Answer Addiction

Tag: Intervention

  • Hard Conversations: Talking With a Loved One About Their Drinking

    Talking with a loved one about their drinking or drug use can seem impossible, but it can also help plant a seed of recovery.

    Watching a loved one struggle with drugs or alcohol can be incredibly painful. Oftentimes, as a family member, you will notice problematic behaviors before your loved one sees them or is willing to acknowledge them. That can put you in a powerful position to point out your concern and help your loved one get into substance abuse treatment before things reach a crisis point.

    In an ideal world, talking to a loved one about addiction can bring you closer and get them into treatment. But this can also be a fraught conversation ripe with pitfalls and opportunities for hurt feelings. To make the discussion go a bit more smoothly, it’s best to prepare ahead of time. Here’s how.

    1. Evaluate your own emotions and responses.

    Before you involve your loved one, start by taking an honest inventory of your own emotions and feelings. Oftentimes, we bring our own history into the current situation, which can cloud how we see things and confuse the conversation. Maybe you have your own personal experience with sobriety, or perhaps you grew up with a parent that was an alcoholic. Either of those scenarios can make you more sensitive to a loved one’s substance use and more likely to react, rather than have a thoughtful and logical discussion.

    Be sure that you’re expressing genuine concern for your loved one, and that you’re not merely being triggered by their behavior. If you have a trusted third-party — like a therapist or confidential friend — to talk through your concerns. Practice formatting your concerns in a way that centers your loved one, not yourself. Putting your own experiences aside might help your loved one take you more seriously.

    1. Organize your talking points.

    People in active addiction often don’t realize the ways that their behavior has escalated. Helping them see their actions can highlight that they really do need help. The key is doing this in an objective way. No one wants to feel scolded or judged; instead they want to feel seen.

    Think about what behaviors you are most concerned about. For example, you might say something like, “I noticed you’ve been drinking every day after work,” or “The kids mentioned that you slept through your alarm three times last week.” Show your loved one their behavior through your eyes, but don’t shove it in their face.

    1. Use “I” statements.

    It’s easy for difficult conversations to escalate, becoming more and more emotional. An emotional, reactive discussion rarely leads to a productive place. One way to deescalate the situation and remove some of the negative emotion is by using “I” statements.

    Here’s how it works: rather than coming at your loved one with everything they’ve done, you focus on the impact that has on you. For example, instead of saying “You’re drinking every night and ignoring your responsibilities,” say “I have to take care of the animals and dinner chores alone when you’re drinking after work.” I statements can incorporate emotions and feelings, too. You might say, “I get scared when you’re out late and I haven’t heard from you.”

    Using “I” statements removes some of the arguing and pushback. Your loved one might disagree about the details of their behavior, but they can’t argue with your experience.

    1. Keep expectations realistic.

    Everyone is familiar with the idea of a big, dramatic intervention that results in someone leaving immediately for treatment. In reality, your discussion is unlikely to look like that. Your loved one might not even agree that there is a problem. That’s ok — this can be the first step in an ongoing conversation. That’s why it’s important to have a positive conversation and leave the door open for your loved one to come back to you after they’ve thought about what you said.

    Of course, there are situations where waiting isn’t the right answer. If your loved one is endangering themselves or others, or having a negative impact on your emotional or mental wellbeing, it is entirely ok to set boundaries and stick with them. Only you can decide what boundaries are right for you at a given time.

    1. Be prepared to offer help.

    Even after a person realizes that they might need treatment, the logistics can be overwhelming. Be prepared before you even start the conversation by gathering some resources on recovery options, different programs, local meetings, and more. That way, you can capitalize on your loved one’s willingness to accept help as soon as they express it.

    Only the person who is struggling with drug or alcohol use can make the decision to get treatment. However, as a family member or close friend, you have an important role to play in encouraging them and planting the seed for recovery.

    Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.

    View the original article at thefix.com

  • Intervention

    I did not know that the next time I held her body, it would be chips of bone and gritty ash in a small cardboard box.

    The following is an excerpt from The Heart and Other Monsters by Rose Andersen.

    I cannot remember my sister’s body. Her smell is gone to me. I do not recall the last time I touched her. I think I can almost pinpoint it: the day I asked her to leave my home after I figured out she had stopped detoxing and started shooting up again, all the while trying to sell my things to her drug dealer as I slept. When she left, she asked me for $20, and I told her that I would give it to her if she sent me a picture of a receipt to show me she spent the money on something other than drugs. “Thanks a lot,” she said, sarcastically. I hugged her, maybe. So much hinges on that maybe, the haunting maybe of our last touch.

