What Is an Intervention?
An intervention is a tactic often used to motivate a person who is substance dependent or is engaging in compulsive eating or gambling behaviours to seek medical and professional help for their addiction. Interventions are typically carried out by family, friends or loved ones of the person who is suffering, in conjunction with a doctor or medical professional. During an intervention, these people unite to discuss the person’s addiction and encourage them to seek treatment or enter a rehabilitation facility.
Discussing addiction with somebody who is experiencing substance abuse or compulsive behaviour issues can often evoke an emotional response; therefore, interventions should be structured and carefully planned in order to be effective. Before the intervention, loved ones often gather information regarding treatment programs, form a team of medical professionals and trusted friends or family and decide upon potential consequences for the person experiencing addiction, should they refuse to undergo treatment.
Interventions can be exceptionally effective, and it is reported that following an intervention, 90% of people suffering from alcohol addiction will seek help (1). However, a poorly planned intervention can have the opposite effect; therefore, it is important to carefully navigate the situation. (2)
Examples of Where an Intervention May be Needed
The intervention tactic is used for a variety of addictions and disorders but is most commonly utilised when a person requires alcohol or drug rehabilitation or is compulsively eating or gambling. In the best-case scenario, an individual would acknowledge their addiction and take action, but often this does not happen, and addiction may spiral out of control, making intervention necessary.
One key signal that an intervention is necessary is if a person’s financial situation, social life or work life is being negatively impacted. Substance abuse, gambling or binge-eating behaviours can become out of control despite their negative impact. (3)
Additionally, an intervention may be needed if somebody refuses to accept that they have an issue with addiction or compulsive behaviour, remains in denial or ignores the advice that their family, friends, or loved ones are offering them about the impact their addiction is having. (3)
Alcoholism refers to excessive alcohol consumption to the point where an individual becomes addicted to alcoholic drink and dependent on the substance. Many who suffer from alcoholism will prioritise drinking over other responsibilities such as work and suffer several negative health issues as a result of uncontrollable alcohol abuse.
The overuse of alcohol can also lead to intense withdrawal symptoms if the person stops drinking, which can make recovery from alcoholism a complex process. This can lead to a lack of motivation to recover, and therefore intervention is often necessary. (4)
Prescription drug abuse
Prescription drug abuse is the misuse of legal medication such as using medication prescribed for somebody else, taking higher doses of medication than prescribed or taking prescription drugs in a manner that they are not intended to be taken.
This type of drug abuse can range from taking too many over-the-counter painkillers to snorting ground-up pills. The most commonly misused prescription medications are painkillers, anti-anxiety pills, sedatives and stimulants. However, any drug can be misused. (5)
If an individual requires the medication that they have started misusing for health-related issues, stopping prescription drug abuse can be a difficult process that people are often reluctant to embark upon. In these circumstances, intervention is advised.
For most people, the decision to take drugs for the first time is a voluntary one, although this voluntary decision can lead to repetitive use and addiction. A person is considered to be abusing drugs when they begin drug-seeking and using those substances in a compulsive, uncontrollable and dangerous way.
Repeated drug abuse can also lead to changes in an individual’s brain as the drugs increase dopamine levels, leading to the feeling of euphoria. When this change happens, those suffering from drug addiction often replace positive behaviour such as socialising or eating with negative but pleasurable behaviour such as drug use. (6)
Due to the chemically addictive nature of drugs, people often do not want to quit and require intervention to realise they require drug rehabilitation to combat the negative impacts their addiction is having.
Compulsive eating, also referred to as binge eating, is the process of regularly consuming large portions of food past the point of feeling satiated to the stage where a person feels uncomfortably full and guilty for their actions. Overeating is considered compulsive eating when an individual consumes food in an out-of-control manner, often in secret or alone or when they do not feel hungry. (7)
As compulsive eating is in many cases a secret act, the disorder can easily go unnoticed by family and friends in the early stages. Due to the secretive nature of compulsive eating, interventions are often the only way to encourage a suffering individual to seek help.
An individual who is experiencing the uncontrollable urge to continue gambling despite the negative impacts it is having on their life and risking large sums of money in the hope of gaining something of greater value is considered to be experiencing compulsive gambling disorder. Compulsive gambling can lead to secretive behaviour, serious financial issues such as debt and even criminal behaviour such as fraud. (8)
Those who suffer from mental health disorders or are taking dopamine agonist drugs are particularly at risk of developing a gambling addiction. However, it is possible for anybody of any age to engage in compulsive gambling (8)
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When to Intervene in a Loved One’s Addiction Problem
Considering an intervention is a difficult and emotional decision and often the last resort following the failure of informal discussions and gentle encouragement to seek help. It is hard to know when an intervention is necessary, and judging this accurately will improve the likelihood of an effective intervention.
