When To Use An Intervention

When to use an intervention?Have you recently experienced a loved one’s ongoing inability and failure to take care of themselves? Have you given him/her the books to read, provided the suggestions to improve their situation, engaged in endless discussions and pleas for how to practice self-care? Has he/she lost jobs, or friends as consequences to their negative behavior? Do you find yourself at your boiling point? If so, an intervention may be right for you.

Many turn to interventions when confronting a loved one’s sex addiction, drinking problem, or an inability to manage their bipolar disorder, etc. The person’s life is spiraling out of control and it’s only a matter of time until the unspeakable happens. An intervention is typically chosen when family and friends feel that their loved one’s behavior has become so damaging to the point that everyone around this person is negatively impacted by the addiction. Often family and friends who are on board with an intervention truly believe that if the person of concern doesn’t seek treatment immediately, permanent consequences are right around the corner (death or jail).

A way to assess if you are at the point of calling an intervention. Questions to ask yourself:

  • Do you fear for your loved ones life and safety due to their negative behavior and poor decisions?
  • Do you find the your loved one is no longer effected by natural/negative consequences (friends distancing, DUIs, employment problems, etc).
    • A) For example, friends of your loved one no longer call, accept calls, or make plans with this person because they feel their efforts and encouragement to stay sober and honest are pointless, or they can no longer put themselves in positions where they have to lie for your loved one, or tolerate inappropriate or risky behavior, like infidelity, drinking and driving, etc.
    • B) Your loved one may continue to choose to get behind the wheel regardless of the number of driving violations, car accidents, or events arrests due to driving while intoxicated.
    • C) Your loved one may have been demoted at work, given less responsibility, or even has hopped from job to job due to his his/her inability to get to work on time regularly, or produce work efficiently.
  • Are you concerned for the addict’s health?
    • A) Impending heart attack, failure to make needed medical appointment
    • B) Lack of medication management(skipping prescribed pills, self-medicating with drugs, alcohol, food, etc.)
  • Has your loved one failed time and again to implement his/her own self care to address their addiction?
    • A) Attending regular therapy, outpatient treatment, support groups, practicing self-control, etc.)
  • If this person continued going on their current pace, could they end up in debt, lose their kids,
  • Do you ask yourself, “If I wasn’t around to help out, what would happen?”
  • Is your loved one preoccupied with the wrong pieces, are they missing the big picture?
    • A) For example, dating or turning to exercise to “feel happy” instead of returning to psychotherapy to address emotion pain or trauma
  • Does your loved one have a realistic perspective of what they are doing? Is their game plan reasonable? (Quitting job to write a book, going back to former therapist after years of quitting and inconsistency).
  • Has your loved one distanced from his/her “regular people” or support system? Have they befriended new people who enable or support his/her negative behaviors?

What are your goals with the intervention? There are many options when it comes to confronting a loved one’s destructive behavior and asking them for change. Options could be as simple as an outpatient treatment center, rehab after work, a career change, an increase in individual therapy, and/or support groups. Or have you already tried asking this person for these things, and they have failed to commit? Are they so over the top that you’ve exhausted all your own resources. If so, inpatient treatment is a better fit for individuals who have struggled to utilize outside resources (therapy, groups, doctors, medication) while managing all of their other daily events (job, kids, family obligations, community roles, etc).

Inpatient treatment options are endless, from the location, type of facility, length of stay, etc. It will help if you do your homework and research online recommended facilities. Start with one facility that appeals to you, and call and speak to the intake coordinator, briefly explain why you are looking for treatment for your loved one, and they can give you feedback as to if their facility would be an appropriate fit based on your concerns and descriptions of your loved one’s behavior. Treatment facilities often have their own recommendation or even requirement as to what they believe is enough time for treatment. Feel free to speak up and ask the facility questions, “Do you address childhood trauma?” “Do you include family in the treatment process?” “Do you prescribe medication, or handled dual diagnosis?” It’s just like picking a school for your child, there is a right fit, and a wrong fit.