    The last time I saw my sister was at an intervention at a shitty hotel in Small Town. Our family friend Debbie flew my stepmother and me there in her three-seater plane. The intervention was put together hastily by Sarah’s friend Noelle, who called us a few days beforehand, asking us to come. There were little resources or time to stage it properly—we couldn’t afford a trained interventionist to come. Noelle told us she was afraid Sarah was going to die. I agreed to fly with Debbie and Sharon because Small Town was far away from home and I didn’t want to drive.

    Debbie sat in the pilot’s seat, and I sat next to her. My stepmother was tucked in the third seat, directly behind us. It wasn’t until takeoff that I realized with my body what a terrible decision it was to fly. I am terrified of heights and extremely prone to motion sickness. I was not prepared for what it meant to be in a small plane.

    I could feel the outside while inside the plane. The vibration of chilly wind permeated through the tiny door and gripped my lungs, heart, head. It would have taken very little effort to open the door and fall, an endless horrifying fall to most-certain death. From the first swoop into the air, my stomach twisted into a mean, malicious fist that punched at my bowels and throat. For the next hour I sat trembling, my eyes shut tight. Through every dip, bounce, and shake, I held back bile and silently cried.

    When we landed, I lurched off the plane and threw up. I do not remember what color it was. My stepmom handed me a bottle of water and half a Xanax, and I sat, legs splayed on the runway, until I thought I could stand again.

    My sister vomited when she died. She shit. She bled. How much is required to leave our body before we are properly, truly, thoroughly dead? I dreamed one night that I sat with my sister’s dead body and tried to scoop all her bodily fluids back inside her. Everything wet was warm, but her body was ice-cold. I knew that if I could return this warmth to her, she would come back to life. My hands were dripping with her blood and excrement, and while begging her insides to return to her, I cried a great flood of mucus and tears. This I remember, while our last touch still evades me.

    My sister was late to her intervention. Many hours late. Seven of us, all women, five of us in sobriety, sat in that hot hotel room, repeatedly texting and calling Sarah’s boyfriend, Jack, to bring her to us. I realized later that he probably told her they were going to the hotel to get drugs.

    The hotel room was also where Sharon, Debbie, and I would be sleeping that night. It held two queen-size beds, our small amount of luggage, and four chairs we had discreetly borrowed from the hotel’s conference room. I sat on one of the beds, perched on the edge anxiously, trying not to make eye contact with anyone else. I didn’t know many of the other people there.

    When I told my mom about the intervention days before, I had immediately followed with “But you don’t need to come.” There were so many reasons. She has goats and donkeys, cats and dogs who needed to be taken care of. She didn’t have a vehicle that could make the drive. She could write a letter, I said, and I would give it to Sarah. The truth was, I didn’t feel like managing her now-acrimonious relationship with Sharon. I didn’t want to have to take care of my mom, on top of managing Sarah’s state of being. It occurred to me, sitting in this crowded, strange room, that I might have been wrong.

    Sitting diagonally across from me was Sarah’s close friend Noelle, who had organized everything. Sarah and Noelle had met in recovery, lived together at Ryan’s family home, and become close friends. They had remained friends even when Sarah started using again. Helen, a fair-haired middle-aged woman who was not one of the people Sarah knew from recovery but rather the mother of one of Sarah’s boyfriends, sat on the other bed. Sarah’s last sponsor, Lynn, sat near me. I had to stop myself from telling her how Sarah had used her name on her phone. Sitting in one of the chairs was the woman who was going to run the intervention. I cannot remember her name now, even though I can easily recall the sound of her loud, grating voice.

    The interventionist had worked at Shining Light Recovery, the rehab Sarah had been kicked out of about a year and a half before, and was the only person Noelle could find on short notice. She had run her fair share of interventions, she told us, but she made it clear that because she hadn’t had the time to work with us beforehand, this wouldn’t run like a proper intervention. She smelled like musty clothes and showed too many teeth when she laughed. She talked about when she used to drink, with a tone that sounded more like longing than regret. When she started to disclose private information about my sister’s time in rehab, I clenched my hands into a fist.

    “I’m the one that threw her out,” the woman said. “I mean, she’s a good kid, but once I caught her in the showers with that other girl, she had to go.” Someone else said something, but I couldn’t hear anyone else in the room. “No sexual conduct,” she continued. “The rules are there for a reason.” She chuckled and took a swig from her generic-brand cola. I felt hot and ill, my insides still a mess from the plane ride. We waited two more hours, listening to the interventionist talk, until Jack texted to say they had just pulled up.