If an individual is experiencing substance dependence, some clear and common indicators that their addiction is getting out of hand include an increased tolerance for alcohol or drugs, a change in appearance, mood swings, aggression and a deterioration in their health.
Other less obvious signs of an addiction that is escalating are secretive behaviour, legal or financial problems, excessive borrowing of money, problems at work or school, a lack of motivation and an increasing indifference to activities that the individual previously enjoyed.
If a person is exhibiting some or many of these common signs, then it is a possibility that they are losing control of their life as a result of addiction. In this circumstance, intervening is recommended.
One common sign of secretive behaviour is enhanced emotions such as unchecked anger, agitation and defensiveness. (9) Recognising heightened emotions in relation to triggering subjects as a sign of secretive behaviour is therefore vital.
Excessive need to borrow money
Requesting to borrow money can be completely innocent and is something close family and friends often do. However, it is important to notice when borrowing money is a signal that something is wrong.
Many addictions such as gambling and drug abuse are costly, and the more intense an addiction becomes, the more frequently a person will engage in that behaviour, resulting in even higher expenditure. When an individual is suffering from addiction, it often becomes the pivotal focus of their life, and the perceived need to fund their habit will lead them to seek money in any way they can. (8)
Other legal or financial problems stemming from substance abuse
As previously mentioned, substance addiction frequently takes over a person’s life, and funding their habit becomes their primary focus. As a result, many people spend all their money and savings on drugs and alcohol and create large debts and serious financial problems.
Once an individual has lost all of their savings to addiction and can no longer afford to fund their habit themselves, they often turn to theft, fraud or other forms of crime to find money to fund their habit. (5)
Unexplained aggression is often a symptom of the shame, anxiety or distress a person feels concerning their addiction or compulsive behaviour. Talking about addiction can be extremely difficult for those who are suffering, and being questioned about the topic can feel like an attack or accusation, which causes them to become overly defensive. (9)
Furthermore, if an individual is experiencing drug addiction, it is also possible that the substance they are abusing is causing aggression as a side effect. Aggression is a side effect of many drugs, including stimulants (5) and alcohol.
Similarly to unexplained aggression, mood swings in relation to gambling, food or substance addiction can be caused by the anxiety and stress a person feels about their addiction, and their change in mood could be a defence mechanism. This is particularly likely if the individual is not substance dependent.
If the person is experiencing substance dependence, however, their mood swings could be a side effect of the drug. Many drugs cause ‘highs’ that can make a person feel extremely relaxed or euphoric, (10) and although these could be considered positive emotions, if they are caused by drug abuse, they are still a concern. Additionally, hallucinogenic drugs can cause frequent mood swings as a direct side effect.
Addiction can completely consume a person’s life, leading them to only be concerned about fuelling or hiding their addiction. This obsession can lead people to lose motivation for engaging in their previous interests and to become uninterested in socialising. (6) Furthermore, if a person is attempting to conceal their addiction, they may purposely distance themselves from loved ones to keep their secret.
Certain drugs can also make changes in the brain that cause people to no longer derive enjoyment from social engagement and other activities. (6)
Deteriorating of physical look
A dramatic change in appearance is also a sign of addiction or compulsive behaviour worsening. When a person becomes consumed by their addiction, it becomes the central focus of their life, and physical presentation and hygiene often take a back seat. When this happens, it is important to intervene as it can also be an early sign of depression as a result of addiction or compulsive behaviour. (9)
Clients suffering from compulsive eating may also gain a significant amount of weight. However, the subject of weight gain is often triggering for those who suffer from a binge-eating disorder and therefore should be approached with caution to avoid worsening the situation. (7)
Insipid appearance or lack of motivation
All forms of addiction have the potential to cause mental health issues in those who are suffering. Insipid appearance and lack of motivation are both early warning signs of depression, which could stem from addiction.
Problems at work or school
It is common for addiction to negatively affect productive parts of an individual’s life. In most cases, school or work take up the largest portion of a person’s day, and therefore they are often the first part of their life to be negatively impacted.
It is common for those who are suffering from addiction to regularly be late for or miss school or work and begin neglecting their responsibilities as they start to prioritise their addiction. Job or academic performance is also often affected. (10)
Both physical and mental health-related issues as a result of substance abuse, gambling or binge eating are extremely common.
