Four Models of Intervention

In 2013, the National Survey on Drug Use and Health (NSDUH) reported that 22.7 million Americans aged 12 or older needed treatment for an alcohol or illicit drug use problem while only 2.5 million received treatment at a specialized facility. Often, an intervention may be staged in order to convince a loved one to enter the treatment that they need in order to recover from substance abuse or dependency. An intervention is often perpetuated by family and friends in a group setting with the primary goal being to motivate the addicted individual to seek drug or alcohol treatment.

Interventions are usually planned ahead of time and sometimes without the loved one’s knowledge. Interventions may be either formal or informal. An informal intervention consists of casual conversations between friends and family members, and sometimes even coworkers or employers, in regard to drug or alcohol use. Formal interventions are planned in advance and more structured conversations that often utilize the help of a professional.

Mental health care professionals such as counselors or therapists as well as professional interventionists can help families stage successful interventions. When a professional interventionist is used, the National Council on Alcoholism and Drug Dependence (NCAAD) reports that interventions are successful at getting someone to commit to treatment 90 percent of the time. Intervention models typically follow a direct, indirect, or invitational model, or a combination of the models.

1. Direct Intervention

Known as the father of intervention, Dr. Vernon Johnson developed the Johnson Intervention Model, a confrontational and direct intervention method, in the 1960s. This is perhaps the most well-known method of intervention, gaining popularity in recent years through reality television shows.

With the Johnson Model, family members and friends meet with an intervention professional a few times in order to plan a surprise intervention for a loved one struggling with drug or alcohol dependency or abuse. Johnson interventions are scripted and address specific ways that drug or alcohol abuse has negatively affected members of the support network involved in the intervention. Everyone involved in the network will write letters detailing specific incidents as proof of how alcohol and/or drugs and addiction have had a negative impact on their lives.

This model hinges on the idea that addicts are in denial of how their drug or alcohol abuse negatively affects or impacts themselves or those around them, and the confrontation is an attempt to help them realize otherwise. Substance users are forced to hit rock bottom through the intervention, and loved ones will deliver an ultimatum if they refuse to seek treatment. The consequences for not seeking treatment may include loss of contact with family and/or friends or a lack of future financial support.

This method is generally considered successful at getting people into treatment, although the American Psychological Association reports that 70 percent of support networks who plan a Johnson Model intervention fail to follow through with the confrontation step. Confrontation, even when designed to be compassionate, may not be easy to accomplish and may not work for every family. Additionally, addiction affects entire families, and the Johnson Model does not address the overall health of the family unit.

3. Combination Models of Direct and Invitational Interventions

Current intervention models that combine direct and invitational methods into a more comprehensive model are gaining popularity. The ARISE (A Relational Sequence for Engagement) Intervention Model is a collaborative and compassionate approach that has an 83 percent success rate at prompting drug or alcohol abusers to enter into treatment, as published by the American Journal of Drug and Alcohol Abuse. The ARISE Model is an evidence-based and tiered approach, and once an addict has agreed to enter treatment, the intervention is stopped. The stages of an ARISE Intervention are:

• Step 1: initial call to a professional interventionist by a family or loved one in order to provide the tools necessary for an intervention and establish the support network
• Step 2: intervention meetings are held with groups of the support network and the interventionist; between one and five meetings may be held; no single member of the support network is alone in the meetings with the loved one needing help, thus spreading out the potential burden
• Step 3: a more formal intervention is staged with consequences put in place if treatment is not sought
• Step 4: entrance into treatment for the family and hopefully the addict as well, usually lasting at least six months and typically encompassing involvement in a 12-step program

The ARISE Model involves the entire family and no secrets are kept; the addicted family member is aware of any and all planned meetings and invited to attend. ARISE is based on respect and principles of caring and love. The American Journal of Drug and Alcohol Abuse states that 55 percent of substance abusers seek help before the modified Johnson Model intervention, or more formal intervention, is held, thus precipitating it necessity over half of the time. Even when some refuse treatment after the more traditional intervention, families are still healed through improving individuals’ self-esteem and the family dynamic as a whole unit. The ARISE Model focuses on healing entire families and encourages long-term recovery with fewer episodes of relapse.

Families are heavily involved in the healing and recovery process. Since family members often have the best personal knowledge of the addict, they instinctively understand which intervention model may work best for the individual.