Intervention (counseling)

Intervention is an orchestrated attempt by one, or often many, people (usually family and friends) to get someone to seek professional help with an addiction or some kind of traumatic event or crisis, or other serious problem. The term intervention is most often used when the traumatic event involves addiction to drugs or other items. Intervention can also refer to the act of using a technique within a therapy session.

Interventions have been used to address serious personal problems, including, but not limited to, alcoholism, compulsive gambling, drug abuse, compulsive eating and other eating disorders, self-mutilation, tobacco smoking, "workaholism", and various types of poor personal health care. Interventions have also been conducted due to personal habits not as frequently considered seriously harmful, such as video game addiction, excessive computer use and excessive television viewing.

Direct and indirect interventions

Interventions are either direct, typically involving a confrontational meeting with the alcohol or other drug dependent person (the most typical type of intervention) or indirect, involving work with a co-dependent family to encourage them to be more effective in helping the addicted individual.

The use of interventions originated in 1960s with Dr. Vernon Johnson. The Johnson Model was subsequently taught years later at the Johnson Institute. This model pioneered the way of intervention, but has come under scrutiny because of the "ambushing" nature that the model falls under.

Two of the major models of intervention that are utilized today are known as systemic and A.R.I.S.E. model of intervention. Both use an invitational approach to intervention and rely heavily on having the family as a whole enter a phase of recovery. This helps take the focus off the addicted individual and notes the need for the entire family unit to change in an effort for everyone who is involved to get healthy. These models place an emphasis on treating the addicted individual with dignity and respect.

Plans for direct intervention

Plans for a direct intervention are typically made by a concerned group of family, friends, and counselor(s), rather than by the addict. Often the addict will not agree that he (or she) needs the type of help that is proposed during the intervention, usually thought by those performing the intervention to be a result of denial; however, a common criticism of the intervention method is that, by surprising the subject and taking a confrontational approach, the intervening parties may cause the subject to go on the defensive. One of the primary arguments against interventions is the amount of deception required on the part of the family and counselors. Typically, the addict is surprised by the intervention of friends and family members.

It has been noted that ' Family intervention is not possible in all or even most cases ', and workplace, medical, or legal practioner interventions have also been explored. To some extent 'a new profession has sprung up based on Dr. Johnson's work - the interventionist'.

Prior preparation

Prior to the intervention itself, the family meets with a counselor (or interventionist). Families prepare letters in which they describe their experiences associated with the addict's behavior, to convey to the person the impact his or her addiction has had on others. Also during the intervention rehearsal meeting, a group member is strongly urged to create a list of activities (by the addict) that they will no longer tolerate, finance, or participate in if the addict doesn't agree to check into a rehabilitation center for treatment. These consequences may be as simple as no longer loaning money to the addict, but can be far more serious, such as losing custody of a child.

Family and friends read their letters to the addict, who then must decide whether to check into the prescribed rehabilitation center or deal with the promised losses.

Controversy

There are significant questions about the long-term effectiveness of interventions for those addicted to drugs or alcohol. A study examining addicts who had undergone a standard intervention (called the Johnson Intervention) found that they had a higher relapse rate than any other method of referral to outpatient Alcohol and Other Drug treatment. However, persons who underwent the intervention were more likely to enter outpatient treatment. The intervention may therefore appear to be more effective than it is because it results in this initial success.