Friends and relatives of individuals who abuse alcohol may often feel compelled to approach the person and discuss how that person’s alcohol abuse is affecting everyone around them. When viewing the actions of an individual with a substance use disorder from the outside, it is often clear that the person’s actions are problematic and self-destructive; however, the subjective view of the person with a substance use disorder is that their actions are “normal” for them and do not represent an issue. The difference between the objective viewpoint of outsiders and the subjective viewpoint of the individual with the alcohol use disorder often results in a reaction to both sides that leads to frustration, resentment, and confusion for both parties.
When an individual’s alcohol abuse is affecting others around them, close friends and family members of that person do not have to sit by idly. A proactive approach to pointing out the individual’s behavior and getting them to do something about it can be accomplished. Often, the best way to approach an individual about their problematic alcohol use is to organize an alcohol abuse intervention for the person.
The Alcohol Abuse Intervention
In the current context the term intervention refers to a structured and organized attempt by family and friends of an individual with a substance use disorder to point out the dysfunctional and destructive aspects of that individual’s behavior and convince the person to get into treatment. Because many individuals with alcohol use disorders are not able to view their behaviors objectively, using an alcohol abuse intervention allows the person to be exposed to numerous points of view regarding their alcohol abuse.
The utility of an intervention lies in the ability of the participants to appeal to the strength of the individual’s bonds with family members and close friends, get them outside of their own subjective and selfish motives, and look at their behavior as individuals close to them view it. Because there is strength in numbers, the intervention can work by removing the person with the alcohol use disorder from their own subjective viewpoint, addressing their issues with reluctance and denial, and implementing undesirable consequences if the person continues to abuse alcohol and decides not to enter treatment.
How Not to View an Intervention
A sure way to reduce the effectiveness of an alcohol abuse intervention is to approach it in a manner that will automatically increase resistance and defensiveness in the individual with the alcohol use disorder. There are certain things to avoid when considering an intervention, such as:
- Simply performing an intervention “on the spot” without any planning or preparation, unless there is some type of emergency situation
- Using the intervention to express anger or frustration at the person with the alcohol use disorder
- Expecting the person to be agreeable and amenable to any suggestions the group offers them
- Viewing the intervention as a method to force the person into treatment against their wishes
- Making the consequences too weak
- Viewing the intervention as a last resort by friends and family members of the person to “help them,” since oftentimes multiple interventions are needed before an individual agrees to enter treatment
How Do Alcohol Abuse Interventions Work?
There are several approaches to substance abuse interventions (see below); however, there are some general commonalities that apply to different intervention models. These models will typically begin with planning sessions, rehearsals, performing the actual intervention, and then following up on the effects/outcome of the intervention. Interventions can be performed without professional help, but this is not advisable.
An overall outline that most models of interventions follow is outlined below.
- Individuals who are concerned about the person’s alcohol abuse will organize one or more planning sessions. These planning sessions are often used to decide who will be part of the intervention team, an approximate time and place where the actual intervention will be performed, and the general expectations of the individuals who will perform the intervention.
- Once the initial discussion regarding the intervention has been completed, the members of the intervention group should recruit a professional interventionist or mental health professional who specializes in addictive behaviors to assist in further planning.
- Subsequent planning sessions with the professional interventionist or clinician will help to structure the intervention.
- In some models, the person with the alcohol use disorder is not part of the initial planning stages, and in other models, the person with the alcohol use disorder is actually included in the planning stages all the way through to the actual intervention.
- Once the intervention group and the professional interventionist or clinician has been identified, the group begins to plan and rehearse exactly what each individual will say to the person with the alcohol use disorder. Often, individuals are instructed to write down what they will say and keep it brief.
- During the planning stages, the group decides on what types of consequences it will place on the person with the alcohol use disorder if they refuse to enter treatment.
