Common Approaches to Drug and Alcohol Intervention

When we think of the word “intervention,” we typically picture a group of friends and family confronting a drug addict or alcoholic in a familiar setting. This type of intervention is known by those in the recovery industry as the “living room ambush,” or the Johnson method. Named for Vernon E. Johnson, an Episcopal priest and author of “I’ll Quit Tomorrow,” it is intended to save the addict from hitting rock bottom by having family and friends try to break through the person’s denial with the help of a professional interventionist.

The reason why a living room ambush works so well is that it uses the element of surprise to capture the addict’s attention in order to deliver an ultimatum – stop using or we will have to step back from your life. The loved one is typically enticed to attend the meeting with a promise of a pleasurable event. However, in reality, the family has already arranged for the addict to enter an addiction treatment center – bags are packed and plans have been made. Although this method of intervention continues to be the traditional approach to encouraging addicts and alcoholics to get help for their substance abuse issues, the medical and psychiatric establishment has begun using less draconian intervention methods.

Given the intense confrontation that goes on during a traditional intervention, those in the forefront of addiction research now believe that this type of intervention can be traumatic on both the addict and loved ones, causing additional harm. There is also evidence that it is the method most likely to cause the addict or alcoholic to become belligerent and refuse to seek help.

A new method of intervention called motivational interviewing is now being used as a substitute to the living room ambush. With this kind of intervention, the addict is invited to join loved ones, who have usually already attended counseling sessions to help alleviate whatever trauma they themselves might experience as a result of the intervention. Right from the start, this approach gives the addict some measure of control over how the intervention will be conducted. He or she can come willingly, grudgingly, or refuse to cooperate at all.

One major difference between living room intervention and the motivational approach is that, with the motivational approach, the addict or alcoholic will not necessarily be ordered to stop drinking or using drugs. Instead, he or she may be asked to reduce their alcohol or substance intake. Because the end result is not necessarily total abstinence, this type of substance abuse treatment, known as harm reduction, is not supported by the traditional addiction treatment community. However, it could be useful in a situation where the addict or alcoholic is not yet ready to envision a life without drugs or alcohol.

No matter what type of intervention is used, one of the best tools in the interventionist’s arsenal is not necessarily the ability to make the addict see how detrimental his behavior is to his own life or the lives of his loves ones. Instead, a strong motivator to get clean is the threat of legal consequences or incarceration. A form of government-sponsored intervention, known as “drug court” is being used in many states. If the Court determines that alcohol or drug addiction has contributed, at least in part, to a defendant’s criminal behavior, the judge may offer substance abuse treatment as an alternative to jail. Although clearly an example of the traditional, strong-arm approach to intervention, states have been reporting decreased recidivism rates for those defendants who successfully complete the programs.

Unfortunately, if the person’s behavior has not landed him in the court system or has otherwise caused him to hit rock bottom, it is possible that no measure of substance abuse intervention will be successful. Sometimes an intervention will only work when things are so bad that even the addict can’t deny that he needs help. In cases such as these, the interventionist and loved ones walk a fine line between delaying the intervention until the addict is ready to listen and being too late.

http://www.nytimes.com/2009/08/06/fashion/06intervention.html?pagewanted=2&_r=3