Interventions For Alcohol And Drug Addiction: The Essential Guide
Interventions are often a last effort by families to try to get a loved one suffering from addiction into a drug treatment program. There is no “right” time over the course of addiction to stage an intervention, but many are delayed until such time that the family has reached a state of desperation trying to deal with the addiction. Times to consider staging an intervention can be any point from early onset of an individual’s addiction to several years into it, perhaps even after numerous failed attempts at treatment, and possibly after incarceration as well. Making the decision to stage an intervention is not easy, as the planning for it can be complicated, the intervention itself is an emotionally fueled confrontation, and the resulting success requires many changes in the lives of the family, following the intervention itself.
Interventions can have a profound and powerful effect on those suffering from addiction as well as their loved ones, but they are not guaranteed to work. It is important to handle an intervention with extreme care, as it can be (and often is) a lifesaving tool for an addicted individual. It is also important to understand that the best-laid intervention plans may not be successful in getting the loved one to treatment, but other successes result from the process, such as helping the family to heal and find healthiness thereafter. So, the outcome of an intervention cannot be predicted, but the definition of “success” is not limited only to the intervention itself.
Yes, the initial and primary goal of an intervention is to get an addicted loved one into treatment, but intervention can still be successful, even if the addict refuses treatment right away.
Staging a successful intervention plays out in three stages:
The planning and preparation
The initiatives and efforts after the intervention
The Effects of an Intervention
An intervention is confrontational, emotional, and often a turning point in the lives of most everyone involved. It is a significant moment, one that may change the course of a loved one’s addiction. Interventions are not only about the addicted person but are also very involved with the family. Especially in the event that the intervention does not accomplish the goal of getting the person suffering from addiction into treatment, tough decisions, and commitments to therapy fall to the family members. Whether immediately successful or not, an intervention can have tremendous effects on everyone involved, but the less the addicted loved one is swayed by the event, the more work the family will have to do to heal from the addiction.
Intervention Is for the Whole Family
There are destructive familial patterns and dynamics brought to light by addiction that must be healed in order for the family to find health and wholeness. Addiction is not just a single-person issue—it is a family disease. When someone becomes addicted, family members suffer their own sets of consequences and can become just as “addicted” to the loved one as the loved one is addicted to the substance of abuse.
Some people immediately cut ties once addiction takes hold, but the majority of family members remain in the loved one’s life, the degree to which can be a conduit for the addiction itself to dominate relationships with the addicted person. Once this happens, the addiction and the individual become one in the same. Unbeknownst to the family, this conflation only pushes the addicted person deeper into the addiction and further damages personal relationships. For this reason, more healing is to be had by family members in staging an intervention. Interventions are centered in getting the loved one into treatment but also offer a time to begin healing an unhealthy family dynamic.
Begin the Separation of Addiction and Individual
Regardless of what they may say in defiance, no person wants to be enslaved by a substance or behavior; they want to be loved and accepted for who they are and not feel judged. Unfortunately, the individual is difficult to recognize through addiction, and the nonacceptance of addictive behavior is perceived as an overall rejection of the person as an individual. This is where intervention can be especially helpful to remind the loved one that there is a difference between them and their addiction. An intervention can be an effective opportunity for the family to express their contempt for the addiction but their unconditional love for the individual.
This dialogue in an intervention, which begins the process of truly separating the individual from the addiction, is necessary for both the family and the addicted person. Most importantly, isolating the addiction as an unwelcome part of the family—and not the suffering family member—lets the loved one know that all hope is not lost, and there is a path to redemption.
Change the Family Dynamic
Addiction is well-known to wreak havoc on the relationships between family members and the loved one suffering from addiction. Distrust, fear, ignorance, or anger often take the wheel in these tenuous and stressful relationships. This stress in relationships is not only with the addicted individual but also occurs within the entire family dynamic. Addiction often pits one family member against another—perhaps one does not agree that ignoring the addicted person is helpful, or another disagrees with actions that are perceived as enabling that person. These are just two examples of the myriad subjects of dissent over the treatment of an addicted loved one that can take place within a family.
