Direct vs Indirect Intervention

About 60 to 80 percent of people who abuse substances have frequent contact with members of their families, according to a study published in the American Journal of Drug and Alcohol Abuse.

As a result, these family members likely know quite a bit about the addiction, and how it is impacting the person they love and the family they’re a part of. Families who want to stop the addiction from progressing may choose to hold an intervention. Here, they can finally address the addiction head on and start the healing process. However, there are multiple ways in which to hold an intervention, and while one type might be best for one addicted person, another person might have a better response to a different type of intervention.

By learning a little more about how interventions work, and whom they’re designed to assist, families can make an informed choice and reach out to the person in need.

Direct Interventions

A direct intervention allows a family to confront the addicted person with a surprise meeting and encourage that person to get help for the addiction.

Direct intervention is a very old, tried-and-true method that originated in the 1960s through the work of Dr. Vernon Johnson, and it’s been memorialized in countless movies, television shows and plays since that time. In fact, most people could probably describe a Johnson Intervention in great detail, if they were asked to do so, due to the endless coverage this type of intervention has been provided within the mainstream media.

In essence, a family holding a direct intervention holds a series of private meetings with an interventionist, and they develop a script for the talk. These concerned family members outline why the addiction is an issue, and they develop consequences that will befall the addicted person if he/she refuses to get help for the addiction issue. These planning sessions can be difficult, according to research quoted by the American Psychological Association, and 70 percent of those planning an intervention like this never do hold the talk. Some people feel as though the intervention will not be effective, while others find that the idea of “attacking” the addict is unpleasant, and simply shouldn’t be done. Interventionists can sometimes help people to overcome these concerns by reminding them that the addicted person will continue onward with the addiction process without help, and that the family has a responsibility to help the person to move forward, but some families simply cannot make this leap.

During the intervention itself, the family reads through the scripts developed in the planning sessions, and they encourage the addicted person to enter a treatment program for addiction. The intervention ends when the addicted person agrees to get help, and according to a study in the American Journal of Drug and Alcohol Abuse, many people who are confronted in this way do get help. In fact, people who were given a Johnson Intervention were more likely to enter treatment programs, when compared to people who were provided with other forms of interventions. It’s clear that this type of intervention can be helpful for some people.

A direct intervention can have drawbacks. Some people refuse to enter treatment programs for addiction when confronted in this way. Some people even leave the conversations altogether, before the family is done speaking.

Direct interventions don’t provide families with another route to take should an intervention fail in this way. In addition, direct interventions tend to focus solely on the needs of the addicted person who needs treatment. Sometimes, families also need treatment in order to heal from the scourge of addictions. Indirect interventions attempt to help families to solve these thorny problems.

Indirect Interventions

An addicted person can do a significant amount of damage to the family during the course of the addiction. In fact, the roles family members play might be significantly altered as the addiction process moves forward. As researchers in the journal American Family Physician put it, “This stressful environment induces emotional changes in each family member and creates a variety of pathologic family roles.”

For example, family members may:

  • Develop their own addictions, in order to relate to the addicted person
  • Coddle the addicted person, and enable the addiction
  • Become angry and withdrawn, due to the addiction
  • Act out at work or at school, in order to draw attention away from the addiction

Even if the addicted person chooses to receive addiction care, those malignant roles played by family members might persist, and they could lead the person into a relapse when addiction treatment has been completed. An indirect intervention strives to help the addicted person to heal by also helping the family to heal. The family works with a specialist and learns more about the addiction and how they can communicate about addiction with the person they love. The addicted person can attend any and all meetings the family has with the therapist, but the family continues to obtain help, even if the addicted person chooses not to respond.

The most commonly used form of indirect intervention is known as the Systemic Family Intervention. Here, the family participates in about 18 hours of training with a therapist, and then participates in a variety of follow-up appointments.

For some families, this model blends nicely with the addiction care their family member receives, and they can put the work they’ve done in the intervention to good use in family therapy sessions. For other families, this intervention allows them to learn how to maintain their mental health and healthy family lives, even if the addicted person never agrees to obtain care. The work they do in this intervention may, in time, help the addicted person to understand the need for treatment, and agree to get help.

Blended Techniques

Some intervention models take the best of both indirect interventions and direct interventions, using a stair-step approach of escalating consequences that allow the family to learn and the addicted person to obtain needed help. Families who choose this approach may be required to make a lengthy and in-depth time commitment in order to complete the process and obtain the results they so desperately want, but those who agree to do so may find that their efforts help them reap big rewards.

Here, the family meets with an interventionist and learns more about addiction and how it might be changing the dynamics of the family. The addicted family member can attend this meeting. If the person does not enter treatment, the family holds a series of meetings, encouraging the person to get help. Again, the emphasis is on education and learning, rather than blaming, and the person is asked to get help while the family also agrees to get help. If the addicted person still refuses treatment, the family holds a modified Johnson Intervention, complete with consequences that can befall the addict if he/she continues to abuse substances.

Making a Choice

Families who want to hold an intervention are faced with a plethora of choices, and each member of the family might have differing opinions about which method is best to use. By determining the answers to these questions, families may be able to make the best choice for the person they love:

  • How likely is it that the person will get help immediately?
  • How likely is it that a confrontation will end in violence or anger?
  • How much damage has been done to the family, and how much retraining is needed?
  • How many family members also have addictions?
  • How dedicated is the family to the long-term success of addiction therapy?

These are difficult and soul-searching questions, but they can be helpful for family members to discuss. Addicted people who tend to respond with anger might need gentler approaches, and those who are on the cusp of accepting help might benefit from more straightforward approaches. The right solution is there, and families can find it with a little planning.

Interventionists can also help families to make informed choices. These experts have training in multiple types of interventions and they can talk with the family members about approaches and help them determine which course is best.

If you’d like to access help like this, please contact us. We’re happy to talk through your options and help you find the right tack to take with the person you love.