Total Family Intervention
Overview of Intervention
People with addictions and mental health issues are often in denial about their situation and unwilling to seek treatment. They may not even recognize the negative effects their behavior is having on themselves and others. Significant others, which can include families and/or close friends, may need to take action through a formal intervention which presents the person with an opportunity to make changes before things get even worse, and can motivate the person to seek or accept help.
What is an intervention?
An intervention is a process facilitated by a doctor, interventionist or counselor which helps family and friends gather and gently confront the person about the consequences of addiction and ask him or her to attempt treatment. The intervention provides specific examples of problematic behaviors and their impact on the person and his or her family and friends, offers a strategy for treatment with clear steps, goals and guidelines and spells out what each person will do if your loved one refuses to accept treatment
How does a typical intervention work?
An intervention isn't just thrown together in an afternoon. It contains many steps to ensure significant others are prepared for the process, identify a treatment resource and plan for treatment and ensure significant others have the support they need to cope during this challenging time.
Make a planning team. A significant other connects with other friends and/or family, proposes the use of an intervention and forms a planning team.
Identify a professional to facilitate the intervention. An interventionist or a professional counselor, social worker, marriage and family therapist or psychologist with specific training in interventions will help prepare significant others, identify a treatment placement for the person with the addiction, identify support resources for the significant others and coordinate the process. It is important to have a trained facilitator because an intervention is a highly charged situation with the potential to trigger anger, resentment and a sense of betrayal. A professional will take into account the particular circumstances of the person with the addiction, suggest the best approach, and help guide the team in the type of treatment and follow-up plan that is likely to work best.
Gather information. The planning team explores the extent of problem, researches the condition and treatment programs and identifies a program the person can enroll in immediately (this is often detox).
Form the intervention team. The planning team may identify a subset of people who will personally participate in the intervention (the intervention team). Team members identify a date and location in which they will meet with the person with the addiction, working together to present a consistent, predefined message and structured plan. (The person with the addiction will not know about this meeting until it is just about to happen). It is important that during preparation and rehearsal as well as the intervention meeting the facilitator keeps the discussion focused on facts of the problem and shared solutions rather than strong emotional responses.
Decide on specific consequences. The planning team, including the intervention team, will work with the interventionist to identify consequences if the person refuses treatment. The consequences need to present a unified message that change needs to happen and the types of changes expected, support is available for change related behaviors and refusal to accept treatment will result in certain distinct changes such as the person with the addiction having to move out, no longer being given money and bail outs, not being able to see children when under the influence etc.
Write your narrative. Each intervention team member will describe specific incidents where the addiction caused emotional, physical, relationship or financial issues, identifying the toll the addictive behavior while still expressing hope that the person can change. Statements are based in facts and emotional responses are owned with "I" statements. For example begin by saying "I was upset and hurt when you got so drunk that you passed out and missed my recital. I miss the days when you used to be in the front row for every performance. I am really looking forward to you being able to get healthier so you can be there to support your grandchildren in their performances."
Hold the intervention. Without revealing the reason, the person with the addiction is asked to the intervention site. Members of the team then take turns reading their narrative in order to help them stay focused on facts. Team member s will also say what changes they are ready to make to support recovery and specific changes they will make if the person with the addiction doesn't accept the plan. Don't threaten a consequence unless you're ready to follow through with it.The person with the addiction is then presented with an option for treatment and asked to commit to that option on the spot.
Follow up. Involving a significant others is critical to help people with addictions stay in treatment and avoid relapsing. This can include changing patterns of everyday living to make it easier to avoid destructive behavior, offering to participate in counseling with your loved one, seeking counseling and recovery support for themselves (addiction is a family problem), and knowing what to do if relapse occurs.
A successful intervention must be planned carefully to work as intended. A poorly planned intervention can worsen the situation and the person may feel attacked withdraw and become even more resistant to treatment.
Who should be on the intervention team?
