What Is an Intervention?

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What Is an Intervention?

In the context of substance use and recovery, an intervention involves an organized attempt to confront a loved one with an addiction about how their drinking, drug use, or addiction-related behavior has affected everyone around them. An intervention provides family, friends, and sometimes even colleagues and employers an opportunity to tell the person in their own words how the person's misuse of drugs or alcohol has been a problem in their lives.

The term "intervention" can be confusing because it can be used to refer to the various therapeutic approaches used to treat addiction, many of which are evidence-based and effective. These include motivational interviewing, cognitive behavioral therapy, and couples therapy. These evidence-based treatments and several others, typically take time and commitment on the part of the person with the addiction but are generally helpful.

What we are discussing in this article is not a treatment per se, but rather a planned attempt by a group of people to persuade someone they have a relationship with to either quit alcohol or drugs on their own or go into a treatment program.

Interventions should be carefully planned and developed by professional counselors who are experienced in such procedures.

How Interventions Work

Most alcohol and drug treatment centers have counselors who are trained to help families prepare for the confrontation, which always takes place in a "controlled" environment, specifically selected to put the person in a position in which they are most likely to listen. Many times, these interventions take place in the workplace, with the full cooperation of the employer.

Sometimes the intervention comes as a total surprise, but newer techniques have been developed in which the members of the intervention team tell the person with the addiction that they are talking with a counselor about their drinking or drug use several days prior to the actual intervention.

This process may be led and guided by an interventionist who is hired by the family or group.

Examples of substance and behavioral addictions that may prompt an intervention include:

  • Alcohol use
  • Prescription drug misuse
  • Illicit drug use
  • Compulsive eating
  • Compulsive gambling

Do Interventions Work?

From a professional standpoint, interventions cannot be recommended, simply because there is not enough research available to support their effectiveness. That doesn’t mean they can’t be effective; it just means that the studies required to “prove” their effectiveness have not yet been carried out.

While a few studies were conducted on the effectiveness of interventions in getting people into treatment during the late 20th century, they typically showed that family members chose not to follow through on confronting their family members.

One study showed that when they did follow through, they were able to get their family member into treatment, but in the end, this was a very small number of people, and the outcome of therapy was not reported.

Bear in mind that all therapies no matter how effective were at one time unproven, went through experimental stages and refinements, were funded for research, and finally, enough studies were conducted showing their effectiveness that they became accepted the practice. But just because they are accepted practice doesn’t mean they are guaranteed to work for everyone.

From an anecdotal perspective, interventions have mixed reviews.

Some clinicians have had the experience of working with people whose families have conducted interventions that have been helpful in persuading their loved one to get help. Others have had much more negative reviews, in which the intervention was poorly conducted or the person with the addiction was not in a place to hear the feedback, and it caused an even greater problem for them and an even greater rift in their family.

Types

There are several types of drug and alcohol interventions. The type of intervention that your medical professional recommends will depend on your goals, unique experience with addiction, and family dynamics.

  • The Johnson Model: Created by Vernon Johnson (“the father of intervention”), this is perhaps the most recognizable form of intervention. The Johnson model involves the family and a guided interventionist who confronts the loved one with a substance use disorder without their prior knowledge of the meeting.
  • Invitation Model: Also known as the Systemic Family Intervention, this method of intervention was developed by Ed Speare and Wayne Raiter and focuses on a family-oriented approach to addiction. As the name implies, the entire family or support network (including the person with the addiction) is invited to a workshop led by an interventionist so they can discuss how the disease has affected the family unit.
  • Field Model of Intervention: Similar to the Johnson Model, the Field Model involves a confrontational approach without the person's prior knowledge. In this model, however, the interventionist is trained in handling crises during the intervention process and after, so it's often recommended if a family believes their loved one is a danger to themselves or if they have uncontrolled co-morbid conditions like depression or bipolar disorder.

Alternatives

Community Reinforcement and Family Training (CRAFT) is an important, evidence-based method for helping families get help for their loved ones. CRAFT has replaced interventions as the preferred method of getting people struggling with addiction therapy and help.

Rather than targeting the person with the substance use disorder, this evidence-based method aims to work with the concerned significant others (CSOs) so that they can assist the identified patients (IPs).

CRAFT helps CSOs to:

  • Identify their loved one’s substance use triggers
  • Break patterns that enable or increase a loved one’s drinking or using
  • Develop and improve communication skills with the IPs
  • Learn or re-learn to practice self-care and reconnect with their values
  • Identify triggers for violence and develop a plan to keep themselves (and their children) safe

Steps to Consider

If you decide to have an intervention for your loved one, you'll need to take a few necessary steps to help you prepare logistically and mentally.

Research Treatment Options

You’ll want to present your loved one with some detailed suggestions for treatment, so you’ll need to do your research. If the person agrees to get help, it's best to already have a treatment center, counselor, or meeting in mind so you can take action immediately. Make sure to find out beforehand about whether your loved one's insurance plan will cover treatment as well as what steps are required for admission.

