Family Drug Intervention
It is useful to first define what a drug
intervention is and to establish what is common across the board
in both of the
following
two models of intervention. Drug intervention is the process of stopping
a chemically dependent person from continuing to use their drug of
choice, despite negative consequences. In the AOD field drug intervention
has come to mean to motivate an individual to enter treatment, who
is currently unwilling to do so.
Models of Intervention
There are two concurrent and sometimes overlapping
models of intervention which dominate the mainstream opinions of
Intervention specialists in AOD care today. One (The Johnson Model)
demands the breaking of an ingrained and seemingly impenetrable system
of denial and the other (Motivational Interviewing) states that denial
is peripheral to the central issues.
The Johnson Model of Intervention
Vernon Johnson, founder of the Johnson
Model of Intervention, based his work on the idea that forceful
confrontation is necessary
to penetrate the barriers and defenses of the denial system inherent
in individuals with AOD problems. The interventionist may attempt
to break through this denial system by dramatic, emotionally charged
and dynamic means. The interventionist typically uses the family
and peers that are close to the individual in a confrontational meeting
to show the individual the damage they have caused and hopefully
in the process illicit the realization that the person must take
action before it is too late. It is this "raising of the bottom" concurrent
with a belief that all people with AOD problems have a strong sytem
of denial that marks the Johnson techniques and what is meant to
be accomplished by it's processes.
"It is a myth that alcoholics
have some spontaneous insight and then seek treatment. Victims
of this disease do not
submit to treatment out of spontaneous insight - typically, in
our experience they come to their recognition scenes through a
buildup of crises that crash through their almost impenetrable
defense systems. They are forced to seek help; and when they don't,
they perish miserably."
- Vernon Johnson. from I'll Quit Tommorow,
1973.
Motivational Interviewing
Later, after the Johnson Institute had long been the
established authority on interventions, a more research oriented
approach came to be. William Miller and co-author Stephen Rollnick
released their book, Motivational Interviewing: Preparing People
to Change Addictive Behavior in 1991 and set out to acknowledge
that clients may not be readily open to such direct techniques favored
by the Johnson school of intervention.
Miller and Rollnick had challenged
the viewpoint that all AODA clients had an inherent "system of
denial" that
was a major barrier to treatment. Miller and Rollnick proposed
that confrontational
techniques elicited a normal reaction of denial and labeled such
as abnormal and symptomatic of a chemical dependency issue. Therefore,
they set out the idea that it is the behavior of the counselor that
is antecendent to resistance and denial in the client.
What Miller and Rollnick instead
proposed was a methodological approach that looked at stages of
change in the client and in determining
the specific desire or willingness of a client to change, thereby
prescribing the counselors appropriate course of action. Where clients
in the action stages would respond well to confrontation, those that
are merely contemplating the idea that they have a problem, or are
wholly unaware will react with resistance and become unamenable to
any attempts to treat the AOD problem. The main point of motivational
interviewing is that "client resistance is a therapist problem";
not a client problem. The point of view then is that professionals
must change their behavior according to that of the client.
When Is The Right Time For An Intervention?
This is perhaps the most often asked and
the most often unanswered question that families and peers have when
confronted
by a loved one with an addiction problem. The best answer is as soon
as an AODA problem has been identified. Through consultation with
a treatment professional or intervention specialist and within a
relatively short period of time, you and the person interviewing
you will know whether or not intervention is neccesary. The truth
is that most cases do not require a full intervention. Intervention
can be a great asset to getting someone the help they desperately
need, however done without the advisement of a treatment professional
or intervention specialist can lead to ambivalence and resistance
in the AODA client.
If you feel that someone you love may
need an intervention, or you would like to speak to someone about
an addiction problem,
feel free to contact a qualified
counselor by email here, or
call us at (800) 722-5570.
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