The word "Intervention" can mean a number of different things in different situations, and among different kinds of people. "Intervention" can refer to the initial phase of treatment (meaning 1). Or it can refer to the process of bringing a person to the point where they will accept treatment (meaning 2). Due to the introduction of the "Johnson Style Intervention" method several decades ago and the TV program "Intervention," we think it is now more common to use the word "intervention" in the sense of meaning 2. We use the word both ways, but we attempt to be clear on which we have in mind in each situation. Even when we use "intervention" in the sense of meaning 2, we might mean something very different from either a Johnson Style Intervention, or an episode of the TV program. A "meaning 2" intervention can involve a wide variety of approaches. All of them are about motivating a person to accept treatment.
A very large portion of these websites are about Intervention (meaning 1), so the rest of this article/ page will focus on Intervention (meaning 2).
Subject to very, very rare exceptions, interventions that are effective in the long run, actually involve family and friends of the person targeted doing the intervening, with the Interventionist acting as coach in that process. We do not doubt that many interventions that are conducted by the Interventionist doing the heavy lifting, as opposed to the Interventionist coaching a team of people who have strong ties to the person targeted, lead to a person arriving physically at a treatment program. But we question whether the person entering treatment on that basis is (at best) likely to be ready to work on recovery. More likely, the person targeted will leave treatment after a very short time, abetted by a close friend or relative coming to his/ her rescue.
The Johnson Style Intervention method was created to target alcoholism and quickly became an important tool for intervening with drug addicts. In addition to our use of this method for alcoholism and drug addiction, we have used the Johnson method where the issue was gambling addiction. It has a place in other process addiction (also called "behavioral addictions" or "non-substance addictions") It can be used with some other kinds of mental and emotional disorders. However this needs to be approached with care. If a person has a tendency to suicidal ideation, a Johnson Style Intervention can exacerbate the problem. With thought disorders it is less likely to be effective.
The one constant in all effective interventions is the change in dynamics surrounding the family and close friends of the person being targeted change. We believe that virtually all addicts and alcoholics are surrounded by a dynamic among those close to them that is sometimes described as the "Drama Triangle." Successful interventions are characterized by substantial lessening if not total elimination of this dynamic. We will not attempt to explain the Drama Triangle in detail here; we have provided a link to an excellent explanation for that purpose.
Very briefly (but not a substitute for reading the linked article) where we have the Drama Triangle we have three roles being demonstrated by its participants: Rescuer, Persecutor, and Victim. Rescuers protect addicts/ alcoholics from the consequences of their choices. Persecutors undermine the will of the addict/ alcoholic to succeed, trigger others in the dynamic to become rescuers, and push the addict/ alcoholic into a victim position. Victims stimulate others to become rescuers and persecutors. Addicts are rarely able meet their needs without support from people on the Drama Triangle. When a person begins to carry out a potentially addictive behavior to a degree that is destructive and their closest friends and family are not on the triangle, our experience is that they move on to find people who are on the triangle, especially rescuers -- or the progression of their addiction stops.
Our experience is that when immediate family and close friends maintain the Drama Triangle, the alcoholic/ addict does not maintain recovery after treatment. Traditionally, people who have tended to rescue the addict or alcoholic (save them from consequences of their own behavior) have been called "enablers." However anyone who interacts with the addict from any of the positions on the Drama Triangle is supporting and/ or re-kindling the addictive behavior.
An effective intervention occurs when the close friends and relatives of the addict/ alcoholic exit the Drama Triangle. A successful Johnson Style Intervention is successful because the intervention confrontation effectively communicates that the enabling from those closest to her/ him is over. A properly conducted Johnson Style Intervention involves all participants avoiding the three roles of the Drama Triangle. This goes to why the Johnson Style Intervention might not be the best approach in some cases. When a Johnson Style Intervention is done properly, the time commitment in preparation is huge. The interventionist must work with the intervention team so that the team members can present what they must say to the person targeted without reverting to the roles. That means being firm and calm, with no displays of hostility, anger, or revenge. That is, no persecutor behavior. It means showing sufficient defenses so that it is clear that the targeted person cannot take inappropriate advantage -- while still showing love and concern. That is, no victim behavior. It means communicating that the team members will the there to support recovery, but any support and ties will be severed if the person does not pursue recovery. That is, no rescuing.
We are using language that is different from what is common among addiction professionals and recovering people because we like the clarity surrounding the literature on the Drama Triangle. We do not disagree with the common descriptions of this phenomenon among addiction professionals who also address the family dynamics surrounding addiction. The differences are largely semantic. You will find the words "co-alcoholic" and "co-dependent" if you explore family dynamics among addiction professionals. Note that the word "co-dependent" was initially coined to extend the concept of "co-alcoholic" to spouses of drug addicts and others in a close relationship with a drug addict. Since then "co-dependent" has been extended to apply to people with the traits of spouses of addicts but might not be into an actual relationship with an actual addict. That person DOES live on the Drama Triangle.
Sometimes the best way to stop the Drama Triangle and move the intervention process forward is to conduct a well prepared Johnson Style Intervention. Sometimes it is not. But intervention will not be successful long term, even if the target of the intervention initially responds by going to treatment if the close friends and family who comprise the intervention team remain on the Drama Triangle. The only exception we see to this is when the target of the intervention follows treatment by cutting off close ties with those who are caught up in the Drama Triangle seeking out people who have a healthier style of interaction. Sometimes this works out anyway when and if the close associates of the recovering addict make the transition while the recovering person is in treatment
As a consequence, the most important activity in any intervention is resolving the Drama Triangle issues among the interveners. If that task is completed successfully, the target of the intervention will either seek help or emotionally separate himself/ herself from the would-be interveners.