For those who are misusing prescription drugs, this issue is of particular importance as they are often prescribed medication to help or prevent a preexisting health issue, and the abuse of these drugs can not only create additional health concerns but also exacerbate preexisting ones. (5)
In addition, alcoholism is known to directly cause liver problems, cancer and strokes (11), binge-eating disorder can cause weight gain resulting in obesity (7) and drug abuse can often cause fatal overdoses. (9)
Tolerance to a substance
The more of a substance an individual consumes, the higher their tolerance becomes, meaning they require more of that substance to experience the same effect. This regularly leads addicts to gradually increase the amount of alcohol and drugs they are consuming. However, as a person increases their intake of dangerous substances, the risk of overdose becomes higher and intervention becomes necessary. (9)
Major Intervention Models
Every person’s addiction is different, and therefore every intervention should be personalised for that individual. There are nine main intervention models that can be used to plan and form an effective intervention.
These models include:
- The invitation model
- The Johnson model of intervention
- The field model
- The systemic field model
- Tough love
- The confrontational model
- Motivational interviewing
- ARISE intervention
- Crisis interventions
It is important to understand how each model works, what type of addiction the model is effective for and what situations each model will suit to choose the appropriate one for the individual who requires help.
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The main difference between the invitational method for intervention and other intervention models is that it removes the element of surprise. Typically, a nominated loved one will discuss the upcoming intervention with the person who suffers from substance dependence, compulsive gambling or binge-eating disorder and invite them to attend. (12)
Using this model means that the person suffering from addiction is fully aware of the situation and can prevent them from feeling attacked and becoming defensive. Using this model can increase the person’s willingness to listen to advice, although as they have the option whether or not to attend, there is a risk that they will refuse to meet for the intervention.
Johnson model of intervention
This model is the most recognised intervention method. Unlike the invitation model, the Johnson model uses the element of surprise to ensure that the individual suffering from addiction is present at the intervention. This model is particularly useful for individuals who are in denial about their addiction and are reluctant to discuss their issues. (12)
Those who choose to use the Johnson model discuss the person’s addiction and behaviour openly and frankly, although they should refrain from making the addict feel ashamed. If an individual is made to feel shameful about their problems, they are more likely to become defensive, refuse treatment or relapse.
The field model of intervention is based on the Johnson model and uses many of the same techniques. In this model, a professional interventionist who is trained in dealing with crises during interventions is present. The interventionist also assesses the person’s suicide risk or potential for violence and assists the family during an intervention.
This method of intervention is most commonly used for individuals who are a danger to themselves or others due to potential depression, suicidal thoughts or bipolar disorder.
Systemic family model
The systemic family model aims to emphasise the fact that those who are substance dependent can go on to live their lives without drugs or alcohol. When families choose this approach, they often discuss addiction as a community issue, rather than solely an issue the person struggling with addiction has. The effect that the person’s addiction is having on their family and friends should also be discussed when utilising the systemic family model.
Using this approach limits the chance of the person becoming defensive and refusing treatment, as it does not blame them for the problem they are experiencing. (12)
The tough love approach is similar to the Johnson model, although specific consequences are defined during the intervention should the person refuse to undergo treatment. The level of consequences can depend on the severity of the addiction and the effect it is having on the individual’s family and friends. Examples of these consequences include taking custody of the individual’s children, asking the addicted individual to leave the home or refusing any additional financial assistance.
All interventions involve some kind of confrontation because the method of intervention is traditionally just that: a discussion during which people confront a loved one regarding their behaviour.
Therefore, the confrontational method is a long-used and traditional method that requires the subject of the intervention to remain unaware of the intervention until it occurs. The individual who is being confronted then must listen to the intervention group members, who discuss their grievances and set the demand that the subject must undergo treatment. In some instances of using the confrontational model, the person is then immediately escorted to a treatment facility. (12)
In some cases of addiction, traumatic or hazardous crises may occur such as an overdose, and during/following that crisis the addicted individual may be unable to effectively use their coping mechanisms. In this circumstance, a crisis intervention is necessary.
Crisis intervention is an immediate, short-term solution to crises that helps to restore an individual’s psychological function and avoid permanent trauma. This method involves understanding the coping mechanisms usually used by the person, confronting their feelings and exploring the potential solutions to develop a treatment plan. (15)
In contrast to other intervention methods, the motivational interviewing approach is structured in a way that is more similar to a counselling session. Rather than approaching the person’s addiction from a community perspective, this model focuses on the individual and their specific problems.
When implementing the motivational interviewing approach, the interventionist listens to the person’s viewpoint and offers empathy and guidance to encourage positive behavioural changes rather than reprimanding the individual. (13)
An ARISE intervention is a method of intervention that aims to offer help both the individual suffering from addiction and their family. Addiction is often viewed as a family disease as it impacts not just the person suffering from addiction but also everybody who cares about them.