    Intervention

    When my sister arrived, she walked into the room and announced loudly, “Oh fuck, here we go.” Then she sat, thin, resentful, and sneering, her hands stuffed into the front pocket of her sweatshirt. Oh fuck, here we go, I thought. The interventionist didn’t say much, in sharp contrast to her chattiness while we were waiting. She briefly explained the process; we would each have a chance to speak, and then Sarah could decide if she wanted to go to a detox center that night.

    We went in turns, speaking to Sarah directly or reading from a letter. Everyone had a different story, a different memory to start what they had to say, but everyone ended the same way: “Please get help. We are afraid you are going to die.” Sarah was stone-faced but crying silently. This was unusual. When Sarah cried, she was a wailer; we called it her monkey howl.

    When we were younger, we watched the movie Little Women again and again. We would often fast-forward through Beth’s death, but sometimes we would let the scene play out. We would curl up on our maroon couch and cry as Jo realized her younger sister had died. For a moment I wished for the two of us to be alone, watching Little Women for the hundredth time. I could almost feel her small head on my shoulder as she wailed, “Why did Beth have to die? It’s not fair.” She sat across the room and wouldn’t make eye contact with me.

    I addressed Sarah first with my mom’s letter. I started, “My dear little fawn, I know that things have gone wrong and that you have lost your way.” My voice cracked and I found I couldn’t continue, so I passed it to Noelle to read instead. It felt wrong to hear my mother’s words come out of Noelle’s mouth. Sarah was crying. She needs her mom, I thought frantically.

    When it came time to speak to her myself, my mind was blank. I was angry. I was angry that I had to fly in a shitty small plane and be in this shitty small room to convince my sister to care one-tenth as much about her life as we did. I was furious that she still had a smirk, even while crying, while we spoke to her. Mostly, I was angry because I knew nothing I could say could make her leave this terrible town I had driven her to years before, and come home. That somewhere in her story there was a mountain of my own mistakes that had helped lead us to this moment.

    “Sarah, I know you are angry and think that we are all here to make you feel bad. But we are here because we love you and are worried you might die. I don’t know what I would do if you died.” My sister sat quietly and listened. “I believe you can have any life you want.” I paused. “And I have to believe that I still know you enough to know that this isn’t the life you want.” The more I talked, the further away she seemed, until I trailed off and nodded to the next person to talk.

    After we had all spoken, Sarah rejected our help. She told us she had a plan to stop using on her own. “I have a guy I can buy methadone from, and I am going to do it by myself.” Methadone was used to treat opioid addicts; the drug reduced the physical effects of withdrawal, decreased cravings, and, if taken regularly, could block the effects of opioids. It can itself be addictive—it’s also an opioid. By law it can only be dispensed by an opioid treatment program, and the recommended length of treatment is a minimum of twelve months.

    “I have a guy I can buy five pills from,” Sarah insisted, as if that was comparable to a licensed methadone center, as if what she was suggesting wasn’t its own kind of dangerous.

    “But honey,” my stepmother said gently, “we are offering you help right now. You can go to a detox center tonight.”

    “Absolutely not. I am not going to go cold turkey.” Sarah was perceptibly shaking as she said this, the trauma of her past withdrawals palpable in her body. “I don’t know if I can trust you guys.”

    She gestured to my stepmom and me. “I felt really betrayed by what happened.” The heroin in her wallet, the confrontation at Sharon’s, Motel 6, breaking into her phone. “You guys don’t understand. Every other time I’ve done this, I’ve done this for you, for my family.” She sat up a little straighter. “For once in my life, it’s time for me to be selfish.”

    It was all I could do not to slap her across the face. I wanted desperately to feel my hand sting from the contact, to see her cheek bloom pink, to see if anything could hurt her. She wasn’t going to use methadone to get clean. She just wanted us to leave her alone. 

    I made an excuse about needing to buy earplugs to sleep that night and walked out. I did not hug her or look at her. I did not know I would not see her again. I did not know I would not remember our last touch. I did not know that the next time I held her body, it would be chips of bone and gritty ash in a small cardboard box.
     