An intervention team usually includes four to six people who are important to the person with the addiction — people he or she cares about, respects or depends on. This may include friends, adult relatives or clergy.
Don't include people who:
Your the person with the addiction dislikes
Has an unmanaged mental health issue or substance abuse problem
May not be able to limit what they say to what was agreed on during the planning meeting
Might sabotage the intervention
If you think it's important to have someone involved (such as a child) but worry that it may create a problem during the intervention, consider having that person write a short letter that someone else can read at the intervention.
How can you help ensure a successful intervention?
Keep in mind, the addiction has served a purpose for the person. People who are often the subjects of interventions either do not realize the impact the addiction is having, are overwhelmed by everything that comes with recovery, are afraid of failure and/or are terrified of losing control. This process is like stripping away their safety net. The one thing that has always been there for them to help them escape pain. Additionally, the significant others involved in the intervention have often become used to the addiction, and may have even played a part in enabling it. For these reasons, the process of planning the intervention and the intervention itself can cause conflict, anger and resentment even among family and friends. To help run a successful intervention:
Take time to plan the intervention. It can take several weeks to gather the people, learn about the addiction and the extent to which the addiction is impacting the person physically, emotionally, cognitively, and interpersonally, write personal narratives, rehearse the intervention process and find an appropriate initial placement which will be able to admit the person the day of the intervention.
Ensure the person with the addition is not under the influence at the time of the intervention
Appoint the interventionist as the primary contact for the team
Anticipate the person's objections. Have calm, rational responses prepared for each reason the person with the addiction may give to avoid treatment or responsibility for behavior. Ensure the family is versed on FMLA, insurance benefits, options for childcare if needed, someone to watch pets, someone who will be willing to make sure bills get paid while the person is in treatment etc. It is helpful if, as an interventionist, you keep a running list of objections people have to treatment that you can share with families to ensure they are prepared for as many of the objections as possible.
Present the messages with love, respect, support and concern — not anger. Set ground rules for intervention team members ahead of time that prohibit name-calling or angry or accusing statements and insist on objective presentation of the facts using "I" statements.
Stay on track during the intervention. Remember that the person with the addiction will likely feel very threatened (angry, terrified and/or guilty) during this process. Natural reactions include shutting down, trying to leave or becoming verbally aggressive. Make sure team members are prepared to remain calm in the face of the person's accusations, hurt or anger, which is often meant to deflect or derail the conversation.
Ask for an immediate decision. Don't give the person time to think about whether to accept the treatment offer.That will just allow the person time to continue denying a problem, go into hiding or on a dangerous binge.
If the person refuses help
Unfortunately, not all interventions are successful. In some cases, the person with the addiction may refuse treatment, erupt in anger, insist that help is not needed or become resentful and accuse team members of betrayal or being hypocritical.
Prepare team members for these situations ahead of time and encourage them to remain hopeful for positive change. When people are extremely upset they often have tunnel vision and have difficulty seeing the big picture or taking other people's perspectives. When they calm down and have a chance to think about it, they may still change their mind and agree to treatment. Sometimes this is their way of trying to retain some control. If they decide on treatment on their own at some point after the intervention, then it feels more like their choice and not like they are being forced into something.
Help team members prepare for what to do if the person doesn't accept treatment. They must be fully prepared to follow through with changes that were agreed upon and continue to present a united front. Daily or weekly team consultation meetings after the intervention are often helpful to ensure everyone is sticking with the plan so the person with the addiction cannot start trying to split the team.
Children, partners, siblings, parents and friends are often subjected to emotional, physical and/or financial abuse and neglect because of alcohol and drug problems. Significant others of the person with the addiction need to understand that don't have control over the behavior of the person with the addiction. They only have control over how they respond to the situation.
Even if an intervention doesn't work, it is important for the team members to recognize the impact that the addiction has had on them and identify not only changes to prevent enabling the person with the addiction, but also changes they can make to start healing themselves.