In this approach, the person is fully involved from the start and their emotional and mental needs are addressed throughout. This technique allows the individual to feel they have ownership over their addiction and that they are in control. (14)
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Steps Before an Intervention
Make a plan
Interventions must be carefully planned to be successful and effective. An unplanned intervention can lead to chaos, and the addicted individual is likely to become defensive and refuse help. When planning an intervention, it is important to consider the family, friends or professionals who are to be present, the location of the intervention and the method of intervention that will be used.
To execute a well-planned intervention, it is also extremely important to be prepared for the potential that the person will refuse treatment. In this situation, it is important to decide on the ultimatum or backup plan that will be used to encourage the person to make the right decision and seek help. (3)
Being informed is another key element in implementing a successful intervention. Understanding the type of addiction the individual is experiencing is highly important, as the more the intervention group understands the illness and how it affects their loved one, the more support, help and useful advice they can offer.
Additionally, being educated on different treatment programs and methods can help achieve a successful intervention. Choosing the appropriate rehabilitation facility and treatment type is the most effective way for a person to overcome addiction. Understanding their specific problems and who they are as a person is fundamental in choosing the correct treatment plan. (2)
Find an intervention professional
In many cases, family and friends alone are not sufficient to successfully encourage an individual struggling with addiction to undergo treatment, and a professional is required. The professional that a family chooses to aid in their intervention will depend on the type of addiction their loved one is suffering from. However, drug, alcohol or gambling addiction counsellors, intervention specialists and mental health counsellors are the most commonly used.
It is important that the professional chosen has the correct credentials and qualifications to act as an interventionist. These professionals can be found through rehabilitation centres or mental health programs. (2)
Form an intervention team
Choosing the correct people to be present for the intervention is of utmost importance. If there are too many people present or those who may trigger an adverse response from the person are present, the individual may feel attacked or shamed and consequently behave defensively or aggressively. Those chosen to be part of an intervention team should be genuinely concerned and care for the individual and be able to behave in a calm and collected manner.
Opting to have a professional present is also advisable as they can offer in-depth knowledge and insight that friends and family may not be privy to.
Learn and rehearse
Each member of the group should understand their role in the intervention and the points they must bring to the table. If the members of the intervention team have clearly rehearsed stories and anecdotes describing how the person has affected them, it can help trigger a moment of clarity for the addicted individual. (16)
Additionally, having an unorganised intervention is likely to be ineffective in motivating a person to enter treatment. Therefore, it is important for the team to have a clear idea of the order of discussion.
Hold the intervention meeting
Once the intervention has been properly planned and put in place, the team must invite the person to the meeting. During the meeting, the team members should take turns expressing their personal feelings and emotions regarding the individual and their addiction and how they would like them to change.
Following that, the person should be presented with a treatment option that they must immediately accept. If the individual refuses to undergo rehabilitation, consequences or ultimatums can then be threatened. (2)
Help a Loved One — Start the Intervention Process Today
Binge eating, gambling, alcoholism and drug abuse can have a dreadful impact on both the addicted individual and their loved ones. Choosing to hold an intervention can be a difficult decision to come to, but it is often the turning point in addiction recovery. People may react adversely initially, but in the long run, it is often the kindest thing family and friends can do.
If you need help orchestrating an intervention for your loved one, call the UKAT advisors to discuss the available options today.
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- (1) https://www.alcoholrehabguide.org/support/interventions/
- (2) https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/intervention/art-20047451
- (3) https://drugabuse.com/5-things-about-interventions/
- (4) https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/mental-health/alcoholism/
- (5) https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/symptoms-causes/syc-20376813
- (6) https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
- (7) https://www.nhs.uk/conditions/binge-eating/
- (8) https://www.mayoclinic.org/diseases-conditions/compulsive-gambling/symptoms-causes/syc-20355178
- (9) https://www.addictioncenter.com/treatment/stage-intervention/when-do-i-need-to-hold-an-intervention/
- (10) https://www.helpguide.org/articles/addictions/drug-abuse-and-addiction.htm
- (11) https://www.nhs.uk/live-well/alcohol-support/the-risks-of-drinking-too-much/
- (12) https://en.wikipedia.org/wiki/Intervention_(counseling)
- (13) https://www.psychologytoday.com/gb/therapy-types/motivational-interviewing
- (14) https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(97)00212-2/fulltext
- (15) https://acws.ca/sites/default/files/documents/6-CrisisIntervention.pdf
- (16) https://www.addictioncenter.com/treatment/stage-intervention/
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