The Right Intervention Strategy for a Chronic Alcoholic

Contrary to popular belief, a person does not need to hit “rock bottom” for an intervention to be beneficial. Learn how to intervene.

In 2016, over 5.5 percent, or 15.1 million Americans aged 12 and older, struggled with alcohol addiction, the National Survey on Drug Use and Health (NSDUH) publishes. Alcohol abuse and alcoholism impact not only the individual battling the disease but also those close to them: families, neighbors, coworkers, teammates, etc. Alcohol abuse costs society nearly $250 billion a year based on costs related to healthcare, criminal justice, and lost workplace production, the National Institute on Drug Abuse (NIDA) reports.

Alcoholism is a treatable disease; however, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) publishes that less than 10 percent of alcoholics will seek treatment. As a chronic and relapsing brain disease, alcoholism is often accompanied by denial and a refusal to get help. Most people who struggle with addiction don’t feel like they need help at all. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that out of all the people who needed treatment substance abuse and/or addiction and didn’t get it in 2015, over 95 percent felt like they didn’t need it. Loved ones may look the other way too many times and either wittingly or unwittingly serve as enablers to the problem.

An intervention may be able to get through to an alcoholic. A formal intervention is a meeting between loved ones and a person who needs help due to alcohol abuse. The intervention aims to help the person recognize how their alcohol consumption is impacting those around them and to motivate them to seek professional treatment for addiction. The goal of an intervention is to encourage a person battling alcohol addiction to enter a specialized treatment program.

Understanding Different Intervention Strategies

Contrary to popular belief, a person does not need to hit “rock bottom” for an intervention to be beneficial. In fact, much of the time, there is not likely one catalyzing event that forces a person to decide they are ready to seek professional help. Families and loved ones often need to step in and help their loved one recognize that alcoholism impacts them as well, that the disease is treatable, and that a professional program can improve quality of life for all involved parties.

There are several different forms of interventions that families can choose from. Just as alcoholism is an individual and personal disease that will manifest differently in each person and family, treatment and intervention strategies need to be specific to the person and family as well. Popular types of intervention strategies are outlined below.

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The Johnson Model

The Johnson Model, as explained by the Association of Intervention Specialists (AIS) focuses on a caring approach, and it is planned without the knowledge of the alcoholic. With this method, loved ones get together to plan the intervention. An intervention “team” is formed that may include family members, neighbors, members of a church, coworkers, friends, and other peers or loved ones that make up a person’s personal network. This intervention team may meet one or more times to plan and set up the actual intervention meeting.

Everyone involved will write a letter to the alcoholic, detailing exact instances when the alcoholism negatively affected them personally. The focus here is to remain on the alcohol abuse itself and not on past issues or anything unrelated. The tone should be nonjudgmental and straightforward, focusing on “I” statements that detail personal feelings. The language should not be aggressive.

Families and loved ones should do research before the formal intervention on local treatment options and potentially even set up admission for one following the meeting. The actual intervention should be planned for a time where the alcoholic is at their best (i.e., not drunk or hungover) and may be most open to hearing what is said. It should be in a neutral location with the entire intervention team present. Members of the team will read their letters and discuss treatment options.

Loved ones and family members need to detail potential consequences if the alcoholic decides against entering treatment following the intervention. These consequences should be clear, and families need to adhere to them in order to stop enabling an alcoholic. The goal is that the person will decide to enter a specialized addiction treatment program following the intervention.

Family Systemic Intervention

This method differs from traditional intervention methods in that families involve the alcoholic from the beginning. There is no surprise intervention meeting that may catch a person off guard or raise their defenses. Instead, the Family Systemic intervention method, as reported by AIS, includes the alcoholic and the entire family right from the start.

Family members decide that it is time to step in and help get a loved one into treatment. They may then make an appointment with a professional in order to learn how to do so. The alcoholic is invited to every meeting, and the entire family spends time talking about how addiction and alcohol use have impacted them personally. It is not a one-way conversation, and the intervention may last for several sessions or meetings.

Again, the goal is to help the person recognize that their drinking is a problem and that professional help is needed. At the end of a Family Systemic intervention, both the alcoholic and the family enter into some form of treatment together. Families may attend family counseling while the alcoholic is admitted into a comprehensive treatment program, and all parties work together to improve the functioning of the entire family unit.