Just as addiction damages family relationships and the overall dynamic, it can also bring to light many other issues that may come to surface throughout the process of intervention preparation, such as:
Indifference and avoidance
The intervention itself is intended only to confront the addicted person and is not the time to air family grievances with one another. However, any chance for a successful intervention requires that all participants present a united front to the addicted person. In order to do this, everyone needs to reach a consensus on how the family will address and respond to the person being confronted, during and after the intervention. A healthy family dynamic is an integral part of recovery for the person suffering from addiction. If the family dynamic can change in a healthy and positive manner, every member, including the addicted person, will benefit. However, without a healthy family dynamic, a savvy person in addiction can easily manipulate the weakest link, and through them, continue with the addictive behaviors and abuse.
Prepare for Intervention
Once the decision has been made to have an intervention, the preparation must begin. The most effective way to stage an intervention is to enlist the help of an intervention professional.
These professionals are well versed in the process of intervention and can be especially helpful with the facilitation of the event. All interventions are emotional moments in the lives of the family members and the addicted person, and an intervention counselor will help to keep emotions at a controlled level. They will also control the entire intervention, ensuring that it remains as calm an environment as possible.
Find an Interventionist
As with any professional, it is important to perform due diligence with an intervention counselor. The fees for these professionals can range from approximately $1500 to over $10,000, so it is necessary to know what an intervention counselor is offering for the cost and to ensure that it is appropriate for the needs of the family. Finding intervention counselors can be as easy as an Internet search, but finding the best one for a family’s unique intervention needs requires deeper research and asking important questions. There are certain facts to know about an interventionist and their approach before enlisting their services.
A professional looking website doesn’t mean a professional owns it, nor does it mean that a person has proper credentials to plan and stage an intervention. At a minimum, an interventionist should have a CIP (Certified Intervention Professional) certification. It is further qualifying for an intervention professional to have some or all of the following certifications:
LCSW (Licensed Clinical Social Worker)
LADC (Licensed Alcohol and Drug Counselor)
BRI-I or -II (Board Registered Interventionist)
CCDC (Certified Chemical Dependency Counselor)
Interventions are serious events and not the time to give a novice the chance to build their career. It is best to aim for intervention professionals with a long and stable career in planning and staging interventions. Each intervention has its own unique configuration, and the safest thing for a family to do is find someone with whom they can be completely confident, who will be able to handle any situation that may arise.
It is important to have a full understanding of how the interventionist works and what process they will use to prepare for the intervention, execute during the intervention, and follow up thereafter.
One thing that all effective interventionists should do is thoroughly interview each prospective participant of the intervention. Since all participants must present a united front, a good interventionist will be able to speak with members as many times as needed to determine who, if anyone, should not participate. If a potential intervention counselor does not express an intent to speak with the family members at length, that should be a disqualifying factor.
Additionally, find out what types of intervention methods the counselor is trained to perform. The most common method is called the Johnson Model, in which the family members gather to express love, express the damage and harm created by the individual’s drug abuse, and then present a set of consequences should the individual refuse treatment. This is not the only method of intervention; there are many iterations of intervention models, and an interventionist may have his or her own approach to staging an intervention. It is important for an interventionist using any approach to listen carefully and weigh the particular process with what is known about the addicted individual, to determine what would be most effective. Lastly, it is necessary to ask what levels of support will be received by the interventionist after the intervention has taken place, both in the case of the loved one going to treatment and if treatment is refused.
Treatment Center Affiliations
Some interventionists may be contracted with addiction treatment programs and aim to get subjects of the interventions they stage directed to certain rehabs. Although this isn’t necessarily a conflict of interests, it is important to know up front, so that an informed decision about the most appropriate rehab can be made. Most intervention counselors have relationships with numerous rehab programs, and referrals should be used to contact several programs and get information about the services they offer and how effective they may be for the loved one’s recovery plan.
