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Guide a Successful Intervention

A substance use disorder intervention is an approach used by close friends and family members of an individual who has some type of suspected substance use disorder, such as an alcohol use disorder. The intervention is designed to convince the person that they need treatment for their behavior. The goal of the substance use disorder intervention is to call to attention the individual’s dysfunctional behavior, how it affects the members of the intervention team, and why they think the person needs to get help, and then to offer the person several treatment choices to enter on the spot.

If the individual with a suspected substance use disorder decides not to enter treatment, the intervention team should have already outlined consequences associated with the refusal to get treatment. This sounds rather confrontational and forceful, and there are types of confrontational interventions (see below); however, being accusing and confrontational should not be the goals of the intervention. Instead, the goal should be to offer loving, nonjudgmental help.

What Not to Do When Organizing a Substance Use Disorder Intervention

Interventions are successful when they follow a general procedure. Unfortunately, media sources often depict an intervention as being confrontational, argumentative, disorganized, and forceful. There is an element to a substance use disorder intervention that requires mild confrontation in the use of mild levels of force, but emotional outbursts, threats, accusations, name calling, etc., will detract from the goals of the intervention (to get the individual to agree to enter treatment).

Interventions should not:

  • Use an authoritarian approach to force the individual to enter treatment
  • Be planned with the goal of “ambushing” the person (attending to overwhelm the person or shame them)
  • Catch the person when they are intoxicated, as this will typically result in failure
  • Be used by the members of the intervention team as a sort of venting session to relieve frustration and anger
  • Be used to accuse the person of being an “addict,” “junkie,” or some other term that carries significant negative connotations
  • Act as a last-ditch effort to help the person, since the team can always try again if the person decides against entering treatment

The bottom line is that the intervention is designed to produce awareness in the subject that they have a problem with alcohol or drugs that affects their family members, close friends, coworkers, etc., in a profound manner. The intervention team needs to communicate concern, how the individual’s behavior affects them, provide treatment options, and support for the individual if they enter treatment. The goal is to get the person to agree to enter treatment, not to force them to enter treatment against their wishes; however, research indicates that individuals who voluntarily enter treatment and those who are forced into treatment by the legal system or some other party have similar success rates.

Interventions run smoothly and have positive results when the intervention team is honest, and expresses genuine concern.

Who Should Be on the Intervention Team?

Interventions are very intimate approaches used by a team of individuals who have an intimate awareness of the person who is the subject of the intervention. The intervention team members should include only individuals who are directly affected by the person’s substance abuse and who have close personal relationships with the person. This includes close family members, very close friends, coworkers who also have strong personal relationships with the individual, and supervisors at work who also have a personal relationship with the individual.

Every member of the team should have firsthand knowledge about the person’s substance abuse and be directly affected by it. These individuals should all be adults (18 or older). In most cases, children should not be included in the intervention team, nor should children be present during the actual intervention. In some cases, mature adolescent children of the target person of the intervention could be included, but it is best probably not to include these individuals unless there is a very good reason to have them present. Members of the individual team should not bring onlookers or other acquaintances who do not have an intimate knowledge of the person who is the subject of the intervention.

There is one case where a member of the intervention team would be an individual who does not have a close personal relationship with the subject. This involves using a professional interventionist or mental health worker who specializes in addictive behavior to organize and run the intervention. As explained below, interventions should include at least one of these individuals who can help in the organization, planning, and execution of the intervention.

When Should Interventions Be Used?

Substance use disorder interventions should be performed when it is apparent that the person’s alcohol or drug use is resulting in severe negative consequences for them, their family and friends, their career, and their physical and mental health. The National Institute on Drug Abuse (NIDA) offers suggestions for deciding when an intervention may be warranted.

Any of these issues could be grounds for organizing a substance use disorder intervention.

The Case for Seeking Professional Assistance

The individuals who form the core of the intervention team typically have some vested interest in seeing the subject of the intervention stop using alcohol. The members of the intervention team are very subjective in their understanding of the situation, the goals for performing the intervention, and their definition of how the intervention should be run. The prospective members of the team most often do not have any experience with performing interventions. They do not understand the most effective approaches to organizing the intervention, confronting the person, and the types of consequences that should be put in place if the person does not enter treatment. It is for these reasons that the best approach to organizing and performing a substance use disorder intervention is to hire a professional interventionist to plan, organize, and actually implement the intervention. Professional interventionists are certified in this process. There is obviously a fee for this service, but it is well worth the cost.

