FREQUENTLY ASKED QUESTIONS (FAQs) ABOUT INTERVENTION*
An intervention is a group process during which the reality of an individual's alcohol or other drug (AOD) use is presented to that person by a group of other individuals, e.g., family, friends, colleagues, etc.. Each member of the group should be a significant person in the patient's life, and should be prepared to relate several experiences in which the person's drinking or drug use adversely affected him or her. The weight of all this objective evidence, presented in an structured manner by friends and family members, usually overcomes the “denial” of the identified patient (IP) so they can be motivated to enter a treatment program. This approach is characterized by statements that affirm: (1) positive regard, love, affection for the individual, (2) statements that specify negative consequences of the IP's AOD use in a descriptive and non-judgemental manner and (3) statements that affirm the need for the IP to seek treatment. When necessary (4) the behavior changes, i.e., consequences, the participants will make if the IP does not seek treatment are presented.
B/ WHAT KINDS OF CHANGES ARE EXPECTED FROM AN INTERVENTION?
OTHER TERMS AND CONCEPTS:
ENABLING: dysfunctional approaches to the person with an AOD problem.
CO-DEPENDENCY: maladaptive, unhealthy reactions to the alcoholic.
DENIAL: a developmentally immature psychological defense mechanism to prevent the recognition of unpleasant aspects of reality. Examples: “I don't have a problem with alcohol.” “I can take care of this problem myself, I don't need help.” “There is no alcoholism.” “Just don't talk about it, don't deal with it.” “You would drink (drug) a little to if you had my problems, my life, to deal with".
C/ WHAT DO WE NEED TO THINK ABOUT AS WE PREPARE FOR THE INTERVENTION?
D/ HOW WILL WE REMEMBER TO SAY ALL THE THINGS WE SHOULD TO THE SUBJECT OF THE INTERVENTION? (THE LETTER OR SCRIPT)
During an intervention structure is very important, and participants are often anxious and may forget what they agreed to say or if allowed, diverge from the agreed upon statements. To better prepare participants and assure that the messages are delivered as agreed during planning and rehearsal, participants write a letter, or “script” their remarks. The content of the letter is relatively simple:
(1) statements of love, affection, positive regard,
(2) data, i.e., descriptions, of the negative consequences of substance use and recognition of the identified patients suffering,
(3) exhortations to accept treatment/therapeutic recommendations, and if necessary,
(4) consequences of unwillingness to treat the substance use disorder and go to treatment.
This latter part, the consequences, are put on a separate sheet of paper. In so far as possible specific examples should be used to illustrate and elaborate on these four themes with as much imagery as possible.
The interventionist and the participants arrive together at the venue and arrange themselves in an agreed upon manner. The interventionist often provides the introduction to the identified patient although another member of the group may have been identified for this task. Each participant in turn presents the text of their letter either by reading the letter or if they feel able, they use the letter as a script from which they speak. This is often a very emotional process and most often this emotion is expressed in hugs or other touching, tears, vocal tones, etc.. Often the process appears to move very rapidly. The interventionist provides structure, responds to unanticipated events and guides the direction of the group process as needed.
The most common outcome is acceptance by the identified patient of the course of treatment offered. When this is not the case the consequence statements are invoked and presented and this may produce the desired outcome: acceptance of treatment recommendations. If the identified patient continues to resist the interventionist may attempt further clinical maneuvers and interventions. In either case the interventionist will bring the intervention to closure at a time and in a manner that seems most appropriate.
When the identified patient accepts the treatment recommendations the post intervention period is a time of bustling activity, the goal of which is to get the identified patient on his or her way to treatment i.e., bags into the car, last minute details resolved, goodbyes, etc. The preliminary planning has hopefully provided for every eventuality. When the identified patient has left there is often a short debrief or discussion of the process and peoples' feelings.
The interventionist will send a summary letter concerning the intervention and the texts of the letters and consequence statements to the treatment program staff. These may be used during the course of treatment.
If the identified patient does not accept the treatment recommendations of the group, the debrief and discussion process will reiterate the action steps that have been already established in the consequence statements, and include a reiteration of the clinical plan for members of the intervention group. It is important to note that on those occasions when the identified patient does not immediately accept the treatment recommendations it is quite probable that if the group members hold firm to their consequences and their own clinical plans, the identified patient will eventually accept treatment.
G/ WHAT HAPPENS DURING TREATMENT, AFTER TREATMENT, OR DURING THE PERIOD AFTER THE INTERVENTION WHEN AN IP HAS REJECTED TREATMENT?
The interventionist will continue to function as a resource and to some extent as case manager for family during and immediately after intervention and/or treatment. The interventionist can often advocate for family and identified patient when needed, identify resources or simply answer questions.
*Courtesy of: The Dublin Group: Behavioral Health Consultants Inc.
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