Interventions and drug rehab combined can be very expensive, and health insurers do not cover intervention counselors, so that will likely be an out-of-pocket expense. Each interventionist will have a payment structure, most of which are upfront payments for the services offered. It is important to know exactly what the fees are if there are any additional costs, and what, if any, payment plans can be arranged.
Although there are some reports of up to a 90 percent success rate for interventions, little published research exists on the overall success rates, and this is mostly because many individual methods track and report their own rates of success, and because the extended timeline that may exist between an intervention and the person finally agreeing to treatment.
However, each individual intervention counselor should be able to express some level of success in the interventions that they have facilitated. Asking for this information is also a great way to determine the degree to which an interventionist follows up with the families they have helped.
There are several steps to consider once a professional counselor has been found to facilitate the intervention. The first step in planning for the intervention is to determine what kind of intervention process is best for the addicted individual. This is a time when the interventionist will individually and collectively gather several details from the family about the addicted person, the substance(s) abused, any potential dual diagnosis conditions, and what kind of personality they will likely encounter during the intervention. All of these factors will help to determine how the person should be approached, the best locations for the intervention, and the method of intervention.
What Method of Intervention Is Best?
While all interventions are confrontational to one degree or another, some methods of intervention focus more on love and compassion, and others are more aggressive, focusing on the addicted person and taking a more forceful position. Depending on the individual in need of addiction treatment, the approach to an intervention may vary, but there are two are basic approaches overall: a surprise and an invitation.
The least confrontational approaches to intervention are the invitational method. As the name implies, an invitational intervention is one in which the addicted person is fully aware of what is happening and being asked to participate prior to it taking place.
Using an invitational model, the family will meet beforehand with a counselor or intervention professional to plan a multiple-day workshop. The interventionist will make clear the expectations of the family members’ efforts to recover from their loved one’s addictions. These expectations can include things like individual counseling, group and family therapy, codependency counseling, and addiction treatment, if necessary. During the meetings with the family, a chairperson will be selected. This is usually someone who holds a close and trusting relationship with the addicted person.
The standout feature of an invitational intervention model is the fact that the workshop is not aimed at the addicted person, despite hopes for an agreement to go to treatment. Different from confrontational interventions, all family members are invited to join the upcoming workshop. The workshop focuses on addiction education, with topics ranging from the effects of addiction to genealogy. Various types and methods of addiction treatment, including family therapy, will also be discussed.
The hopes are that the addicted person will attend the workshop and accept treatment by the end of it. However, if the addicted family member does not attend or refuses treatment by the conclusion of the workshop, the goal is that the family has been educated on addiction and how not to enable the addicted member any further. It is at this time that the family members must fulfill their commitments, made with the interventionist in the meetings before the workshop.
The main focus of an invitational intervention is to provide education on addiction and counseling for the family, in hopes that the addicted person will sign on to get help as well. Some of the main objectives in educating the family are aimed to provide tools they can utilize to live healthfully, whether the addicted member gets well or not.
These include things like:
Understanding the personal dangers of codependency with an addicted person.
Learning how to create and hold reasonable boundaries.
Coping with anger and fear surrounding an addicted loved one.
Understanding what is and what is not enabling an addicted person.
A number of iterations of invitational interventions exist, and counselors themselves may have their own unique approach, tweaking aspects throughout the process. It is important to remember that no one exact intervention type and approach will work for every person who suffers addiction. This is much the same way that no one form of addiction treatment will be the most effective for every individual. Each person must be approached as the unique individual they are, and it may not be uncommon for interventionists to alter some aspects of an intervention based on the individual and the circumstances surrounding the addiction.
The most commonly known forms of intervention use the element of surprise, where the family and loved ones confront the addicted person and may use a variety of different approaches to encourage treatment. Several models of intervention use this method, and the differences between them vary in the approach and tone the family will take once in front of the addicted member. The most effective approach depends heavily on the person being confronted, the severity of the addiction, and the family dynamics. Different approaches can vary in intensity and confrontation based on the needs of the situation.