The American Board of Addiction Medicine (ABAM) provides specialized training and certification for physicians, and so talking to an ABAM-certified physician is a great place to start.

The best approach to treating an addiction depends on many factors, including the substance being used, how severe the addiction is, the addicted person's attitude towards treatment and quitting or cutting down, and whether they have concurrent mental and/or physical health problems.

Treatment options may include:

Gather an Intervention Team

Depending on the situation, an intervention can involve the following people:

  • The person with the addiction
  • Friends and family
  • A therapist
  • A professional interventionist

It's also important to consider who should not be on the intervention team. For example, someone your loved one dislikes or a person with an unmanaged mental health condition or substance use disorder.

Choose an Interventionist

Unfortunately, there is no current system for evaluating the credentials of interventionists and very little information on which to base your decision. If you feel an intervention might be right for your loved one, here are some common-sense considerations—not based on medical fact or research—to think about in making the decision to employ an interventionist:

  • Inquire about certification. The Association of Intervention Specialists (AIS), Family First Interventions, and The Network of Independent Interventionists are three organizations that offer certification.
  • Get a personal recommendation. Do you know anyone who was helped by the interventionist? If so, were their problems similar to those of the person you care about? Were their characteristics (such as age, culture, and how long they have had the addiction) similar? A personal recommendation from someone dealing with similar issues is often a way that people make decisions about therapists.
  • Talk to the interventionist. Did you develop a good rapport? Do they seem to understand the problems you are describing? Do you get a good “gut feeling” from this person?
  • Consider the costs. How much do you stand to lose if it doesn’t work out? Could these funds be used on a different program that offers more credibility?

Give Consequences

While you’re not trying to punish your loved one, you do want them to understand that there are consequences if they refuse to seek help. Such consequences may include:

  • Losing visitation rights with children
  • Taking away their car
  • Asking them to move out until they’re ready to begin the recovery process

Be sure to state any consequences clearly and don’t make any threats you’re not willing to carry out.

Know the Risks

Professional intervention is not an option for every family and every situation. The decision to choose the intervention path is one that should be made carefully and with the advice of an experienced counselor.

Confronting someone with an addiction is a very risky approach, and can just as easily backfire, making the addicted person feel attacked, alienated, and misunderstood instead of feeling supported.

In these cases, an intervention can even worsen an addiction, causing the person to seek comfort in alcohol and drugs, and to seek out the company of those who "understand," such as drinking buddies and drug dealers.

Seek Support

Whether or not your loved one decides to seek help, you can likely benefit from the encouragement and support of others in your situation. Many support groups, including Al-Anon, help family members understand that they are not responsible for their loved one's addiction and that they need to take steps to care for themselves regardless of whether or not the person they care for seeks treatment.

You may not be able to persuade or bully your loved one into treatment. In fact, trying to do so may actually make both their addiction and your relationship with them worse.

Potential Pitfalls

Remember that although many people working in the field of addiction know what they are doing and genuinely want to help their clients, there are others who just want your money, and will prey on the desperation felt by loved ones who are looking for a miracle cure. There are no miracle cures, and overcoming addiction is hard work, especially for the person with a substance use disorder.

Interventions for addiction are big business, especially in the United States, where they are often portrayed on TV and in movies. In desperation, families of people with addictions pour their life savings into interventions, hoping to save a loved one who seems to no longer see reason.

Part of why interventions are so appealing, and also so unlikely to be effective, is that they offer the dream of a simple solution to an incredibly complex situation.

We know from decades of research that people do not become addicted purely by nature or nurture, but a complex interplay between the two. It's common that someone with an addiction is also struggling with underlying issues that they themselves may not even be aware of, in which case, an interventionist or well-meaning family member is even less likely to be aware of.

Although some people are able to overcome severe addictions on their own, it takes great determination and access to alternative ways of coping to do this. For many others, overcoming addiction requires treatment, and it often takes many attempts to completely quit alcohol and drugs.

This does not mean that people are never helped by an intervention. The process of becoming aware that your behavior is harming yourself and those around you is an important step toward recovery, and the first step through the stages of change from pre-contemplation to contemplation.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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Article Sources
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  1. Liepman MR, Nirenberg TD, Begin AM. Evaluation of a program designed to help family and significant others to motivate resistant alcoholics into recovery. Am J Drug Alcohol Abuse. 1989;15(2):209-21. doi:10.3109/00952998909092721

  2. Association of Intervention Specialists. What Is the Johnson Model of Intervention? Updated 2019.

  3. Association of Intervention Specialists. What Is the Family Systemic Model? Updated 2019.

  4. Hellum R, Nielsen AS, Bischof G, et al. Community reinforcement and family training (CRAFT) - design of a cluster randomized controlled trial comparing individual, group and self-help interventionsBMC Public Health. 2019;19(1):307. doi:10.1186/s12889-019-6632-5

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