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'Tough Love' and 'Love First' Intervention Techniques

In 2016, the National Survey on Drug Use and Health (NSDUH) reports that over 20 million Americans aged 12 and older struggled with addiction to drugs and/or alcohol. Only around 10 percent of those who needed treatment for an alcohol or drug abuse problem actually received services in a specialized facility that year, however.

The 2013 NSDUH states that more than 95 percent of people who didn't seek treatment for substance abuse and addiction didn't feel like they needed professional help. Individuals are often hesitant to admit that they may have a problem with alcohol, and denial is a common side effect of alcoholism. Family members and loved ones may need to stage an intervention in order to get someone to agree to enter a specialty alcohol abuse treatment program.

An intervention is a formal meeting wherein loved ones meet with an individual who struggles with alcohol abuse, with the overarching goal to get them to agree to admittance into rehab right away. During an intervention, family members and loved ones will tell an individual how the drinking and alcohol abuse has impacted them directly, with the hope of motivating them to recognize how addiction disrupts the lives of everyone around them.

A formal intervention is a planned and structured event involving those close to a person battling alcohol abuse and/or addiction, and often includes the help of a trained professional, or interventionist, as well. There are many different types of interventions, including the Tough Love and Love First approaches. Every family dynamic is different, and one intervention type may be better for some people than others. A professional interventionist can help families decide on the right type of intervention that will have the best chance of success.

The National Council on Alcoholism and Drug Dependence (NCADD) publishes that when a trained interventionist is used, most people (more than 90 percent) will make the commitment to seek professional help. When planned and carried out properly, an intervention can be a very useful tool.

How a Tough Love Intervention Works

A traditional intervention is often planned as a kind of surprise meeting where the person in question is unaware that the event is going to occur. A loved one or family member sets up the intervention team – the group of people who will plan the intervention. This team may consist of anyone who has been affected by the person's struggle with alcohol and may include family members, coworkers, neighbors, classmates, friends, teammates, members of the clergy, or other loved ones who are close to this person, as well as a professional interventionist. The intervention team will meet several times to plan the formal intervention.

The actual intervention takes place in a neutral location; it can be helpful to use the office of a trained professional for this. It also takes place at a time when the person will be most susceptible to hearing what is being said, so ideally, they should not be drunk or hungover. During the intervention, members of the intervention team will directly explain how addiction has impacted them personally, using "I" statements and sticking to specific instances and events related to the alcoholism. Often, these statements are shared in the form of a letter written ahead of time.

At the end of an intervention, the individual is presented with treatment options and encouraged to go directly into a rehab program. The Tough Love approach sets a "bottom line," or specific consequences that will occur if the person does not agree to get professional help. These boundaries are clearly laid out, and loved ones need to be prepared to stick to them, no matter what. The ultimatums may not even need to be read if the person agrees to enter into a treatment program after hearing about each individual's personal stories and experiences.

The idea behind a Tough Love approach is that the people around an individual struggling with addiction need to stop enabling them and instead show that they are serious about the person getting help. Consequences may include:

  • Kicking the person out of the house
  • Refusing to offer further financial assistance
  • Removal of children from their custody
  • Threat of divorce or the end of a relationship
  • Termination of employment

The Tough Love approach may be optimal when families feel the need to protect themselves from further damage and to shift the power back in to their own hands. Instead of continuing to allow addiction to rule the family's life and create issues within it, a Tough Love intervention says “enough is enough.” The individual either needs to get help, or the family moves on without them.

This type of intervention may be best suited for individuals who are experiencing significant behavioral, social, emotional, and/or physical issues related to their alcohol abuse. If a person is prone to outbursts of violence or self-destructive behaviors; suffers from a co-occurring mental health disorder; or abuses drugs in addition to alcohol, it is ideal to enlist the professional help of a trained and experienced interventionist. The American Society of Addiction Medicine (ASAM) defines addiction as a brain disease, stating that those dealing with addiction are unable to manage their impulses regarding alcohol use and abuse. In this vein, the Tough Love approach may not be optimal, as the individual may not be able to stop drinking regardless of threats and potential consequences. The Tough Love approach is often considered a last resort, and generally, only 10 percent of interventions will even get to this point.

Specifics of the Love First Intervention Approach

A different kind of intervention technique, developed by Debra and Jeff Jay in 2000, is the Love First method. With a Love First intervention, a concerned loved one sets up an intervention team of at least three members and no more than seven. The team can include anyone close to the individual who is impacted by their alcoholism, but small children are generally not part of the team. A professional interventionist can be hired to be the team lead and guide the whole process. This team will meet several times to make a loving plan to encourage positive change.

Each member of the Love First intervention team will write an intervention letter. These letters have four parts:

  1. A summary of the relationship between the person writing the letter and the intended reader: This recap can highlight some of the good times and special shared memories, the first meeting, and challenges overcome together. The main focus of this portion of the letter is to show the reader how much the writer cares for the person and values the relationship.
  2. A detailed list of specific instances when addiction impacted the writer directly in the past year: This can include times when the loved one had to cover for the individual, a fight in public, missed family obligations, or events that were ruined due to alcohol abuse.
  3. Statements of concern: Here, the writer will focus on the negative side effects of alcohol abuse and the consequences of continued consumption. This portion of the letter is nonthreatening and merely encourages a person to enter treatment for their own personal safety.
  4. A bottom line: This portion of the letter is separate from the rest of the letter, even on a different piece of paper altogether. The bottom line explains consequences that will occur if the reader does not enter into a specialized treatment program after the intervention.

Members of the Love First intervention team will meet after the letters are written and share them together, revising them as a group. Letters are meant to be encouraging; any anger or judgmental statements should be edited out. The team will work together to determine the best order in which to read the letters during the intervention, so they will have the most impact. The letter that may be the most emotional may be saved for last, for example.
Members of the intervention team will research treatment programs before the formal intervention, ensuring that all details are taken care of, so the individual can go straight into rehab after the meeting. Copies of the intervention letters are often given to the treatment program, so providers can share them with the individual during treatment to encourage continued participation. During the actual intervention meeting, loved ones will read the letters in the preplanned order, omitting the bottom line portion at first. If the person agrees to enter rehab at any point, the intervention is stopped. The bottom-line portions of the letters are only read if the person continues to resist entering treatment. At this point, team members need to be prepared to stick to the outlined consequences if their loved one still won’t seek professional help.

In Summary

Both Love First and Tough Love interventions aim to help families and loved ones get someone who struggles with alcohol abuse and/or addiction the professional help they need. A Love First intervention takes a lot of planning and time; however, it may be a more humane and gentler approach than a Tough Love intervention.

Each person is different; as such, the intervention model may need to be tweaked and personalized. A trained and professional interventionist can be very helpful in choosing an intervention model, helping to plan the meeting, and carrying out the intervention in order to help get a person into a specialized alcohol abuse treatment program. Medical and mental health providers, as well as professional substance abuse treatment providers, can help with an intervention and offer suggestions for families and loved ones. Regardless of the type of intervention used, the idea is to help all parties impacted by alcohol abuse and addiction to get professional care.