together to communicate their feelings and concerns to the addict. While the addict is likely to have to listen to the devastating effects his behavior has had on the family, it is not laid on him in a shameful or blaming manner. The lines of communication are open so that addicts may relay their feelings as well. If there is a victim in this scenario, then the whole family as a unit is a victim of addiction and its effects. A skilled interventionist acts as the facilitator of a more peaceful engagement between parties, encouraging openness in a way that defensive attitudes aren’t elicited.
When a systematic approach is planned, the interventionist actually makes the addict aware of it and invites him to attend the gathering in effort to avoid making him feel ambushed or like he has no control over the situation. This approach is almost like a string of therapy sessions that guide the family in communicating more effectively with one another. Not only is the addict urged to seek treatment, but their loves ones are urged to attend support group meetings by organizations like Al-Anon, a resource for the families of addicts, specifically alcoholics. Generally, this intervention is carried out in several long spurts or meetings over a period of a few days, but many families continue with them for long-term treatment purposes, too.
\The ARISE intervention brings the best of both worlds to the table — both indirect and direct modules of intervention. It focuses on the whole family group and how they work together to solve the addiction problem rather than just the addict and what her behavior is doing to everyone else. In one study published in the American Journal of Drug and Alcohol Abuse, 83 percent of patients agreed to enter treatment following an ARISE intervention. This method focuses on bettering the entire family. While the addict is in an addiction treatment program, her family members and loved ones are also seeking counseling and learning how to manage life with an addict, how to help her after treatment, and how to heal their own wounds that stemmed from their loved one’s drug or alcohol abuse.
An ARISE meeting is planned ahead of time, but not in secrecy, and the addict can be a part of these sessions if she wishes. Sometimes it takes more than one meeting, and other times, the addict agrees right away and the meetings are stopped. ARISE interventions not only encourage the addict to seek treatment, but they educate the family, too, as to why treatment is so necessary and what it’s like to be an addict.
Who are interventions best suited for?
Addicts in denial are the most typical candidates for an intervention. According to Healthy People, nearly 95 percent of all substance abusers don’t even recognize that they have a problem. Some aren’t in denial at all, but they are fearful of undergoing treatment because they know they’ll have to endure withdrawal. Most addicts have heard horror stories from others, or they have felt withdrawal set in once or twice on their own and the last thing they want is to experience it again.
Those who struggle with co-occurring addiction and mental illness often battle more conflict with themselves over whether or not to seek help. They may not always have the luxury of thinking clearly, and when they do, it can be difficult to trust their own thoughts. Some 53 percent of drug addicts and 37 percent of alcoholics are living with a severe mental health disorder, NAMI reports.
Likewise, someone suffering from mental health issues, like bipolar disorder or borderline personality disorder, may be on board with a treatment plan one day and not the next. This is typical behavior for many addicts, but even more so for those who are mentally ill. Thus, acting quickly is a vital step in every intervention process. If you think someone you care about may be addicted to drugs or alcohol, look for the following symptoms:
Weight and/or appetite fluctuations
Distancing oneself from social activities that were once enjoyed
Legal or financial problems stemming from substance abuse
Tolerance to a substance
Using drugs or drinking to avoid withdrawal
Inability to stop using or cut back when attempted
Preoccupation with using and maintaining a supply
According to the National Institute on Drug Abuse, approximately 23.9 million people surveyed in 2012 were current illicit drug users. A professional interventionist can best determine the type of intervention an addict needs. The process of getting the addicted individual to the treatment facility should be carefully thought out ahead of time. Every moment that goes by is an opportunity for the patient to get cold feet and change her mind.
Generally, it is best if the interventionist is the person in charge of transporting the patient. A long car ride or flight to a treatment facility with a family member or loved one only gives the patient time to play on emotional weaknesses and allow her to divert from the treatment plan ahead. In 2013, the SAMHSA reported 22.7 million people needing treatment for an addiction and fewer than 3 million of that number getting the needed treatment. There is no definitive data on how many of those who sought treatment ended up admitted by way of an intervention, but the numbers surely aren’t high enough if so few are making it to treatment altogether.
The treatment process begins before you ever set foot in a facility. Getting there is half the battle, and a skilled intervention professional knows how to make it happen. If you suspect your loved one may be addicted and you want to help him get better, putting your trust in a professional interventionist is the best avenue to a successful recovery.