New Directions for Women will be participating in the inaugural Recovery Plus Intervention Workshop and Training in London this May. It is an honor to learn about treatment and intervention all around the world so that New Directions for Women can help more women and their families heal from throughout the globe. We would like to share this article by our CEO Becky Flood.
The Historical Perspective of Intervention
By: Becky Flood
In the 1900’s, there were high mortality rates from what was then called alcoholism. In the 1930s, psychiatry defined uncontrolled drinking as an emotional/psychological problem. Finally in 1956, the American Medical Association (AMA) for the first time recognized alcoholism as a permanent and fatal disease with defined symptoms. In the 1960’s, Dr. Vernon Johnson studied 200 recovered alcoholics with an attempt to figure out why they chose to quit. He found that most of these alcoholics quit when there were multiple disruptions or a variety of negative consequences in one or more of their major life areas, such as work, family, and so forth, rather than a defining moment such as a car accident or visit to the emergency room. As a result, he developed and birthed the Johnson model of intervention. Dr. Johnson was an Episcopal priest who devoted his life to the study of then alcoholism (known to us today as substance use disorders). He is best known for developing the original intervention model, but also for the landmark book that still sells today, I’ll Quit Tomorrow, which began distribution in 1973. The Johnson model had seven components.
- An intervention specialist heads up the team to help the addict. The team is made up of family members, friends, and co-workers.
- In a planning session held with the interventionist and team, they plan out how to lovingly share exactly what they would like to say to the alcoholic.
- All information focuses on concern and care, not blame or anger. Families may remind the addict that they love them, they hate their disease.
- All information presented should be tied to the alcoholism, not other problems or concerns that may be occurring.
- Statements should be backed up by evidence, statistics, relating stories (in a factual manner), and that evidence should be specific.
- The team had to agree that the goal of the intervention was to lead the alcoholic into a residential setting of treatment. The goal was not presented as a punishment, but as an offer of assistance.
- The team would offer this help with their presentations to the alcoholic in an office at a meeting that everybody was openly invited to attend.
From that day to this, there has been an ongoing evolution of the intervention process, and a variety of models and perspectives have continued to assist getting thousands of individuals help for substance use disorders over the last six decades.
Jeff and Debra Jay are the co-authors of Love First, a Family Guide to Intervention. Together, they developed what they call the Love First Intervention Process, which is probably the most well known continued take-off from the Johnson Model. A gentleman by the name of Ed Storti, the author of Heart to Heart, created the Storti model of motivational intervention. Wayne Rader and Ed Speer developed the Family Systemic Invitational model of intervention, which was seen as the first invitational model. This approach involves changing of the relationships that surround the addicted person, which leaves them no longer supported by old enabling behaviors, thereby forcing change in the addict’s action or behavior. It differed from the Johnson model, because it was invitational and educational. The invitation was to all loved ones (including the one that suffers from a substance use disorder) to attend a family workshop. It is educational because the interactive family workshop is held so that all participants can learn about the disease, their family system, their family of origin, and the impact that the historical family system has on them and their current relationships with everyone else in the family.
Another well known model that has been developed is the ARISE model, known as a relational intervention and a sequence of engagement developed by Dr. Judith Landau. This model integrates traditional family therapy, Johnson Intervention techniques, and DiClemente and Prochaska’s research dealing with motivational stages. This model is also known as a collaborative process; from the initial invitation, the process conveys respect and establishes the ground rules for openness. In addition, it acknowledges that mistrust will be a major issue if things are created in secret, and assures the individual suffering from a substance use disorder that they can trust family and friends.
It’s important to note that intervention is not a coercive process. It is not shame-based. It is not an ambush or uncaring attack. It is a planned interaction between an individual and a group whose sole purpose it is to modify the individual’s dependence on a harmful substance or practice. It is a process of invitation, education, and preparing family and friends who make the commitment to initiate change in their, or a loved one’s, life. The goal is to return to healthy productive living for the individual suffering, and each of the individual family members. The truth is that intervention is a process founded on love and honesty. I have always defined family intervention, regardless of the model being utilized, as a process in which you present an individual suffering from substance use disorder and their significant others with objective information in a caring way with the goal of motivating each of them to accept appropriate help and/or treatment. It is always wise to remember that someone who suffers from substance use disorders and their loved ones are blind to their disease (as it is a disease of denial). They need to be motivated in a way that will allow each of them to seek immediate help.
The overarching five ethical principles that each of these models hold true are: to do no harm, make things better, respect others, be fair and be compassionate. Historically, the arenas in which one can practice intervention work have been: private practice, delivering intervention as a single service. In a private practice setting, a variety of services could also be offered, such as educational consultation, being an author, developing marketing strategies, offering other clinical services such as individual and outpatient services, or be within the context of a larger organization that deliver an array of addiction services such as detox, residential, and/or outpatient. As the evolution of addiction treatment services have evolved, we have found that these techniques can be utilized to help all individuals with substance use disorders, family members that suffer from codependency, people with eating disorders, gambling addictions, mental health issues, and other process addictions and compulsive behaviors. The role of the interventionist remains consistent through all of the models: providing information about the nature and dynamics of substance use disorder, being the one to describe the principles and specific techniques about the intervention model being utilized, selecting and equipping the family members with information about each of these roles within the intervention process, listing the various alternatives in a continuum of care for all of those involved in the process, and coaching and modeling throughout the process.
In closing, I hope that this overview has provided you a snapshot of the roots and origins of intervention, as well as the evolution. My favorite saying has everything to do with interventions: you can lead a horse to water, but you can’t make him drink. But you can make him thirsty.
New Directions for Women is a treatment facility located in California that offers help to women of all ages, pregnant women in any trimester, and women with children. Founded in 1977, our courageous and visionary founders asked for the help of Newport Beach Junior League members to fulfill their vision of a tranquil home-like facility that would treat women with dignity and respect. Our caring admissions counselors are available 24/7 to take your call and answer any questions you may have on getting help. Reach us by phone at 800-93-WOMEN. We can help. Stay in the loop with New Directions for Women by connecting with us on Twitter, Facebook, or LinkedIn.