Friday, January 31, 2014

Does Intervention Really Work

What to do when you suspect your Loved One is abusing or addicted to Drugs or Alcohol, Or is addicted to something such as Internet Use, Gambling, Shopping, Food, and Porn or  Sex.
Does the Addicted Loved One (“ALO”) need to “HIT BOTTOM” before getting help?
The myth that “Hitting Bottom” is required before an ALO is ready for treatment has been disproven and disregarded by addiction professionals, mental health professionals, and medical professionals for quite some time.   Further, waiting until an ALO recognizes his or her problem or asks for help is potentially dangerous because denial is a strong characteristic of addiction and the ALO may cause irreparable damage to himself, herself, or others if left untreated.  More importantly, the definition of “hitting bottom” is often different for every person.  For some, becoming homeless is hitting bottom.  For others, simply having their boss or their spouse tell them they have a problem is enough.
If your ALO’s substance use or abuse has become out of control, has progressed beyond recreational use, or its consequences require attention, it is the right time for concerned others to take action.  As a concerned family member or friend, in the past you may not have been more than vocal in your concerns.  Either way, your approach has not been successful.  If you haven’t stated your worries, if you have stood by silently while your fear, resentment, and frustration grew, the first intervention you should do is calmly express your concerns about his or her behavior.   He or she need to hear this from you.  The first step is to express your fears and tell him or her that you want him or her to get professional help.
Indicators of Drug or Alcohol Abuse or Other Addictive Behaviors
1.       Has the drug or alcohol use or other behavior affected your ALO’s
a.       Responsibilities at home (housework, daily responsibilities, paying bills)?
b.      Responsibilities and performance at work or school (calling in sick, being unable to perform at work, missing classes and assignments)?
c.       Personal relationships (canceling on friends and family)?
d.      Financial status?
2.       Has the drug or alcohol use or behavior led to legal or financial difficulties?
3.       Does he or she have feelings of shame, regret, or embarrassment about what he or she has done when under the influence or uses again after staying sober?
4.       Does he or she continue to use even though he or she puts himself in physically dangerous situations?
Initial Interventions
If your ALO is willing to try to quit his or her substance abuse or addictive behavior, it is critical to put a plan into action.  Most of the time, the ALO will want to do the minimal amount of changing possible.  There are two things the addict or alcoholic dislike most – 1) the way things are, and 2) change that he or she cannot control.  So what is the ALO willing to do?
1.      Quit strictly on his or her own?

2.      Attend a 12 Step Meeting – AA, NA or some other program?

3.      See an addiction counselor?

4.      Outpatient treatment?

5.      Intensive day/night treatment?

6.      Inpatient treatment?
However, what if her or she says “NO” when asked to get help? What if he or she agrees to cut down but not quit?  In these circumstances, a more formal intervention may be necessary.
The Family Intervention
A family or friend intervention can be very effective.  There are several books, available on family intervention.  Many interventionists have published books on “do-it-yourself” interventions.  The following are a few:

·         Vernon E. Johnson, “Intervention: A Step-by-Step Guide for Families and Friends of Chemically Dependent Persons”, Center City: Hazelden, 1986.
·         Jeff Day & Debra Day, Love First, Center City: Hazelden, 2000.
·         Judith Landau & James Garrett, Invitational Intervention: A Step by Step Guide, Booksurge, 2006.
·         Andrew T. Wainwright & Robert Poznanovich, It’s not OK to be a Cannibal, Center City: Hazelden, 2007.
·         Brad Lamm, “How to Change Someone You Love”, New York: St Martin’s Press, 2009.
·         Candy Finnigan, When Enough is Enough, New York: Penguin Press, 2008.
·         Joanni Gammill, The Interventionist, Center City: Hazelden, 2011.
·         Mark S. Komrad, You Need Help!, Center City: Hazelden, 2012.
The Do-It-Yourself Intervention
The Do-It-Yourself Intervention can be highly effective if done with compassion and clarity.  To do this type of intervention, select one person to be the chairperson and another or the same person to be the detail person.  Try to find three to eight family members and friends whom the ALO trusts, respects and values.  Then, generally follow the checklist below:
1.      Set up a planning meeting to discuss moving forward with the intervention and set a date.
2.      Discuss the importance of not alerting the ALO until all the plans are finalized and everything is in place.

3.      Have each person write a letter describing how much the ALO means to you, the ways that his/her substance abuse have caused negative consequences and affect you as well as him or her. Make sure to include a message of hope at the end.

4.      Read your letters to each other to edit out anger, blame, and judgment.

5.      Determine bottom lines,

6.      Find an appropriate treatment program and make arrangements for treatment.

7.      Discuss with the treatment center whether detox will be necessary.  If the person is abusing alcohol, opiates, benzodiazepines such as Valium and Xanax, the person will likely need detox.  If the person is abusing cocaine, crystal meth, crack, or other forms of speed, then detox may or may not be necessary.

8.      Make airline reservations if the treatment center is out of state.

9.      Create a plan to likely assure the ALO will be present at the intervention.

10.  Pack suit case and make list of prescriptions used by ALO.

11.  Conduct the intervention in a peaceful, safe place – usually not the home of the ALO.

12.  If the ALO agrees to get help, have someone accompany him or her to treatment with encouragement.  If the ALO does not agree, have a back-up plan in place.
Types of Interventions  
Many people have seen the A&E television program “Intervention” so they have an idea of one type of intervention.  Generally, there are three types of interventions:
1.      Confrontational – This is the type used by the A&E television show “Intervention”.  The ALO is not told that the intervention will take place; it is a surprise.  The focus is simply on getting the ALO into treatment and generally does not deal with concurrent issues in the family. 

2.      ARISE or Invitational – This type of intervention is set by the Family Contact and the ALO is told “We are concerned about “your drinking” or “your behavior” and a few of your friends and family are meeting this Saturday at 10 am to discuss what needs to be done and we would like you to come.  Often the ALO refuses, but when he or she is told that the group is still going to meet to discuss what they are going to do, the ALO rarely refuses to attend for the mere fact that he or she wants to know what everyone will say about him or her.  In this method, usually everyone becomes involved in change or treatment of some kind.

3.      Systemic Family Systems – This model is highly successful with multiple addictive or mental health issues among family members.  The focus is on the family, not the individual.
When to Use a Professional Interventionist
A professional interventionist takes a great deal of the heavy work off the shoulders of the family member who is planning the intervention.  They have access to the appropriate treatment center, can arrange for detox and special needs, and often can safely transport the ALO from the intervention to treatment.  The specific situations when a professional interventionist is advisable are the following:
1.      If there have been previous attempts at intervention and they were unsuccessful,

2.      If there is a history of violence or abuse,

3.      If there are concurrent mental health issues, such as depression, bi-polar, anxiety or schizophrenia,

4.      If there have been threats or attempts at suicide,

5.      If the ALO has a complicated substance abuse or cross-addictive behaviors, or

6.      If the family members are intimidated or beholding to the ALO.
Professional interventionists should be licensed and insured.  Ask for references and check them out. 
Intervening upon a person engaged in such self-destructive behavior such as substance abuse, compulsive gambling, shopping, or sex, or eating disorders, such as bulimia and anorexia, is one of the greatest acts of love that one can give.  Trauma and other painful experiences are usually behind addictive behaviors. Interventions bring hope and healing.  It allows everyone to heal, to change and to grow.  I never give up on anyone and I encourage you to seek help from family, friends or a professional if you are dealing with someone in the grip of addiction.

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