Intervention (counseling)

An intervention is an orchestrated attempt by one, or often many, people (usually family and friends) to get someone to seek professional help with an addiction or some kind of traumatic event or crisis, or other serious problem. The term intervention is most often used when the traumatic event involves addiction to drugs or other items. Intervention can also refer to the act of using a technique within a therapy session.

Interventions have been used to address serious personal problems, including, but not limited to, alcoholism, compulsive gambling, drug abuse, compulsive eating and other eating disorders, self-mutilation, tobacco smoking, "workaholism", and various types of poor personal health care. Interventions have also been conducted due to personal habits not as frequently considered seriously harmful, such as video game addiction, excessive computer use and excessive television viewing.

Direct and indirect interventions
Interventions are either direct, typically involving a confrontational meeting with the alcohol or other drug dependent person (the most typical type of intervention) or indirect, involving work with a co-dependent family to encourage them to be more effective in helping the addicted individual.

The use of interventions originated in 1960s with Dr. Vernon Johnson. The Johnson Model was subsequently taught years later at the Johnson Institute. This model pioneered the way of intervention, but has come under scrutiny because of the "ambushing" nature that the model falls under.

Two of the major models of intervention that are utilized today are known as systemic and A.R.I.S.E. model of intervention. Both use an invitational approach to intervention and rely heavily on having the family as a whole enter a phase of recovery. This helps take the focus off the addicted individual and notes the need for the entire family unit to change in an effort for everyone who is involved to get healthy. These models place an emphasis on treating the addicted individual with dignity and respect.

Plans for direct intervention
Plans for a direct intervention are typically made by a concerned group of family, friends, and counselor(s), rather than by the addict. Often the addict will not agree that he (or she) needs the type of help that is proposed during the intervention, usually thought by those performing the intervention to be a result of denial; however, a common criticism of the intervention method is that, by surprising the subject and taking a confrontational approach, the intervening parties may cause the subject to go on the defensive. One of the primary arguments against interventions is the amount of deception required on the part of the family and counselors. Typically, the addict is surprised by the intervention of friends and family members.

It has been noted that ' Family intervention is not possible in all or even most cases ', and workplace, medical, or legal practioner interventions have also been explored. To some extent 'a new profession has sprung up based on Dr. Johnson's work - the interventionist'.

Prior preparation
Prior to the intervention itself, the family meets with a counselor (or interventionist). Families prepare letters in which they describe their experiences associated with the addict's behavior, to convey to the person the impact his or her addiction has had on others. Also during the intervention rehearsal meeting, a group member is strongly urged to create a list of activities (by the addict) that they will no longer tolerate, finance, or participate in if the addict doesn't agree to check into a rehabilitation center for treatment. These consequences may be as simple as no longer loaning money to the addict, but can be far more serious, such as losing custody of a child.

Family and friends read their letters to the addict, who then must decide whether to check into the prescribed rehabilitation center or deal with the promised losses.

Controversy
There are significant questions about the long-term effectiveness of interventions for those addicted to drugs or alcohol. A study examining addicts who had undergone a standard intervention (called the Johnson Intervention) found that they had a higher relapse rate than any other method of referral to outpatient Alcohol and Other Drug treatment. However, persons who underwent the intervention were more likely to enter outpatient treatment. The intervention may therefore appear to be more effective than it is because it results in this initial success.

Civil liberty problems with forcible intervention
Sometimes direct interventions involve physical force (e.g. by family members or friends) to capture or confine the targeted person. Typically a government-licensed psychotherapist is involved. Indeed, the government's involvement prevents the intervention from comprising a crime, such as battery or kidnapping. In such cases the person has (usually) neither been served with any legal action alleging the necessity of intervention, nor had the opportunity to appear in court to defend against the proposed intervention. Civil libertarians argue that in such cases the intervention may be illegal because it deprives the person of liberty without due process of law.

In film and television

 * The A&E television series, Intervention, follows participants who have addictions or other mentally and/or physically damaging problems, in anticipation of an intervention by family and/or friends. Each participant is given a choice: go into rehabilitation immediately, or risk losing contact, income, or other privileges from the loved ones who instigated the intervention.
 * The Bravo TV reality show, Thintervention, follows American fitness trainer Jackie Warner as she helps a group of eight clients lose weight. Warner's clients receive psychological, nutritional, and lifestyle counseling in addition to physical fitness training.
 * The comedy movie But I'm a Cheerleader is about a high-school girl that been sent to a residential inpatient reparative therapy camp to cure her lesbianism.

In literature

 * Faye Resnick reveals in the book Nicole Brown Simpson: The Private Diary of a Life Interrupted (1994), which she co-wrote with gossip columnist for The National Enquirer, Mike Walker), that she learned about Brown's murder three days after Brown and her friends forced Resnick to enter a rehab clinic for drug and alcohol abuse.

In film and television

 * In The Sopranos episode, "The Strong, Silent Type" (Season 4, Episode 49), Tony Soprano organizes a drug intervention for heroin addict, Christopher Moltisanti.

In popular literature
There is a good-humoured account of a well-meant but perhaps misplaced intervention in Jayne Ann Krentz, All Night Long. The family of the protagonist (Luke) want him to abandon his "destructive" writer-lifestyle and return to the family business. Irene, his new partner, only learns of the intervention at breakfast, after it has already begun.

'"It's called an intervention", Vicki explained. Irene choked on a bite of muffin that she had just slathered with butter. "A what?" "An intervention", Katy said hastily. "It's a psychological technique that is used to confront a person who is exhibiting self-destructive behavior patterns...." "I know what an intervention is". Irene swallowed hastily...appallled. "But you don't understand. Luke thinks he's going to get breakfast and an offer of a job this morning."'.

Luke had indeed not been best pleased; and was soon attempting to leave the complex, taking Irene with him. The good family therapist/interventionist - clearly 'made of sterner stuff' - unstoppably confronts Irene, 'accusation radiating from her in waves. "You are enabling his behavior", the woman said quietly'. As Irene sought to reassure the concerned family, suddenly 'inspiration struck. "If it helps", she said, "I can assure you that there's no need to worry about Luke's erectile dysfunction problem...Actually he's a lot bigger than normal"....Bigger, she thought, had been an unfortunate choice of words. "I mean better than normal", she said quickly. She could tell immediately that the hasty rephrasing wasn't quite right, either', and eagerly seized on Luke's suggestion that '"this is one of those situations that call for a strategic retreat"'.

Together the couple made for the door with their breakfast to go. Sadly, the intervention had failed.