A confrontational intervention can vary from those with a very soft and loving tone with a gentle push toward treatment to one of harsher criticism and a demand for treatment. The premise of this intervention is that the family catches an addicted person off guard and essentially states their case for the need for that individual to enter into a treatment program immediately. This type of intervention consists of several steps, the first of which is to meet with the facilitator, who ideally should be a certified and experienced interventionist.
Meeting with the interventionist
The first thing an interventionist will want to do is get information from each of the family members about a few key elements. In addition to asking about each family member’s own relationship with the addicted individual, the interventionist may want to know:
Does the addicted person live with a family member? If so, whom?
Does the addicted person have expenses (i.e. rent, cell phone, car payments)? If so, who pays for those things?
Are there concerns about enabling any other members of the family? If so, with whom, and what are the concerns?
Are there any pending or potential criminal charges the addicted person is facing?
What was childhood like for this person?
How long has the addiction been going on, and what details are personally known about it?
Has treatment been sought in the past? If so, what was the outcome?
Is there any diagnosis or suspicion of a mental health disorder?
Are there any past traumas or major life events that may have precipitated destructive behaviors, or driven them to have a propensity toward substance abuse?
What has the attitude of other family members been toward the individual since the addiction?
Every interventionist is different, so in no way is this a specific list of questions that will be asked, but more so a baseline for the topics covered in initial meetings, so that the interventionist may get a fuller picture of the loved one and the circumstances surrounding their addiction. During meetings with the family, the interventionist will discuss the importance for each member to come up with a bottom line and consequence for the addicted person if treatment is refused. Any family member who may not be able to hold to their consequence should not participate in the intervention because showing a united front during and after the intervention is very important.
Make Plans for Treatment
When staging an intervention, it is important to already have plans in place should the addicted person agree to go to treatment. While it is important to get an agreeable loved one to treatment as soon as possible, it does not necessarily need to be done the same way it has been sensationalized on television shows—that is, immediately rushing the person off in a waiting vehicle, directly to rehab. In some cases, there may be a need to deal with important business or make final preparations in between the time of the intervention and the time to leave for treatment. However, the shorter that time period can be, the better.
It is necessary for the family to decide upon and plan for at least one treatment option for the addicted individual ahead of the intervention. This can be discussed with the interventionist, as some approaches to intervention recommend more than one option, while others call for only one. Therefore, it is important to carefully weigh treatment options in consideration of the individual attending and what may be the most effective form of rehab for them. And if the selected treatment program is far away, it is beneficial to reserve a flexible or refundable plane ticket in the event that the intervention outcome does not go as planned.
Write Letters to the Loved One Suffering from Addiction
When writing letters to the addicted individual, it’s important to follow the protocol laid out by the interventionist. Effective intervention letters should include:
Focus on the addiction.
The personal effects of addiction on the writer.
No chastisement or blame toward the addicted person.
Only firsthand experience (never hearsay) of the addicted person’s behaviors, in detail.
Expression of concern for the addicted person.
Expression of love and gratitude towards the addicted person.
An offer to help.
Always follow structures provided by the interventionist, but one example of an intervention letter, including the aforementioned components, reads as follows:
I love you with all of my heart, and I know you love me. Our love has endured for over 15 amazing years. You have been my rock, and the love of my life, ever since we met at CalTech. I don’t think I would have graduated, had it not been for your support and encouragement. I remember when I was so discouraged and ready to drop out, but you refused to let me fail. You studied with me, introduced me to brilliant professors who helped me along the way, and never let me forget my own self-worth. Our college experience laid the foundation for our future together, and I have been so proud to call you my husband, and the father of our beautiful children.
