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Intervention

Intervention: A group of concerned people meeting with the alcoholic to force him to accept treatment immediately.

It has been said that no one could help the alcoholic until he wanted help. Nothing could be further from the truth.

It has also been said that the alcoholic must have hit "bottom" before he can be helped. Again, nothing could be further from the truth.

Alcoholics can be successfully treated no matter how they got to treatment. It has been said, with a good bit of validity, that the way to get a teenager to treatment was to take him by the hair of the head and throw him in the back seat. It is the job of any good treatment team to get him to trust and bond and then treat successfully. People who demand motivated clients are just saying we don't really know enough about treatment to get a client to bond and trust.

The slightly informed ask if he has "hit bottom", and of course there is not such thing as a "bottom." There is only a cluster of losses occuring close enough together to form an accummulative strength which can break through his denial or ego defense mechanisms. But if he don't get sober this time there MIGHT be another "bottom" and so on. There is a grave danger in family and friends waiting until "he is ready" since the last bottom is very often in the grave.

Actually no one comes to treatment voluntarily. Some say they do but if you question them carefully and they answer you truthfully, it is readily seen that they were going to suffer some unacceptable losses unless they came to treatment. In essence this is their bottom. It must be understood that the alcoholic can have more than one bottom. He may come to treatment on several occasions, because on each occasion he does not want to face the alternatives in reality. There is no guarantee that he will eventually get sober having coincidental "bottoms." As we just stated; his last bottom may be death.

So an intervention is an artificial bottom. Intervention means to interfere or to break in to the cycle of drinking in which the alcoholic is involved. It could also mean "presenting reality to a person out of touch with reality in a receivable manner." It is a means of bringing the alcoholic to treatment as early in his drinking history as possible.

This is usually done by having a group of people who are most closely emotionally tied to the alcoholic (family and loved ones), or in whom he places much credence (doctor, lawyer, pastor), get together with the alcoholic and confront the alcoholic with his alcoholic behavior. This is done by letting each one recite from a written script the exact behavior they have witnessed the alcoholic taking and the exact time and date it was taken. They usually add how this behavior made them feel, but if they do so this must be said in a non-judgmental manner. Each of these statements should end with the statement that they believe the alcoholic should go to treatment "now" or they will no longer ....(whatever their supportive behavior has been to this point).

The intervention process can only start when friends and family quit "taking care of" the alcoholic and "start caring about him." This group confrontation is an empathic and understanding confrontation but not a sympathetic one. This is a face to face affair. Since it sometimes is not very pleasant the person conducting the intervention usually places his/her chair in front of the door so the alcoholic cannot simply walk out without further confrontation

Some Elements of the Intervention:

Gathering the intervention team. The most likely person to participate should be the first one approached so that there are at least two people to start gathering the intervention team. The quicker one can get the more prestigious, or the natural leaders, of the group on board, the easier it will be to complete the job. It will also help to keep the team together once they are gathered.

Forming the intervention team. The structure of the team should be developed as definitely as possible. Almost always there are a few people who can talk to selected other people because of special circumstances they share or for some other reason that makes it possible for one person to build the confidence of another. Each person on the team should have another person who they are responsible for encouraging.

Gathering the presentation data. At the first meeting of the intervention team the leader should go over the data that the team will need to make the intervention succeed. Each person will be asked for the more bizarre behavior or the most embarrassing situations they have seen the alcoholic indulge themselves in. There should be no shortage of these at all. If there seems to be a lack of information demanding treatment, the leader should take a long look at his team. Most likely there is a great deal of denial on the team and in some cases it can be so strong that the intervention becomes impossible until present team members come out of denial or until other team members can be recruited.

WARNING: There should be at least two people with bizarre enough behavior to send the alcoholic to treatment otherwise one person, feeling alone and solely responsible for sending the patient to treatment make get cold feet and back out. It is far less likely to happen if two or more people have the same information. In fact, the entire presentation should be careful that no one person has information the others do not have, since the brings on the possibility of the patient attacking the treatment team members one at a time and "selecting them out" and creating a hole through which he can escape facing the consequences of his own actions.

Rehearsing the intervention. Just as a therapist would have a client "role play" a certain role so they can do it more easily when the real deal comes along, the treatment team should rehearse or practice their recitations at least once before the actual intervention. The leader should be alive for people who show up late, or not at all. Losing at least one person during the time before the intervention is normal but the behavior of the others in getting to and participation in the reheasal is a sure sign of how they will act in the real intervention.

Researching treatment programs. Treatment centers should be called. There success rate should be quoted to the team in writing. If there are local people who have been to that particular treatment center they should be interviewed. Be alive for the fact that everyone thinks their place was the toughest and the best. Just like an army man who comes home after basic training telling "war" stories. Old times in AA and local therapist specializing in treating alcoholism should be interviewed as well. Of course the cost will come into play and one may not have a large selection. If not, do the best you can. Keep in mind that people with good sobriety visiting in treatment can be a factor in rehabilitation. UNDER NO CIRCUMSTANCE SHOULD ONE USE A TREATMENT PROGRAM THAT IS NOT 12 STEP BASED. THEY MUST TREAT KNOWING THAT ALCOHOLISM IS A PHYSICAL OR BIOGENIC DISEASE.

Deciding on the treatment program This is not hard. Once we have discussed the money, tried to get a center as close to home as possible so the family can be treated as well, the rest should be rather obvious.

Packing to leave for treatment. The packing should be done before hand and the suitcases in the car. Do not be embarrassed, most clients come to treatment with their clothes in a paper bag. Toothbrush and toiletries etc should be packed. A few, but very few, dollars of coke money should be available and left with the intake counselor so the client will not use it for a beer and bus fare. In fact, they should hot have enough for bus fare. A passive wife should not be left alone to carry a hard headed alcoholic to treatment. She needs an oldtimer from AA to go along with her. On returning hoe arrangements should have been made for her to go to Alanon, for friends to call and support her and otherwise just not dump her now that he is out of the house.