- During the planning stages, the group should also research and decide on several different treatment options that the person with the alcohol use disorder can immediately enter. This may entail contacting these treatment providers, setting up initial meetings, and also understanding the costs of the program and if the person’s insurance covers it.
- The group then sets the final date, time, and place of the intervention and stages it. When the person with the alcohol use disorder is not aware that the intervention is going to be performed, it is typically sprung on that person as a sort of surprise action, whereas when the individual is part of the planning group, they are aware of when the intervention will take place.
- After the intervention has been completed, the group members follow up with the person in order to ensure that their treatment is going well or to plan other interventions/actions if the person with the alcohol use disorder did not enter treatment.
Some Specific Intervention Models
There are several models of substance use disorder interventions.
- The Johnson Model of intervention is often referred to as the first organized model of a substance use disorder intervention. The model strongly follows the blueprint outlined above, does not include the subject in the planning stages, and is relatively confrontational.
- Other confrontational approaches that generally follow the blueprint above but attempt to use force or coercion are more often used by individuals who do not recruit a healthcare professional or professional interventionist into their team. In addition, many of these types of approaches are the ones depicted in the media. These approaches are notoriously ineffective and often attempt to force the individual into treatment.
- The Tough Love model or Love First model of intervention is an approach that attempts to tone down the confrontational aspect of the intervention by first having members of the team express their concern and love for the individual. Team members then discuss how the person’s alcohol abuse affects them and why the person needs treatment, and then presents consequences if the person does not enter treatment.
- The Systematic Family Approach is an intervention model that consists primarily of family members who form the intervention group.
- The ARISE Model (A Relational Intervention Sequence for Engagement) utilizes a different approach that has different planning sessions, includes the person with the alcohol use disorder in the planning stages (unlike the above models), has several levels of the meetings as opposed to one intervention meeting, and has more research evidence to suggest that it may be effective compared to the models listed above.
A major issue that occurs when individuals attempt to organize an intervention for a person with an alcohol use disorder is that the majority of interventions do not progress beyond the initial planning stages. Obviously, if an intervention is not performed, it cannot be effective.
In addition, as mentioned above, when interventions are planned and not supervised by a professional, they run the risk of becoming venting opportunities for frustrated family members and friends, and can get quite confrontational. When interventions are viewed as opportunities to vent and accuse the subject, their effectiveness is significantly decreased.
Finally, not having concrete and ready opportunities for the person to enter treatment right on the spot (during the actual intervention) will reduce the effectiveness of the intervention. The intervention team should have already researched, outlined, and contacted prospective treatment programs and providers, and should be able to get the individual into treatment immediately in order to increase the chances of success.
Finding a Professional Interventionist
In order to increase the probability that the intervention will be successful, it is imperative that the group utilize the services of a professional interventionist or mental health provider who specializes in the treatment of addictive behaviors.
The perspective intervention team should attempt to find a professional interventionist who is qualified to assist them with the intervention. When interviewing perspective interventionists, the team should ask about the credentials of the interventionist. Professional interventionists have different certifications depending on the state they are in. Individuals who have Certified Intervention Professional (CIP) credentials have been specifically trained and certified to perform interventions. The team should also ask how much intervention experience the person has, and the type of intervention model they use. This will help the team decide whether or not the person’s approach is suitable for their needs.
The following three organizations are recommended as starting points to help groups find a competent interventionist:
- The Association of Intervention Specialists (AIS) is a national organization that trains and certifies professional interventionists.
- Family First Interventions specializes in interventions that use family members and the family.
- The Network of Independent Interventionists offers a listing of professional interventionists across the United States.
These organizations welcome inquiries from concerned friends or family members of individuals with alcohol use disorders. One can simply call the organization, contact them by email, contact them via their website, or make an appointment to show up in person. The potential success of an alcohol use disorder intervention is greatly enhanced if the intervention team includes a professional interventionist or mental health worker with significant experience in performing these types of interventions. Utilizing these professional resources is well worth the cost.