Author: Ruben Bermea, LPC

Individuals, families, and communities suffer when addiction and substance misuse goes untreated.¹ Sometimes the risks and effects of substance use require immediate, intensive interventions. If you have concerns for someone you know, you may have considered conducting a drug intervention to change their behavior.

Important questions to consider before starting an intervention include:

• What purpose does an intervention serve?
• How do you conduct an intervention?
• Who would participate in the intervention?
• How might your loved one respond to the intervention?
• What happens after the intervention takes place?

Understanding the evidence, methods, and approaches behind this tool can improve the success of your intervention. To find rehab options for your loved one, call 800-934-1582(Who Answers?) to speak to a rehab specialist today.

What Are Interventions?

The goal of a substance use intervention centers on getting your loved one into a treatment program.¹ Research has focused on several types of interventions. These approaches start by enlisting family and social support in the process.^1,2,3

Family members can lead the person experiencing addiction to recognize their suffering. Members of your loved one’s support network can show them how treatment can foster health and recovery.²

Some interventions use an invitational approach. Other intervention types may use the element of surprise, blunt confrontation, and forceful approaches to motivate people to engage in treatment.¹

Carefully consider your loved one’s needs when deciding how to approach intervention. Talking with a qualified treatment specialist or interventionist can help you choose an approach.

Considerations that may factor into the approach you choose include:

• The severity of your loved one’s addiction or substance misuse
• The length of time your loved one has engaged in substance misuse
• Your loved one’s openness to change
• Your loved one’s awareness of their need to change
• People that your loved one will listen to
• Immediate risks to you or your loved one’s health
• Any children that may face risk due to your loved one’s substance use

Seeking professional support to run an intervention can help you navigate this potentially challenging process. A professional can also help you and your loved one identify any factors which could improve or hinder the intervention process. They can also help you understand how different intervention approaches may impact your loved one’s motivation for treatment.

The Johnson Model of Interventions

This intervention method takes a direct and confrontational method to encouraging others to engage in substance use treatment.⁴ In this model, you and other members of your loved one’s support group confront the person over the impact their substance use has had.

This approach emphasizes the damage that substance use has caused for the person, you, or other members of their social system⁴. Participants will also describe the consequences your loved one will face if they choose not to engage in treatment.

While this model opens up the door for communication between you and your loved one, other interventions offer different tools and perspectives to motivate engagement in the treatment process.

The ARISE Model

ARISE stands for A Relational Intervention Sequence for Engagement. A professional who uses this method will ask family members and other important people to participate in the intervention. This method takes an inviting approach to the intervention.

The rationale behind inviting your loved one to an intervention session rests in their motivation.¹ When your loved one receives the invitation to engage in an intervention session, they have the choice to say yes or no to the meeting. This has the potential to reduce defiance or defensive responses to the intervention process¹.

This method differs from therapy in that the professional guiding the process works to get the entire family into a recovery-oriented process. While the main goal of intervention is to get your loved one into treatment, this approach also focuses on the family’s strengths and needs.¹

There are three levels of this approach:

• Level 1: Focuses on increasing motivation, fostering hope, and developing a plan to get the person with addiction into treatment.¹
• Level 2: The second level of this intervention extends the first level processes into 2 to 5 more sessions.
• Level 3: The family sets boundaries, enacts limits, and enforces consequences if the addicted person continues to refuse treatment.¹

The family progresses through each stage, whether the person with addiction attends the intervention or not.¹ When the individual agrees to engage in addiction treatment, then the intervention process transitions toward family engagement in the clinical recovery process.

The CRAFT Model of Interventions

This model, which stands for Community Reinforcement and Family Training, focuses on the family members or “Concerned Significant Others” of people experiencing addiction.³ The model works toward three goals. The first and primary goal targets the person with addiction by promoting their motivation to get treatment. The second goal centers around reducing the amount of alcohol or substances your loved one consumes.

The third goal focuses on promoting your own psychological health and well-being.³ CRAFT serves as a form of family therapy that promotes change by reinforcing positive behaviors.³

Important parts of this model include:³

• Increasing motivation for recovery with an emphasis on hope and potential
• Knowledge of the triggers and impacts of your loved one’s substance use
• Care and consideration for any potential aggression or domestic violence
• Improving communication skills
• Using reward systems to change behavior
• Discouraging substance use with careful use of rewards and consequences
• Developing plans for how you can improve your life
• Suggesting that your loved one engage in treatment

CRAFT takes a motivational and behaviorally focused approach to help you improve your life as you encourage your loved one to get treatment. Talk with a treatment provider who has training and experience with the CRAFT intervention methods for further guidance.