Ron, your cocaine abuse has been a part of our lives for a long time now, and it has been ruining your life. We don’t get to spend time together as a family, like we used to. When I come home from work, you’re sleeping on the couch, and you’ll stay there all evening. This makes it so the kids and I eat dinner with an empty seat at the table, even though you’re in the house. Anytime I try to wake you, so we can support Sarah at her basketball games, you get very irritated with me for interrupting your sleep. When you stay up all night, bingeing, you can hardly function the next day. You don’t eat, you don’t shower, you barely get out of bed, and I can see your health deteriorating every day. You used to take such pride in your hygiene and personal health, but now it frightens me to see you neglect yourself like this. Ron, I love you, and it breaks my heart to see you like this. Just as you were there to help me through CalTech, I am here to help you now. We are all here to help you. Will you accept our help today?
Love, your wife,
Each member of the family should compose a letter to the addicted person, consistent in format, and include their own personal experiences with the effects of the individual’s addiction. The order in which the family members will read their letters will be predetermined by the facilitator, who will guide the entire intervention from start to conclusion.
Decide on a Time and Place for the Intervention
It is important to give some thought to the best time and location to hold the intervention. The interventionist will help to determine the pros and cons of various places and times. A general rule is to aim for a time of the day when the addicted person is least likely to be under the influence. In some circumstances of severe substance abuse, this may not be possible. The interventionist will discuss with the family any likelihood of the person running away from the intervention, and the contingency plans if that should happen.
The location also matters in the effectiveness of an intervention. It is important that the confronted person not feel ambushed, and as such, any location which may be a hostile environment for them is not the best place for an intervention. An example of a hostile environment might be a parent’s home, where the addicted person constantly encounters judgment and might have painful memories of events regarding their addiction. Obviously, any location where there are drugs (whether prescription or illicit) or alcohol is also not a good place to hold an intervention. At a minimum, ensure that all drugs and alcohol are completely removed from the premises before the intervention.
Set the Bottom Line
Each member of the family in an intervention has his or her own relationship with the addicted individual. Whether that relationship is a close one or estranged, everyone will need to set a bottom line for the addict, in the event they choose not to accept treatment. Bottom lines will vary, based on the addicted person, the family member, and the circumstances. The most important thing to remember when setting a bottom line is to ensure that follow-through with the set consequence is realistic.
If an addicted person is given a consequence or bottom line for refusing treatment but the family never follows through, the person has only learned that they have been issued an empty threat, which will only make it harder to persuade them to accept treatment in the future.
The intervention counselor will be able to guide the family through realistic and impactful consequences should the addict refuse treatment.
The consequences need not be too draconian, but they should be of significance to the addict. They often include things like moving to:
File for divorce.
File for custody or calling child protective services, if the addicted person has minor children.
Call the police, if the addicted person is evading a warrant or engaging in illegal activity.
Deny housing, if the addicted person is residing with a family member.
Refuse to provide financial support, if the family is financing the addicted member in any way.
There are often more specific things within the family, such as an upcoming wedding or birth of a child, where omission from these certain important events or the lives of other minor children in the family may be used as a bottom line.
It cannot be stressed enough that no bottom line should be given unless it can and will be fully enforced.
Go through the Checklist
The list of things to do in preparation varies depending on the type of intervention and the family circumstances.
A general guideline is to have everything prepared that can possibly be prepared. Some examples of items on a preparation checklist may include:
Having the treatment program on standby, ready for a call as to whether or not the addicted person will be checking in.
Having bags packed, according to the guidelines of the selected treatment center.
Having plans in place for the care of any pets the addicted person may have.
Having a stable home (preferably with a trusted member of the family) ready for the immediate occupancy of any minor children the addicted person may have.
Having a plan to deal with any bills or financial obligations of the addicted person in their absence.
Planning transportation to the treatment program or airport ahead of time.
Having plans in place in the event of a refusal by the addicted person.
It is important to be as prepared as possible for an intervention. Emotions will be high, and family members will likely be very nervous and anxious. Despite these uncomfortable feelings, no one in the family should be under the influence of any mood-altering substances at the time of the intervention.
When the time comes for the intervention, each family member will need to be as calm as possible. This is easier said than done, but the tremendous work in preparation that has all led up to this moment makes this essential.