That leads to several alternative approaches to intervention. If an Intervention is to lead to a successful recovery the most important result to seek is the conversion of the intervention team so that those people are no longer on the Drama Triangle. This is more important than the entry of the targeted person into a treatment program if measuring the value of the intervention by the criterion of start of stable recovery. When a successful Johnson Style Intervention occurs, one of the most important aspect of that Intervention is the plan with an intervention client, our immediate goal is the elimination of the Drama Triangle. Some times the best thing to do is to coach the family through the process of finding a different way to approach the person who would be the target of any intervention, eliminating the Drama Triangle. In many cases, the family's material support of the would-be target for an intervention. That sometimes dries up if when the family gets off the Drama Triangle.
The point is, in many if not most adult situations, when close family members and close friends get off the Drama Triangle, the person of concern becomes remarkably more flexible about treatment. Johnson Style Interventions have the advantage of getting the job done more quickly than other approaches to adults in need of treatment. The problem with that is that properly preparing an Johnson Style Intervention is an extremely time consuming process. Unfortunately, many if not most so-called Johnson Style interventions have too many shortcuts taken to do a proper job, and the result is that many if not most of the interventions that start out to be "Johnson Style" end up with the "Interventionist" doing something like what would happen if the coach of a NFL team canceled practices all week before the big game then went out on the field during the game to throw passes and do some blocking. Actually the NFL referees would not allow that, so this could not happen. Unfortunately, we don't have NFL referees checking up on interventionists. We think more would be accomplished for less money if we did have them.
Many successful interventions consist of coaching a family through the process of getting off the triangle. In those situations we usually see no evidence of the formal trappings of a Johnson Style Intervention. Sometimes work starts on the Drama Triangle issues among family and friends before deciding whether to apply the Johnson method or parts of it as one of the final steps in the intervention process. Sometimes the end of the Drama Triangle for the would-be intervention team leads to the targeted person simply asking for treatment once the Drama Triangle activity stops. We no not see a rubric of how the intervention process works when the Johnson Style is not followed.
When the suppression of Drama Triangle behavior is complete, the situation needs to be assessed and a decision is made as to how to motivate the person to do what is necessary to move to stable recovery. As the family and friends group gets off the triangle, they also learn how to confront off the triangle. At that point a decision might be made to move to a Johnson Style confrontation, or a decision made for one or two out of the group to meet informally to suggest treatment, or the family to contract with the person to be clean and sober, with an understanding that treatment will be accepted if clean and sober is not maintained or any number of other scenarios. Note that it is possible that the professional guiding this process might never come face to face with the targeted person.
We have not seen many episodes of the television show so we can't generalize very much. But the episodes we have seen show exactly what NOT to do. In those we saw no evidence of genuine efforts to get close family and friends to get off the Drama Triangle. We did see the interventionist himself doing most of the work. (We are not being sexist here; in the episodes actually viewed, the interventionists were consistently male) These kinds of interventions might be effective in getting a person to enter treatment; it is not convincing that these efforts will result in the targeted person making a real effort in treatment or staying for more than a very short time.
We need to say a word about "escort services" or "transport companies" that take adolescents and possibly children to treatment programs they do not want to go to. Increasingly the people providing that service call themselves "Interventionists." MORE TO COME
Interventions (meaning 2) should be guided by a professional who is highly skilled in guiding people through an intervention. Many if not most people who claim this expertise describe themselves as "Interventionists." However, we give a strong warning about ethical concerns and opacity in this profession. What you should look for:
- What methods does this interventionist use?
- Is the interventionist choosing the treatment center where the person targeted person will be going? If so, is this interventionist being paid by that treatment center for directing referrals to them?
- Does the Interventionist plan to guide the family and friends of the target person to do the intervening, or does he/she plan to do it himself/ herself or a mixture of the two.
We want to be clear that many competent and ethical interventionists are available. Several webpages we have discovered about interventions state that a properly conducted Johnson Style Intervention should involve a choice between at least three treatment options. We do not agree with that rule, although we see some very serious advantages to so doing. The problem is that getting the targeted person to treatment immediately upon completion of the intervention. In these days of obtaining insurance coverage, checking bed availability, reserving an admission time and obtaining pre-certification, sometimes the principle of being prepared to be admitted immediately after the intervention is not compatible with offering three options. Also treatment center choice tends to be limited when the treatment center absorbs the cost of the intervention itself.
A good interventionist without ties to (and income coming from) treatment centers can be hard to locate but they do exist. We have no objection to a treatment center offering to cover part or all of the interventionists fees, IF THAT IS AN UP FRONT UNDERSTANDING AND THE RELATIONSHIP IS FULLY DISCLOSED. Treatment centers will, in many situations, provide intervention support in order to facilitate admission (and their revenue). The downside to this is that this interventionist will be tied to the treatment program(s) that pay for this. We are not raising an ethical objection here unless the relationship between the interventionist and the treatment center is concealed. Please note the reference in the previous paragraph to views of others that Johnson Style Interventions should lead to the targeted person having a choice between at least three different treatment venues.
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Last Update June 4, 2016