    THE HEART AND OTHER MONSTERS (Bloomsbury; hardcover; 9781635575149; $24.00; 224 pages; July 7, 2020) by Rose Andersen is an intimate exploration of the opioid crisis as well as the American family, with all its flaws, affections, and challenges. Reminiscent of Alex Marzano-Lesnevich’s The Fact of a Body, Maggie Nelson’s Jane: A Murder, and Lacy M. Johnson’s The Other Side, Andersen’s debut is a potent, profoundly original journey into and out of loss. Available now.

     

    View the original article at thefix.com

  • A Kinder, Better Way: How CRAFT Uses Love and Kindness to Heal Families with Addiction

    A Kinder, Better Way: How CRAFT Uses Love and Kindness to Heal Families with Addiction

    There are programs designed to help families but many of them advocate “tough love” and aren’t terribly effective.

    About ten years ago, I got one of those letters. It was painful to read it but once I had a drink, my pain turned into indignation. I folded the letter multiple times till it ended up a tiny square, which I shoved into a shoebox where it lives till this day, next to old birthday cards and love notes from exes. I’m talking about my first Intervention Letter. 

    If you’ve never gotten one of these, then you were probably not destroying your family’s life successfully enough! I’m kidding, of course, and not everyone gets an Intervention Letter; some of us also get a serious talking-to; most of us get ultimatums and threats; and all of us get tears. This is what it’s like to have a family while high or drunk. Not fun. But it’s even less fun for the families—they are some of the most tortured, miserable, angry, confused people entangled in their misery by love. 

    It’s no wonder that resentment is ever-present, fuelling many misguided attempts to help circumvent addiction. Why misguided? Because those attempts rarely get anyone better. And a person going to a rehab to please their loved ones has less of a chance of staying clean than a person going on her own account. On top of it, the families are still often left without any solid tactics in place on how to keep their loved one sober, how to prevent relapses, and how not to fall back into the muck of co-dependency. There are programs designed to help families but many of them advocate “tough love” and aren’t terribly effective. So Intervention Letters and ultimatums are common. 

    Instead of Ultimatums and Threats, Compassion

    Fortunately, there might be a better way—specifically the CRAFT way. According to one definition, “Community Reinforcement and Family Training (CRAFT) teaches family and friends effective strategies for helping their loved one to change and for feeling better themselves. CRAFT works to affect the loved one’s behavior by changing the way the family interacts with him or her.” At first look, CRAFT’s techniques might appear contra-intuitive as a lot of its teachings seem to advocate dismissing the addictive behavior—complaining, arguments and demands are discouraged. In fact, on the cover of the popular book on CRAFT, Get Your Loved One Sober, the tagline reads “Alternatives to Nagging, Pleading, and Threatening.” Instead of tough love, CRAFT advocates gentle love—and that approach seems to be working.

    According to one trial by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), CRAFT was more effective than Al-Anon and Johnson Institute Intervention. CRAFT had a 64 percent success rate of getting the person with addiction into treatment compared to 30 percent for Johnston Institute and 10 percent for Al-Anon. Johnson Institute is a model that’s based on confrontation that is supposed to motivate the person with addiction to enter treatment. Al-Anon, similar to CRAFT, teaches detachment with love, but it is also a 12-step-based program which includes the sometimes-problematic concept of Higher Power and advocates a certain kind of passivity, which might not be conductive to strengthening the very fragile fabric of families dealing with active addiction. 

    In contrast, CRAFT focuses on attending to your own needs along with steering the problem user toward treatment, which often happens organically as the patterns of interaction change. CRAFT’s mission is to help reduce the loved one’s alcohol and drug use, whether or not the loved one has engaged in treatment yet. CRAFT discourages enabling, encourages problem solving, employs reward systems and aims to empower the beaten-down, frustrated family members. CRAFT doesn’t approve of breaking the family apart and its goal is to not only keep it all intact but also get everyone better. 

    A family member who’s part of CRAFT is taught to change her/ his reactions—from negative to positive—in response to the triggers from the person with addiction. For example, a husband coming home late after a night of drinking with his buddies again won’t get a lecture for being late for dinner, as he usually does in that situation, because the wife will have been instructed to take care of her own needs, and she will have eaten the dinner on her own. 

    Observing and Adapting

    As part of CRAFT, the family members are asked to observe and monitor the addictive behavior of their loved one—this means noting what situations might cause the person to reach for another drink, what creates conflict, and observing any patterns in behavior. With time, as these patterns become obvious, the family member changes the approach—from aggressive to more passive and compassionate—and in that more loving way, upsets the predictable trajectory of maladaptive interactions with the addicted person. Instead of yelling at someone and accusing her of being a liar, the family member might say, “I know you haven’t been going to work all this time and I am hurt that you’re lying to me. Let’s talk about it in the morning after you sleep it off.” A calm, reasonable way of dealing with the situation will most likely elicit a reaction that’s not combative. Eventually those kinds of interactions will become a norm and change will occur.