Are you comfortable with the person rejecting the intervention? For example, an 85lb anorexic may not have any other option because of the risk, vs the functional bipolar. The person you question “are they going to survive until tomorrow?” is different from the person who creates havoc on their professional life. Your loved one may not have hit their “bottom” yet, and may have few to no consequences that negatively impact their daily life.

With this information, is important you and the others in the intervention have a clear map of expectations for the loved one receiving the intervention. When you are dealing with someone who’s preoccupied with any addiction (food, exercise, work, sex) they are viewing things through a foggy or cloudy lens. When this happens, it’s helpful to be as clear and as black and white as possible. “Will you or won’t you?” “Will you accept this gift and attend this 5 week treatment facility in Texas or not?” The clarity of black and while will give the individual no room to manipulate, as well as little information to be confused by.

How do you want to frame the intervention? Someone in the group will have to be appointed “the messenger” role. Someone in the family will agree to be with the loved one while the rest of them family and friends are arriving together to the agreed location of the loved one. Once all the participants are in place, this person will have to turn to the loved one and inform them of what’s to take place. The person chosen can be decided by the group, the interventionist, or by the person who wants to take on that role (adult child, sibling, etc). When it’s time to inform the loved one, a simple statement like, “Mom, there’s some of the family downstairs to see you.” or “There’s some people who want to talk to you.” Once you get the loved one in the room with everyone, there is someone who informs the loved one of each step, “Mike, your family because they love you and are concerned for your health, they each have prepared something to say.” This person again can be different from the originally messenger, if you have hired a professional, this is a great job for that person because they won’t get distracted by their emotional investment in the family (because they don’t have one.)

It is all about how you frame things, if you use more positive language, and key words such as: love, concern, health, accept, gift, help; you will be coming from a place of positivity and concern, rather than a place of blame. At the end of the letter, all readers should have the same last line to signify a united front and to promote consistency. Such as “Please accept this gift and go to the treatment program.” Again, words like gift and accept and please are not words of blame or implying wrongdoing, these are words that come form a place of love, and deep concern.

Are others on board? You can’t do this type of intervention alone. You need backup, support, and other family and friends who have similar negative experiences and serious concerns for your loved one’s well-being. It’s best to start with primary/immediate family members (spouse, children, siblings). Reach out to these identified family members, share with them your experiences with the identified addict, and share your current concerns, explaining your reasons for exploring rehab options. This is your chance to find out if other immediate family members are in agreement with your assessment. It’s important that everyone involved is in agreement with the goal of the intervention (inpatient treatment, outpatient treatment, etc.). The more support and unity there is in the group, the less chance there is for the addict to manipulate any of the family members, and an overall higher chance for the intervention to be successful. When the intervention does take place, remember to be discussed as a group if there is anyone else that you want to include who happens to be a positive or strong influence in the addict’s life (best friend, brother in-law, etc.).

Letters Interventions require a lot of work, and time from the loved ones putting this together. There is a lot to organize, and consider. Letters are typically prepared and read to your loved one the day of the intervention. These letters include details of the relationship you have to this person, the positive qualities the he/she has, positive memories you hold onto, as well as what you see the problem to be (including an example and the impact it has had on you.) These letters are read one after the next in person to your loved one. This is a lot of emotion and information for anyone to take in, especially someone who doesn’t have a clear perspective right now. Interventions are emotional, time consuming, and when you are dealing with someone who can manipulate the situation to their advantage and avoid discomfort its easy for the intervention to get off track and off it’s focus. It’s much easier to organize an intervention and stay on task with a professional third party. Whether it’s a counselor, addictions specialist, or interventionist, this type of professional is not emotionally invested, and therefore it’s easy for that person to stay unattached and on focus with the intervention and the goal. There are the little things to consider, like time of day for the intervention, the location, the order of the letters being read, the quality of the letters, even the seating for the intervention, and much more.