Hours before the intervention, it may be helpful to engage in some familiar and relaxing activity such as light exercise, yoga, meditation, reading a favorite book, or even a short nap.
The first thing to do on the day of the intervention is relax. The interventionist is there to facilitate, mediate, and guide the entire event. The letters are already written. The best way to get through it is to stay calm and let the interventionist do their job.
Although emotions will likely be very high, do not get angry or aggressive. If the addicted person begins to lash out at a family member, do not get defensive. The interventionist is there to intercept that type of communication.
By the time of the intervention, the family has likely been told about the chances that the loved one will refuse treatment. It is important to understand that a “no” at the intervention does not mean that it has been unsuccessful.
If the Addicted Person Says No
There is no guarantee that an intervention will work according to plan, ending with the loved one on their way to treatment. If at the end of an intervention, the addicted person continues to refuse treatment, all hope is not lost. There are two remaining successes that may result.
Bottom Lines Held Are Powerful Tools in Getting Loved Ones to Treatment
If the addicted person refuses treatment, it is time for the family members to express their bottom lines. This dialogue should always happen until the addicted person refuses treatment. Bottom lines should not be a part of the letters read aloud to the loved one.
It is unlikely that hearing the consequences alone will sway the person to accept help, although it is possible. As consequences are expressed, it is again important that family members remain calm and not take a threatening tone. At the time when consequences are given, the focus is no longer on the loved one but shifts to the family members and their well-being. This is particularly effective with addicted individuals who rely on family for one thing or another. One bottom line at a time, the loved one will be handed back the problems of their addiction, as the family members resolve to no longer shoulder them.
It may not be apparent to the addicted person during the intervention, but as the reality of problems mount higher and higher, without relief provided by family members, the motivation to change gets stronger. This is why it is so important that family members hold their bottom lines. Many addicted people, especially those dependent on family, will talk a big game, as though being homeless or having no car or cell phone is perfectly fine with them. Often it takes no more than a week of finding out that they cannot beg, cry, or manipulate their way back to being enabled by the family before they are ready for treatment.
This isn’t always the case, but it is worth holding bottom lines to give it a chance.
The Family Must Get Well, with or without the Addicted Family Member
If bottom lines are given and held and the addicted person is still unwilling to accept help, the family has already been coached and prepared by the interventionist. The goal for success at this point is for the family to get well, whether the addicted person chooses to or not. The interventionist will likely have already referred the family members to several family treatment programs and will have provided information on local support groups like Al-Anon and Nar-Anon.
This is the time for the family to learn more about addiction, codependency, enabling, and how they can be healthy in their own lives even though they continue to have an addicted loved one. This does not necessarily mean that the family has to completely cut ties with the addicted person, but through counseling and support groups, they can learn how to cope with the situation and how to have healthy communication with their loved one while still holding firm on their bottom line.
After all this, the family should be secure in knowing they’ve done all they can for this loved one, and the door should remain open if and when the addicted person comes asking for help. Assistance with getting into a treatment center should be the only help a family is willing to offer after an intervention. When families can hold a realistic and impactful bottom line, not only do they provide themselves with tremendous healing and peace, but they continue to encourage their addicted loved one to accept help.
No two interventions are exactly the same just as no two addicts and their families are exactly the same. As such, much research and preparation should be done before a decision is made to stage an intervention. Although there is no promise of getting an addict to accept help, one thing a professionally facilitated intervention can do with an almost perfect success rate is to help the family members—individually and collectively—recover from the trauma of having an addicted loved one.
Interventions aim to discover what it would take to get addicted family members into treatment, to encourage with love those people suffering from addiction, and to be ready to act on consequences for not accepting help.
Whether the addicted person gets help right away, years down the line, or, perhaps sadly, never gets help, the family must do all they can to offer health to the loved one and be healthy themselves. After staging an intervention with professional help, going through the preparations, pouring their hearts into offering help to their loved one, and holding their bottom lines, the family can rest assured that they have indeed done all they can.