Addiction Interventions by Professionals for Professionals
Staging an effective addiction intervention is an art form. While some people respond well to confrontation, others need a softer, gentler approach. Because different strategies motivate different people to enter drug treatment, special consideration should be given to the individual’s background when planning an intervention.
Doctors, lawyers and other professionals make up a group with unique needs. While they may face hurdles such as denial and stigma, there are also motivating factors that help these individuals into drug rehab and back into their chosen fields.
Greg Skipper, MD, the Director of Professional Health Services at Promises addiction treatment center in Los Angeles, has been conducting successful interventions on professionals for more than 30 years. Drawing from his experience as medical director at some of the nation’s leading drug rehab programs as well as years of service in physician health programs, Dr. Skipper shares some of the most effective strategies for getting an addicted doctor, lawyer or other professional into drug treatment.
Alternatives to the ‘Johnson Model’
Since its development in the 1960s, the Johnson model has become the standard for many addiction interventions. In the Johnson model, the addict is invited to a “surprise” meeting where friends, family and/or co-workers explain how the addict’s drug use has affected them as well as the consequences if they refuse to get help. While the Johnson model is one of the most widely used intervention strategies, it may not be the most effective for addicted professionals, says Dr. Skipper.
“With addicted professionals we have a great tool, which is the leverage of potential job loss,” says Dr. Skipper. “When used subtly and with sensitivity, most professionals will agree to accept help if it means being able to continue their profession.”
In many cases, interventions on impaired professionals begin with a call to a professional assistance program. Once a referral has been made, the program verifies its legitimacy and attempts to get an additional concerned person involved. For doctors, this may be a nurse or the chief of staff at the hospital. For a lawyer, it may be a senior partner or judge.
The professional assistance program then contacts the impaired professional to ask them about their drug or alcohol use and let them know others are concerned. While often done face to face, Dr. Skipper has found that telephone interventions can be just as effective as in-person interventions with the added benefits of being easier logistically and less confrontational.
When Dr. Skipper conducts an intervention for a doctor, lawyer or other professional, his goal is to remain neutral and non-confrontational throughout the process. If the professional denies having a drug or alcohol problem, Dr. Skipper asks them to get a professional evaluation to prove that they are right. If they acknowledge the problem, he explains that together they will put a plan in place to get the addicted professional the help they need and get them back to work as soon as possible.
“I make it clear that I’m here to help and that getting an evaluation is a win-win for protecting their reputation and career,” he says.
In some cases, the professional declines to be evaluated. Although the process is voluntary and confidential at this level, Dr. Skipper advises that it may not be if the problem goes unaddressed. While the concerned individual called a professional assistance program this time, next time they may call the police or licensing board.
By Dr. Skipper’s estimations, as many as 99 percent of these interventions for addicted professionals are successful. Even if the professional needs to think about it for a day or talk to their attorney first, they will usually agree to the evaluation.
Drug Evaluation & Assessment
Once the professional agrees to an evaluation, they are referred to an appropriate drug treatment center. At Promises drug rehabilitation center in Los Angeles, addiction specialists complete a series of exams before providing an opinion about whether the professional has a drug or alcohol problem. The opinion is based on clear and credible criteria, which makes it more difficult for the professional to remain in denial.
If the evaluation confirms a substance abuse problem, the treatment team recommends that the individual take time off and address it. Because they have already spent 2-3 days away from work in a safe, supportive environment, many impaired professionals will agree to stay in drug treatment. Even if they can’t fully acknowledge the scope of their substance abuse problem yet, they may be willing to get help to preserve their career.
“At Promises, we make the evaluation process as efficient and effective as possible,” explains Dr. Skipper. “We want our patients to know that we care about them, to feel respected and valued, and to rest assured that they will be supported through this experience. Once they begin treatment, our job is to guide them through denial and into recovery.”
Addiction Treatment for Professionals
Doctors, lawyers and other professionals have a few unique needs during drug rehab. They typically fare best in counseling with therapists who understand the stresses and demands of professional life, and often thrive with the support of other professionals with similar struggles.
Overall, says Dr. Skipper, professionals need the same basic elements of drug rehab treatment that others need, including:
1. A comprehensive evaluation that is holistic in nature, encompassing not only substance abuse but also co-occurring mental health disorders, other addictions or compulsions, and any other issues affecting mind, body and spirit.
2. Highly individualized, patient-oriented treatment that includes a treatment plan and length of stay based on the individual’s specific needs, rather than a one-size-fits-all approach.
3. Long-term monitoring and support that includes a thorough relapse prevention plan, regular drug testing and a return-to-work contract that outlines the conditions of continued employment.
“At Promises, we know what kind of treatment works and provide it not only to doctors, lawyers and other professionals but anyone struggling with the disease of addiction,” says Dr. Skipper.
This process of intervention, evaluation and treatment, though daunting at first, gives professionals the tools to return to their profession healthier, more stable and better able to do the work they love.