    It’s not exactly “kill them with kindness” but it’s a similar principle. When you expect Intervention Letters—like I did—and you’re stuck in a hamster wheel of constant conflict, getting something completely opposite might just shock you into action. Receiving praise for sticking to commitments—even something as small as coming home on time—or staying sober for a string of days, is more effective than having those subtle changes ignored or taken for granted. No, we don’t need to applaud every nice thing a person with addiction does but in the beginning, perhaps it makes sense to do so. People who are just starting to get sober are very much like babies—deregulated emotions, lack of impulse control—and praise goes a longer way than punishment does. Punishment tends to prolong trauma where praise leaves the person wanting to earn it again, which leads to repeating the desirable action. 

    A Better Alternative to Tough Love

    My family has always taken the “tough love” route and my addiction did contribute to me eventually separating from my husband. I imagine if we were a part of CRAFT program, things could’ve gone differently. I lived through ultimatums and anger and once I was kicked out of my house. I’ve often felt alone and ashamed and angry with myself for disappointing everyone. I thought I was worthless and my loved ones’ attitude confirmed that. But I don’t think they knew any better. So many of us with addiction still live in an episode of Intervention; we have never been shown a kinder, better way.
     

    View the original article at thefix.com

  • 8 Steps for Starting (or Restarting) Discussions About Substance Use Disorder with Loved Ones

    8 Steps for Starting (or Restarting) Discussions About Substance Use Disorder with Loved Ones

    Intervention is never easy. But this step-by-step guide can help you navigate the difficult task of talking to a loved one about their alcoholism or addiction.

    When you know or suspect that a friend or family member has a drug problem, even well-intentioned conversations can turn prickly. Here are eight steps that may help smooth things out and pave the way to productive, respectful, and supportive discussions. Even if you already have a history of bickering and arguing, all is not lost. You can ask for a new start and then follow these steps. 

    1. Keep Calm

    If you’re worked up and agitated, it’ll be almost impossible to have respectful and cooperative dialogue. So, put aside your hurt, scared, or angry feelings. Take a deep breath. The feelings won’t go away, but maybe you can think of them as parked – pushed aside for the time being. Deep conversations that lead to connection and empathy require a measure of self-discipline. It’s difficult to process information and communicate effectively in emotionally charged discussions. 

    2. Set Realistic Expectations

    When you see or suspect a drug problem, you may want to rush to the rescue and fix everything right away. Maybe you think it’s best to demand a commitment to abstinence, or insist upon counseling, or even send the person to rehab. The thing is, no one wants to be “fixed.” The harder you push, the stronger the resistance you’ll encounter. The best way to help someone is to engage their brains – to get them to think things through for themselves and to make their own decisions. So, start with a reasonable and realistic expectation: to open the dialogue and increase mutual understanding. This won’t fix a substance use disorder, but it can improve the situation.

    3. Ask Permission

    It’s common courtesy to find out if someone is receptive to conversation at a particular moment. Start out by saying: “I’d like to talk with you about something that concerns me. Can I do that now? Is this a good time?” Asking permission gives your friend or family member a sense of control over the discussion and a moment to prepare for it. If not now, then you can ask: “When would be a good time?”

    4. Explain Your Plan

    Communication has to be a two-way street. You want to express your own point of view, but you need to also hear the point of view of your loved one. Make it clear that you want a mutual and cooperative exchange of information, and have as much desire to hear your friend or family member’s point of view as to express your own. This is important because communication about drug problems is often one-way, as in: “I know what’s going on and you need to quit drinking (or quit using drugs).”

    You could put it this way: “I’d like to tell you what I’ve been thinking and feeling. I’d like to hear how you see things as well.” When friends and family members are treated with this type of respect, you might be surprised at how much they are willing to disclose.

    5. Start From a Place of Concern

    When you get the go-ahead to talk, start with an expression of concern based on your observations, being as specific as possible about what you have noticed, and your thoughts and feelings about it. You can also talk about how you are affected by the drug or alcohol use. Be sure to pause as you speak to give your partner time to think.