To find a professional interventionist, one can contact therapists or other mental health providers in their area who treat addictive behaviors, discuss the issue with their physician, or refer to some of the links at the end of this article.

Methods of Substance Use Disorder Interventions

When planning a substance use disorder intervention, one should consider the different models that are most often used. The major models of substance use disorder interventions are outlined below.

  • The Johnson Model is less confrontational than many other popular approaches. It is also one of the first formal models of a substance use disorder intervention, and it has been around for many years. The team meets prior to the actual intervention to define the goals and plan the intervention. The members also develop a list of at least three different treatment options to offer the subject of the intervention.
  • Various confrontational interventions lay out very strict and clear consequences for not immediately getting into treatment. These consequences can be very harsh and are often accompanied by accusations and emotional outbursts. Interventions that are very confrontational and caustic in nature have the second least probability of being ineffective; interventions with the highest probability of being ineffective are those that are not actually performed.
  • A confrontational intervention, often termed as the Tough Love approach, simply uses the addition of expressing one’s love and concern for the person and then making harsh demands and imposing consequences on the individual if they do not enter treatment immediately. A similar type of intervention, the Love First intervention, was the subject of a popular book. In this model, the members of intervention team write a letter to the person expressing their love and concern and detailing how that person’s alcohol abuse affects them. They then read the letter out loud to the individual during the intervention, and then make strong demands and promise strict consequences for the person if they do not get into treatment. Research has found that approaches that are extremely demanding and confrontational have not been found to be successful.
  • A Relational Intervention Sequence for Engagement model (ARISE) is an intervention model that basically uses a nonconfrontational approach, numerous planning sessions that the subject of the intervention may attend, multiple meetings with the subject, and a final meeting where consequences for not attending treatment are presented to the subject. The subject of the intervention can choose to enter treatment at any stage during the process, and if this happens, further planning sessions or meetings are canceled. Supporters of this model claim that in the vast majority of cases, most individuals agree to enter treatment in the early planning sessions. This model has some significant research evidence that supports its effectiveness.
  • A crisis substance use disorder intervention is an intervention that occurs as a result of some type of crisis and is performed with little planning and no rehearsal. The intervention occurs on the spot during a serious event that has occurred as a result of the person’s substance abuse.

Other approaches include the simple intervention, where one person meets with the individual to discuss their concerns about the person’s alcohol abuse, and family interventions where the intervention team only consists of family members. Family interventions can follow any one of the above formats.

Things to Consider

Organizing an intervention is a daunting task. The following list can be used to ensure all bases are covered.

  • Hire a professional interventionist. If a professional interventionist is not available, attempt to hire a licensed mental health worker who specializes in addictive behaviors to help run the intervention.
  • Explain to the interventionist why the intervention is needed.
  • Meet with the interventionist and determine who is appropriate for the intervention team. The team should not be too large. It should be a minimum of three people and no more than 8-10 people.
  • When scheduling planning sessions, ensure that these occur when all members of the team are available.
  • Make sure everyone on the team is introduced to one another.
  • Let the professional interventionist organize the intervention and follow the individual’s instructions. Ask questions and provide input, but in the end, defer to the interventionist.
  • Develop a list of at least three treatment programs the subject can attend immediately following the intervention.
  • At least two members of the intervention team should continue to support the individual during treatment. Simply performing an intervention and then leaving the person without support is not a sound strategy.

A professional interventionist will discuss other specific issues regarding what should be said, how material should be presented, etc., with the team. The format of the intervention, rules and regulations of the conduct of individuals on the team, etc., will all be explained to the team by the interventionist. Depending on the model, there may be more than one planning session and the subject of the intervention may attend planning sessions.

Resources

It is strongly recommended that individuals who wish to stage a substance use disorder intervention for a friend or loved one utilize the services of a professional interventionist. There also several national organizations that may be of assistance.