Which Intervention Approach Should You Take?

Consider the outcome you would like to achieve when choosing an intervention approach. Evaluating your and your loved one’s needs can inform your choice and help you decide how to coordinate an effective intervention.

Certain interventions may occur when other entities initiate them. Such “coerced referrals” can occur in situations involving:⁴

• The legal system
• Interventions initiated by your loved one’s employer
• Interventions associated with medical crises
• Psychiatric emergencies resulting in involuntary treatment

Substance use can often amplify or mask symptoms of psychiatric disorders.⁵ Understanding the relationship between your loved one’s mental health and their substance use can guide your intervention planning. The risks of aggression, suicidal ideation, or erratic behavior can create a need for a high level of treatment.⁶

Understanding your local laws and regulations for involuntary hospitalization or treatment can help you guide your loved ones to the treatment they need.

Who Should Participate?

Think about who you would like to participate in the intervention. Some people may have a better response to a one-on-one conversation. Others may benefit from a group discussion about their use.

Typically, people respond more openly when they feel safe and supported in their relationship with others. Make a list of people that you and your loved one trust. Invite people who are open to learning the intervention process and attending to your loved one’s needs.

Consider Your Experience and Relationship

Interventions may carry a heavy emotional burden, given the challenges associated with addiction. Understanding how you and your loved one feel can help you maintain compassion for your collective struggle. Your experience of your loved one’s addiction may bring up painful memories and feelings.

Your choice to maintain compassion and understanding can help you remain focused on the goal of motivating your loved one to seek treatment.

Implement Rewards, Limits, and Boundaries

Identify rewards, limits, and boundaries that you can implement in the intervention. This planning can help you motivate your loved one to recover while preserving your own health. Remain firm in the boundaries you set. Be honest about the limits to the support you will offer your loved one.

Individuals facing addiction may live a life of extreme chaos or rigid boundaries. Offering firm, flexible boundaries can help you meet your own needs and role-model healthy changes.

Addiction Treatment: The Ultimate Goal of Interventions

We cannot control what another person does. We can prepare how to respond to others’ behavior. Your loved one may not agree to engage in treatment immediately. Some interventions create multiple opportunities for engagement. Each intervention will prompt you to consider limits in how you encourage your loved one to make changes or seek treatment.

Knowing your choices and limits can reduce feelings of helplessness and empower you as you engage in the intervention process. If your loved one shows even a slight interest in treatment, capitalize on their motivation.

Taking time to attend to logistical concerns can remove potential barriers or reasons for your loved one to avoid treatment. If you or a member of their support system can, prepare your loved one for treatment by assisting them with:

• Child-care coordination
• Management of financial obligations
• Coordinating time off with their employer
• Navigating any legal obligations
• Discussing their needs with insurance providers
• Transportation services
• Coordination with a facility to quickly transition your loved one into care

The fewer reasons to avoid treatment, the easier it will be for your loved one to get help when they recognize the need.

Give yourself the gift of forgiveness and compassion as you guide your loved one to healing. Addiction and denial can create frustrating circumstances which try your patience. Taking care of yourself can help you maintain appropriate boundaries as you offer support to your loved one.

If you or someone you care about needs help to access substance use services, a specialist can help you understand the available treatment options. Call 800-934-1582(Who Answers?) to speak with a treatment specialist about which programs and interventions would best suit your needs.

References

1. Landau, J., & Garrett, J. (2008). Invitational intervention: The ARISE model for engaging reluctant alcohol and other drug abusers in treatment. Alcoholism Treatment Quarterly, 26(1–2), 147–168.
2. Loneck, B., Garrett, J. A., & Banks, S. M. (1996). A comparison of the Johnson Intervention with four other methods of referral to outpatient treatment. American Journal of Drug & Alcohol Abuse, 22(2), 233–246.
3. Smith, J.E., Meyers, R.J. (2004). Motivating substance abusers to enter treatment working with family members. Guilford, New York.
4. Loneck, B., Garrett, J. A., & Banks, S. M. (1996). The Johnson Intervention and relapse during outpatient treatment. American Journal of Drug & Alcohol Abuse, 22(3), 363–375.
5. American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
6. Miller, W. R., Forcehimes, A. A., & Zweben, A. (2011). Treating addiction: A guide for professionals. The Guilford Press.