ARISE Intervention

An ARISE intervention also involves families and an intervention team or network of individuals who are committed to helping a loved one get help for addiction. There are three stages involved in an ARISE intervention. Individuals may only go through the first one, or they may need all three stages, depending on when they make the decision to enter treatment.

The first stage is when a loved one calls a trained professional and is coached on how to set up a support network and the first meeting. The support network will work together so that no single person takes the brunt of the work. All meetings involve the alcoholic as well.

The second stage may involve several meetings with the support group, along with the alcoholic, encouraging the individual to seek treatment. Stage three is a formal intervention meeting.

The ARISE model of intervention is non-confrontational and can provide a gradual approach to motivate a person to recognize that addiction treatment is necessary. Families and loved ones all work together to accomplish the goal of getting the person help.

Love First Intervention

The Love First intervention strategy is a highly structured and well-planned model that involves a team of 3-7 people in a person’s support network. This team will meet several times before the formal intervention meeting is held.

The intervention team will all write an intervention letter that will have four parts: details of the personal relationship with the alcoholic; how and when alcohol abuse specifically impacted them; a statement of concern for the alcoholic’s health and wellbeing, potentially highlighting the consequences of addiction and perpetuated alcohol abuse; and an outline of concrete consequences that will occur if the alcoholic refuses to enter into a treatment program following the intervention. The letter will not contain threats; instead, it will contain specific consequences that the writer is prepared to carry out, such as not giving the person any more money, not allowing them to continue to live in the house, not permitting interaction with their children, etc. Each letter should end with treatment options.

Members of the intervention team will share the letters with each other, possibly rewriting them multiple times to ensure they will have the desired effect. Letters should be encouraging and concise, and refrain from hostility and judgment.

The team will plan the intervention in detail, even down to setting up treatment admission following the meeting. The actual intervention will be in a neutral place and is highly structured, beginning with an introduction from the team leader as to why everyone is gathered. Each family member or loved one will stand up, in an order specified ahead of time, and read their letter. The portion of the letter that includes the consequences will not be read at this point. If the loved one agrees to enter into treatment before all letters are read, that’s perfectly fine; the letters can be sent to the treatment team for them to see at a later point. If the person still refuses to enter a treatment program after all letters are read, then the consequence portion of the letters are introduced.

Members of the intervention team are to remain passive; they should not engage with the alcoholic if they become confrontational or try to manipulate the conversation. The intervention may last a long time, with the hopeful end result being that the alcoholic goes straight into a chosen treatment program.

Families remain active in the treatment of their loved one, encouraging them and participating in counseling and sessions together. Families can play an important role in treatment and throughout recovery.

Help in Choosing the Ideal Intervention Method

Every method has its own set of pros and cons. While one may be best suited for a particular person, it may not be right for someone else. The Johnson Model may be too confrontational, for example, and not ideal for everyone. An alcoholic may be resistant to attending meetings for a Family Systemic intervention. A gradual approach like the one used during the ARISE Intervention may be preferred to a sudden and more confrontational one. The Love First model is highly structured and requires a lot of planning that can help to ensure the intervention itself goes smoothly.

A professional interventionist can help families decide on how to choose the right intervention model, and guide them through the planning and implementation of the intervention itself. There are several instances when a trained professional should always be present, such as:

  • When co-occurring mental health issues are also present or there is a history of mental illness
  • If the person is prone to self-destructive, violent, or aggressive outbursts
  • When alcohol is abused in conjunction with other drugs
  • If there is any fear of suicidal behaviors or actions

When a person is in crisis, a professional interventionist is ideal for helping families get their loved one quickly into a treatment program. The Johnson Model may be optimal in this case, as some of the other intervention strategies can be more drawn out and take longer to complete.

Mental health professionals, medical providers, and substance abuse treatment professionals can all be helpful when planning and carrying out an intervention, and all may be present during the actual meeting. A professional interventionist can take the guesswork out of the process and help families get the right kind of help for their loved one. Professionals can provide the neutral location to host the formal intervention; offer suggestions or referrals to treatment programs; and advise families on how to go about getting a loved admitted.

The National Council on Alcoholism and Drug Dependence (NCADD) reports that when families use a trained professional during an intervention, most of the time (90 percent) the person in question will agree to get professional help for their addiction. An interventionist can meet with families to discuss a plan and help them decide how to proceed, with the ultimate goal of getting the individual into a specialized addiction treatment program. Ultimately, an intervention can motivate a person to seek positive change.