It is best to approach your loved one and initiate your loved one when they are most vulnerable, and most “off their game” in order to catch him/her off guard. For example, the morning time is on ideal time for many because one’s day has not fully started yet, most people are often still groggy and waking up before being fully “on” and ready for the day. This time of the day often ensures the least resistance, less of a “show” from your loved one, and less of an excuse that they are in the middle of something, or off to work. One other factor you want to consider is sobriety, or a manic state. When is your loved one least likely to be high or low functioning? You want your loved one as present and clear minded as possible in order for them to really hear you and take this all in. (It’s important to note, this doesn’t always happen depending on the severity of one’s problem, but try to at least factor this in when planning).

The order of the letters being read believe it or not, is an important decision. It’s like any music concert, or Broadway musical, you want to save the best for last. Meaning, ease your loved one into this experience of hearing his/her flaws, and what they will perceive to be negative, by starting with the friends or family members who have a less direct involvement to the problem, and likely this person will also have a letter with less pain and hurt than someone closer. As the letters continue, they should increase in intensity of what the friend/family member perceives the problems to be, as well as how close the person is to the loved one. For example, if the spouse of the loved one in question has been most impacted by the problematic behaviors, and has the closest relationship with this person, then he/she should go last. The point of the letters is for the loved one to hear their family and friend’s experience of his/her negative behaviors and exactly how they hope change will occur.

Consequences You are probably reading this tip and asking yourself, “Well what he/she says no to getting help?” That is a good question, and a realistic possibility. If your loved one rejects the intervention and the offer for help after all family and friends have read their letters, that is when you share the written consequences you plan to implement if your loved one does not accept your terms. These consequences are what you plan to no longer, or are things you plan to now do in response to your loved one refusing to help himself/herself. For example, “Mom if you do not complete the treatment center program we are asking you to attend, I will no longer loan you money.” Or, “Dad, if you don’t complete rehab after work, I refuse to no longer visit you and witness your health deteriorate anymore.” In order to create your consequences, it is helpful to look back at your own behavior and identify where do you contribute to your loved one’s problems? Where do you help your loved one continue their addiction and remain uncomfortable. People change in response to discomfort. Your loved one will never change until his/his life is so uncomfortable that it becomes unmanageable. So take an inventory of how you interact to your loved one and how to you typically respond; what can be your change in all of this? Please be sure to only choose consequences that you know you can follow through on. If you’re unsure if you can really stop accepting your dad’s phone calls, find a more feasible consequence.

Interventionist or not? Many families and friends hold interventions on their own without the guidance of an interventionist. Some families want to keep it intimate involving only those who know the loved one, or believe they have enough knowledge without turning to a professional. However, we’re therapists, and we recommend plan A’s, B’s, and C’s. Of course we would recommend to at least come in and talk with a therapist or specialist to ensure you have all your ducks in order, about how envision the intervention to go. Having a professional guide the intervention will take pressure off of you. You already have a big enough job participating in the intervention, it’s great self-care to assign an outside member the role of organizing all of the participants, editing and organizing the letters, etc. A professional in this scenario provides the structure to help friends and family organize in a way that will feel support to the individual with the problem.

This description of an intervention may sound overwhelming, and like a lot of work. Don’t be fooled, it is a lot of work. It’s even more work helping someone fail to manage their addiction. It’s exhausting watching someone disappoint, lie, and put their life in danger yet again. An intervention tests every part of you (physically, emotionally, mentally). This is often because an intervention is way long overdue, and you and your loved ones are more burnt out than you realize. This can be a very cathartic experience. Anything you have been bottling up, not saying to your family, and to the addict; this is your chance to say in way to influence positive change, and the acceptance of help.

The point of this intervention is put the person in a position where they have no choice but to make a change even if they are not willing. This type of intervention is designed for person who is so out of control they are unable to see that they are out of control. For the person who is so anorexic, they are so out of touch with their own reality. An intervention is asking everyone in this persons’ life to go on a risk and limb.

 

 

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