When a patient is diagnosed with diabetes at the doctor’s office, the patient is often told that the disease can cause a painful and swift death unless the patient makes significant changes right now to change the course of the disease. Family members worried about the diagnosis might help the patient change meal plans, get exercise and attend medical appointments. The patient and the family work together to fight the disease.
Another chronic condition impacts a significant number of people in the United States, yet many family members don’t assist in the fight in quite the same way. The disease is addiction. Over seven percent of adults have disorders relating to alcohol, according to the American Academy of Family Physicians. Many more abuse drugs or engage in compulsive gambling. Instead of receiving help from concerned family members, they may face scorn, confrontation or blame. According to the National Institute on Drug Abuse, participation in inpatient treatment programs can help addicts kick the habit, but they must enter those programs in order to get the help they need. Some addicts lack this motivation, and their families may not help them get motivated.
The Love First intervention technique model strives to change all that. Here, the family and friends of the addict put together concrete plans to help the addict improve, and they present that information in a firm and loving way. The families then put the plans in action, making the change a reality. The method was developed in 2000 by Debra and Jeff Jay and has been gaining traction since that time.
At the core of a Love First intervention is a team of concerned family members and friends. The Love First method calls for at least three participants, but up to seven can be involved. Small children are often not included in the team. Letter writing forms the core of this method, and small children may not have the skills needed to do the job properly. Members of the clergy, doctors, employers, friends and family members are all common members of the intervention team, and one person is selected to function as a sort of team leader. This person can be a hired intervention specialist, able to guide the team during the planning of the intervention and making sure the intervention functions properly, but a professional’s help isn’t explicitly required. The team typically meets multiple times during preparation for the intervention, and all members must commit to participating in all practice sessions and the intervention itself.
Each person on the team is asked to write an intervention letter, and these letters form the core of the Love First intervention plan. The letters have four parts:
A recap of the relationship between the addict and the writer. Here, the writer might mention how they met, the great times they’ve had together, the challenges they’ve been through together and how much they love one another.
A list of specific instances within the last year when the addiction caused the writer embarrassment. It might be a public event, such as a drunken brawl or an arrest, or it might be a private event, such as a spoiled phone conversation or ruined dinner.
Statements of concern. Here, the writer encourages the addict to look at the consequences of the addiction and enter treatment. These statements typically focus on the health consequences of addiction. They do not contain threats.
Bottom line. This portion of the letter appears on a separate sheet of paper. The writer outlines specific consequences that will befall the addict if the behavior doesn’t change. The writer might take custody of the children, for example, or the writer might cut off all contact with the addict.
Once the letters have been written, team members read them aloud to one another and help one another edit letters for maximum impact. Phrases that seem hostile might be removed and replaced with softer statements of encouragement. These letters are incredibly important, and the team might spend several sessions editing and refining these letters to make sure they’re perfect. The team may also spend a significant amount of time thinking about the impact of the letters and determining the order in which the letters will be read. Letters with the most emotional impact or leverage might be read last, when the addict’s resolve is at its lowest point.
At the end of each letter, the addict is encouraged to enter a treatment facility that very night. Rather than simply suggesting that the addict get help and stop the behavior “soon,” a deadline for participation is attached and the team does all it can to make that plan easy to put into place. Love First participants choose an inpatient program, and they do their homework to make sure the addict can enter the program right after the intervention is over, with no excuses. The team might:
Pay the admission copayment. The addict may not agree to pay for treatment alone, so all team members may chip in to cover expenses.
Schedule time off at the addict’s place of work. This may not be legal in all states, so the family must tread carefully here.
Pack a bag for the addict to take to the treatment center.
Send copies of intervention letters to the treatment center.
Determine who will drive the addict to the center, and print out a map to help the trip go smoothly.
Set up kennel reservations for the addict’s dogs and cats.
Arrange childcare for the addict’s children.
The team ensures that all of the small details are taken care of, so when the addict agrees to the intervention, he or she can simply be whisked away immediately. The team thinks of answers to any and all excuses the addict might provide to stave off an impatient treatment program, and then makes plans to solve all problems and resolve all concerns. If the addict claims he or she doesn’t have insurance coverage for treatment, for example, the family can outline the methods they’ll use to pay for treatments. This excuse will have even less traction in 2014, when the Affordable Care Act will require insurance policies to include substance abuse treatment benefits.
The addict is asked to come to a neutral meeting place, and the intervention begins. Unlike other methods of intervention where the form is loose and the addict and the family are allowed to interact informally, the Love First method has a strict agenda to follow. The team leader provides a small introduction, telling the addict why everyone is gathering together, and then the real work of the intervention begins. One by one, each family member stands up and reads the letters. At this point, the “bottom line” portion of the letters is not read.
If at any point the addict agrees to enter the inpatient treatment program, the intervention is immediately concluded and the addict is taken away. This may mean that not all letters are read, but the addict’s treatment program still has copies of all letters.
If the addict refuses to enter a program, the family moves on to read the bottom line statements. Jeff and Debra Jay say this happens in less than five percent of cases, but it can provide a dramatic moment in the intervention. Here, the family tells the addict directly about all of the things he or she will lose if the behavior doesn’t stop. The family must be prepared to keep these promises if the addict will not change.
If the addict begins to yell, curse or behave in an angry manner, the family refuses to engage in the behavior and simply waits for the addict to stop speaking. The family then moves forward with the reading of letters. If the addict leaves the confrontation, one or two people leave with the addict and encourage him or her to return.
Some interventions can last for hours, as the letters are read and the addict interrupts or interjects his or her own opinions. It can be difficult to stay impassive during these moments, but the practice sessions the team has held can allow the family to make these moments slightly easier.
One the addict enters the treatment program, the letters remain an important part of therapy. If the addict expresses a wish to leave the facility, for example, therapists can encourage the addict to read the letters first to strengthen the resolve to stay. If addicts backpedal about the severity of disease, therapists can point to concrete behaviors described in the letters and read the bottom line statements to reinforce the seriousness of the situation.
If the addict has a relapse after the treatment program is over, the team may reconvene for another formal session or the letters can be used once more. The family can simply encourage the addict to read through the letters again, and the family can put the bottom line statements back into play if the addict will not comply. In this way, the letters form a sort of contract between the addict and the family, and they can provide a powerful incentive the addict can use to keep the addiction at bay for good.
This form of intervention requires the family to do a significant amount of planning and plotting. Some families may find the time commitment to be a bit daunting, and they may feel uncomfortable with the idea of taking over aspects of the addict’s private life to ensure that the treatment plans move forward. Other families may truly appreciate this aspect of a First Love intervention. Instead of speaking in general terms about treatment, they are planning a treatment program in advance and setting the wheels in motion. Families with a strong do-it-yourself streak may find this empowering.
While an intervention specialist isn’t explicitly required, it may be advisable for families to consult with a professional. Taking over some aspects of the addict’s life for planning purposes may be legal, but going too far could cause problems. An intervention specialist can assist in these planning stages and help the family members determine exactly what they can and cannot do. An intervention specialist may also provide invaluable input during the letter writing stage, helping the family to craft strong letters that both inform and persuade. An outsider’s perspective could be truly useful.