Surprise vs. Invitational Model

When an addiction issue has become so intolerable and so persistent that the family begins to buckle under the pressure, an intervention can provide the pathway out of the darkness and into the light. In an intervention, the family can finally confront the addiction in a loving and caring way, and hopefully, they can persuade the addicted person to make changes that could help the entire family to improve. While any kind of intervention is bound to bring about some kind of change and help the family’s situation to improve, there are some intervention types that are better suited for some types of families, while other types of families might benefit from interventions that use slightly different techniques. There are no right or wrong answers here, but finding out more about how interventions work can help families to make an informed choice and hire the right kind of interventionist to help. Interventionists and family mediators often specialize in one particular type of intervention or a range of interventions, so it’s important for families to know what they want before they start shopping for help.

This article will outline the difference between intervention types that utilize the element of surprise, compared to intervention types that rely on group work and communal learning. If, at the end of this article, you have any questions about how these interventions work or you need more information on specialists who utilize a certain type of intervention you’re reading about here, please call us.

The Benefits of Surprise

man who needs an interventionOf people who have addictions, more than 80 percent fail to look for treatment options that could help, according to an article in the journal Trends in Cognitive Sciences. For some of these people, denial is to blame for this addiction complacency. They may believe, deep down inside, that they’re not really addicted at all and that everyone around them is simply exaggerating the scope of the problem. Talking to someone who is deep in denial like this can be frustrating, and many families find that simple discussions about the addiction are futile, as the person simply will not admit that anything is amiss. It’s as though a wall stands between the person and the truth, and the family might come to feel as though a big shock is needed in order to break that wall down.

A traditional intervention utilizes surprise in an effort to break down that wall of denial. Here, the family pulls together a team of concerned people who know about the addiction and who want that addiction issue to stop. The team could be made up of almost anyone at all, but typical participants include:

  • Parents
  • Spouses or significant romantic partners
  • Close friends
  • Children

The family holds a series of meetings in which they plan what they’d like to say, and then they surprise the addicted person with a meeting. Here, they outline all of their comments and they push the person to accept treatment or accept a series of negative consequences.

girl who needs interventionMeasuring the Effectiveness of Surprise

Confronting someone with an issue that is so personal, and threatening to bring about negative consequences if the person doesn’t change, is never easy. It’s not surprising, then, that studies suggest that 70 percent of people who plan an intervention like this don’t ever hold the formal conversation. It might be too hard for people to think about discussing this topic with the person they love, and it might not seem that holding a confrontation could be effective.

Those who do hold an intervention like this, however, may find that they can help the person they love get needed care. The threat of consequences might be a motivating factor, but it’s also possible that a surprise intervention provides such a shock to the person’s system that he or she simply cannot persist in the belief that nothing is wrong. A surprise intervention alone can’t help to treat an addiction, however, and some families find that relapses to addiction take place after the intervention is held. In one study of the issue, published in the American Journal of Drug and Alcohol Abuse, relapse rates ranged from 38 to 79 percent after a surprise intervention. This study points out, however, that this form of intervention is still considered successful, as families can use the same methods to push the person to resume care after the relapse. An intervention that worked once might work just as well the second time around.

Families might also ameliorate the relapse risk by participating in family therapy. This isn’t a given when families utilize surprise interventions, but family therapy can help the family continue to learn about addiction, and perhaps, they could change their habits and create an environment that is less conducive to substance use and abuse. Families who take this approach may be building upon the success they had in a surprise intervention, and they may see their family heal as a result.

An Invitational Approach

Intervention SexWhile a surprise intervention can be shocking, providing the person with a wakeup call fueled by confrontation and a bit of embarrassment, an intervention like this may deprive the addicted person in some ways. While the family might have time to learn about an addiction during the planning stages, the addicted person is left out of those talks. The addicted person is also left out of conversations about treatment options, and may not have a feeling of ownership about the treatment plan chosen as a result. An invitational method may help, as the addicted person is allowed to participate in discussions from the very beginning. As soon as the interventionist is hired, the addicted person has the opportunity to learn.

An invitational approach may also have benefits for the family. While a traditional intervention is focused solely on the addicted person’s habits, and the goal of an intervention like this is simply to get the addicted person into treatment, an invitational model focuses on the needs of the family as well. For example, the CRAFT Model (Community Reinforcement and Family Training) is based on the idea that the whole family has a role to play in keeping an addiction alive or making an addiction fail. Families that go through CRAFT are asked to:

  • Learn about addiction.
  • Identify situations in which they may enable poor behavior.
  • Look for situations in which they can glamorize the sober life.
  • Learn to reward good choices, rather than punishing poor choices.

Even if the addicted person never chooses to learn about addiction and never attends even one training session, an approach like this can help the family learn to escape from the addicted person’s behavior. Enabling stops and the family might gain emotional health, no matter what the person might do.

Measuring the Effectiveness of Alternate Approaches+

Families who use the CRAFT approach learn to make addictive behaviors unpleasant, as they refuse to reward this type of negative behavior. In one study of the effectiveness of CRAFT, researchers found that 64 percent of those who utilized this approach saw their loved ones enter a treatment program for alcoholism. This is a remarkable success rate, and it indicates that confrontation isn’t the only way to bring about change in someone with an addiction. Similarly, a study in the Journal of Substance Abuse found that family members who utilized CRAFT were also less likely to drop out of their training sessions. In this study, 87 percent of participants completed all the training sessions they were offered. Unlike a surprise intervention, in which many people chose not to complete their assigned care programs, an invitational intervention seems to retain clients.

Making a Choice

Family members may know, on a gut level, which type of intervention is likely to bring healing and help the situation to change. Families that aren’t sure, however, may benefit from interviewing interventionists and family mediators who use different approaches in their work. Families can ask questions such as:

  • Why do you feel that this intervention is best for our family?
  • What kind of success have you had with this intervention?
  • How should we follow up after the intervention?
  • What happens if the person won’t enter treatment?

Answers to questions like this might make the right approach clearer and allow families to choose the right intervention with confidence. If you’d like to start your interviews now, please call us. We’re happy to help.