Johnson Model of Intervention
"It is a myth that alcoholics have some spontaneous insight and then seek treatment. Victims of this disease do not submit to treatment out of spontaneous insight – typically, in our experience they come to their recognition scenes through a buildup of crises that crash through their almost impenetrable defense systems. They are forced to seek help; and when they don’t, they perish miserably." – Vernon Johnson, I’ll Quit Tomorrow, 1973
The Johnson Model of Intervention is a confrontational approach to drug and alcohol intervention that was introduced in the 1960s. Named after Vernon Johnson, often considered the father of intervention, it is based on his belief that denial is so pervasive in addicted individuals that they are only able to see the reality of their situation when presented with the crises it has caused in their life. An interventionist leads the family and close friends in this planned confrontation, which is unknown to the addicted individual beforehand.
The Johnson Model of Intervention assumes that addicts are unable to see how their substance use is negatively affecting themselves and those around them, and will remain unable to see this reality until they “hit bottom.” This is not due to an unwillingness on the part of the addict, but rather on the extreme defenses they have created in response to addiction. The purpose of the intervention is to precipitate a crisis that would motivate the addicted individual to seek treatment, rather than waiting for the addict to hit bottom on his or her own—a potentially life-threatening situation. This is referred to as “raising the bottom.”
In the Johnson Model, those closest to the substance abuser form a team that will confront the individual under the guidance of a trained interventionist. The team prepares for the intervention by learning about the disease of addiction, listing specific facts about the effects of the individual’s substance abuse, and deciding on potential treatment options. All preparations are conducted without the knowledge of the addicted individual.
During the intervention, the reality of the addicted individual’s behavior and its consequences are presented in detail, in a nonjudgmental, unequivocal, and caring way. It is important to remain objective and specific, as the object of the intervention is to present reality in a way that the addict can accept. When this has been accomplished, and the addicted individual accepts help, available treatment options are offered to the individual and decided upon together. Although the intervention is confrontational in nature, it should be clear that it is the result of concern, not malice.