Do Interventions Actually Work?
Sam Davis started using marijuana when he was 10 years old. By the time he was 36, he was addicted to cocaine.
“I was pretty much [always] pickled,” Davis told MensHealth.com.
“I was doing a lot of cocaine and had pretty much lost everything. I was deluded about the fact that I could do it on my own or stop. I had, to some degree, given up and thought that this was just what I was going to be.”
Then one day, Davis says he went to what he thought was going to be just a routine meeting with his parole officer. (He was on probation at the time for possession of cocaine.) “Somebody’s here to see you,” the officer said. His sister, mother, father, parole officer, and a professional interventionist were present, ready to try a last-ditch effort to get him off drugs.
“They had always bailed me out, were always trying to save me. They were really keeping me sick,” Davis, says. “At that point, it was about removing my options to do anything else. The interventionist said, ‘You can go to jail or you can go with me.’ I had to think about it.”
Ultimately, Davis chose to undergo treatment, and he is now nine years sober. Now a certified interventionist and founder of Broad Highway Recovery, in Richmond, Virginia, he credits the intervention his parents staged with the 180-degree turn his life took.
But Davis’s story is only one of many. According to the National Survey on Drug Use and Health (NSDUH), 21.5 million American adults (aged 12 and older) battled a substance use disorder in 2014. Almost 80 percent struggled with an alcohol use disorder. And with our nation in the throes of an opioid epidemic, many families will turn to interventions to try to save their loved ones’ lives. But interventions aren’t always successful, and some health experts believe they have limited efficacy.
MensHealth.com spoke with mental health experts to learn more about interventions, and how to go about helping someone you love whose life is falling apart due to a drinking, drug, or other addiction problem.
What’s an intervention?
An intervention is a meeting staged by family and friends to convince a loved one struggling with addiction to get help. The concept of interventions rose to popularity 20 to 30 years ago, says Andrew Saxon, M.D., a professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington and chair of the American Psychiatric Association’s Council on Addiction Psychiatry.
The long-running A&E series Intervention, which first aired in 2005, has also brought attention to this method of helping people with serious addictions turn their lives around. The show profiles people dependent on drugs, alcohol or compulsive behaviors and what happens when their families and friends give them an ultimatum to get better or lose everything.
The idea behind an intervention isn’t to bully someone with a drug or alcohol problem into reforming, says Saxon. It’s a methodically planned-out meeting that’s usually arranged as a surprise due to the concern that if you tell the person in advance, they won’t show up.
During the gathering, loved ones constructively tell the person, in a non-threatening way, that they want to help them, says Troy Jackson, MSS, LSW, a licensed therapist from Philadelphia, who works mostly with male patients between the ages of 17 and 35.
“You’re coming from a place of love,” says Jackson, who counsels patients and their loved ones in his office setting after an intervention takes place.
“You’re coming from a place of love.”
What’s it like to participate in an intervention?
When it comes to organizing an intervention, it’s best to get professional help from an interventionist, says Saxon, who personally does not practice interventions. “It’s good to have a neutral party,” he says. A professional can also help you pre-arrange treatment, so if the person agrees to get help, you have experts ready to work with him.
As for the intervention itself, it’s rigorously scripted, says Davis, who works with families all across the U.S. “When families try to go at it alone, I call it the fly-by-the-seat-of-your-pants-driven-by-emotion-and-resentment model,” he says, and there tends to be “too much dialogue.”
A person addicted to drugs or alcohol “know[s] what buttons to push on the family, and the family knows what buttons to push on the addicted individual. The addict has to be in control and without that opportunity for dialogue, the individual can realize, ‘My manipulation isn’t going to work anymore,’” Davis says.
The interventions Davis leads typically include four to eight family members and close friends (no children are allowed) who get together in the addict’s home or another setting that works for everyone. They usually consist of three parts: the family members take turns saying how much they love the person, and share one quality they admire about that person; they state in simple terms how the person’s addiction has affected them, and they ask the substance user to accept the help being offered.
If the substance user rejects the ultimatum, Davis says, the family member then explains how their relationship will change — for instance, their marriage will end, or they’ll be asked to move out of the house.
“It could be as severe as, ‘You’re fired,’ or ‘I’m going to leave you,’” says Davis.
Finally, the family should have a place set up and ready to receive the substance user. “You don’t want to have an intervention with caring friends and family members and when the person says ‘yes’ not know what to do. You don’t want to be sitting around with them saying, who do we call,” says Saxon.
“Certainly, it’s not something that most psychiatrists would do.”
Do interventions work?
Davis says in his personal experience, the interventions he facilitates are a success about 95 percent of time (meaning the person is willing to enter a treatment program). Whether the person ultimately gets sober, however, is unclear, though he does try to stay in touch with many of the families.
There are varied professional opinions when it comes to how effective an intervention can be, both in the short-term and in the long run. One complicating factor is that addiction often goes hand-in-hand with other mental health conditions, including depression, anxiety
“Interventions are certainly nothing ever studied with any rigor. You can’t say, ‘Yes, this is something that will work.’ I think certainly, it’s not something that most psychiatrists would do, although some may do it rarely,” says Saxon.
The primarily concern is that interventions can turn confrontational. (A classic example: the intervention scene from the show It’s Always Sunny in Philadelphia.) “We don’t think that’s very useful. We think about the stages of change and trying to motivate people toward action,” he says.
Dr. Sarah Reagan, Ph.D., a clinical psychology in Florida, who specializes in alcohol addiction, says the goal of interventions shouldn’t be for family members to pressure someone into getting sober.
“If you’re looking for longterm rehab or recovery, you want motivation to come from the inside of the person, for them to see what they’ll get if they comply, not do it out of guilt or just to keep other folks from being mad,” she says.
How do you find an intervention expert?
One way to locate an intervention pro is to call an established residential or outpatient addiction center and ask for names and contact numbers of the interventionists they work with and would recommend. You can also reach out to a psychiatrist who is a member of the American Psychiatric Association through a local branch office, says Saxon, as interventionists often work with mental health professionals to become part of the substance user’s long-term care team.
“Unfortunately, people have to have a crisis before they recognize the problem,” says Saxon. If you believe a loved one is struggling with drug or alcohol addiction, and you are considering staging an intervention, “be very non-confrontational and non-accusatory, and try not to strong arm the person into doing something. Do it in an empathic way. Express love, show support and how much you care and want to help. And hope for the best.”
If you are struggling with drug or alcohol abuse, please seek professional help or contact SAMHSA, the Substance Abuse and Mental Health Services Administration, which has a hotline anyone can call 24/7 for help and advice at 1-800-662-HELP (4357).