    Here is an example of a well-stated expression of concern that combines observations, thoughts, and feelings:

    “I’m concerned because I’ve noticed you’ve been drinking more often and in larger quantities in the last few months. It seems that you drink every night as soon as you get home from work, and much more than you used to drink. By dinnertime you’re often groggy and a little incoherent. Sometimes, you even fall asleep before dinner, then wake up and start drinking again. 

    “I’m worried because, in my opinion, the amount you drink is unhealthy. I’m also concerned for myself. The drinking seems to interfere with us talking about our lives and enjoying each other’s company. I can’t say it’s all because of the alcohol. There might be other things happening. But it seems to be part of the pattern.”

    Notice that these are “I” statements, as in: I’m concerned; I’ve noticed; and I’m worried. They merely express what the speaker saw, thought, felt, or noticed when certain events occurred. There are no labels or put-downs. They contrast with “You” statements, which are often pronouncements about a “truth,” or a dire prediction about the future:

    • You’re an alcoholic.
    • You drink too much.
    • You’re addicted to opioids.
    • You have a drug problem.
    • You need to quit now.
    • If you don’t quit now, you’ll end up a drunk in the street.

    These “You” statements are opinions that may or may not be true. They are judgmental. Without explanation, they seem arbitrary. Without discussion and an understanding of the other person’s point of view, they come across as arrogant.

    Be careful to steer clear of two pitfalls that could arouse defensiveness:

    • Avoid self-certainty. It kills discussion. You may think you are right. You may be convinced you are right. You may even be right!! But keep an open mind and show some humility. Leave open the possibility that there are other ways to look at what is happening. (There’s always another side to a story.) Until you listen to what your communication partner says, you really don’t have the full picture: You may misunderstand something or not fully understand the situation.  
    • Resist the urge to jump in with advice. It’s too early. You don’t even know what your friend or family member is thinking. Save recommendations and advice for later.

    6. Request Feedback

    You can be sure your friend or family member will have a reaction, perhaps a very emotional one. So, in good faith ask: “What do you think about what I just said?” Also: “Please tell me how you see things.” At this point, you never know what to expect and you’ll have to use your best judgment about how to proceed. If your partner is highly receptive, listen carefully to what is said and then proceed to the next step.

    If your partner gets angry and highly defensive, back off, stay calm, and let some time pass. Take the high road and avoid an argument. Later, when things calm down, you can say: “You know, I told you how I see things. I’d like to know how you see things.” 

    7. Listen to Understand, Not to Argue

    Too often while someone else is talking, people get busy developing their counter-arguments. This transforms a discussion into a debate. While your friend or family member talks, try to listen closely and understand their perception of the issue. You will certainly increase your understanding of your partner, and quite possibly be surprised by what you learn. Maybe the problem is not as big as you thought. Maybe there have been changes you didn’t notice. Maybe you will get some clarity as to why your friend or family member was using drugs. Maybe you’ll discover that your friend or family member is also concerned about the drug use. To the extent you show respect and demonstrate open-mindedness, you serve as a role model to your communication partners.

    8. Seek Mutual Understanding

    Now you can say, “Let’s see if we understand each other.” A good way to do this is by using what is called reflective listening: you make an effort to paraphrase what the other person said, then ask: “Did I understand you correctly?” Then, you allow for clarification. When people reflectively listen to each other, there are two advantages:

    We often get insight when we hear our own thoughts reflected back to us. 

    We think twice when we have to paraphrase what someone else said.

    Reflective listening will force you and your communication partner to think hard about what each of you say. Of course, you hope your loved one will be influenced by your presentation. You can be sure, too, that they want to be understood and hope that you will be open-minded.

    At this point, you have to use your best judgment about what comes next. You could try to calmly discuss differences, now or in the future. You might want to ask if there is anything you could do that your loved one might find helpful. Also, you could politely ask if you can offer advice. Regardless, these eight steps are foundational to a productive dialogue and can stand alone as a measure of success. Savor it and avoid the rush for a quick fix.

    Robert Schwebel, Ph.D. is a clinical psychologist who wrote and developed The Seven Challenges program, now widely used across the United States. He is also the author of his soon-to-be released book, Leap of Power: Take Control of Alcohol, Drugs and Your Life.

    View the original article at thefix.com

  • Candy Finnigan Interventionist

    Candy Finnigan Interventionist

    Finnigan has an ability to balance assertiveness with the addict alongside shining a light on how the family’s actions may have contributed to the addiction. At the same time, she is incredibly compassionate, caring and understanding.

    Since the A&E network is airing a special limited season of its popular series Intervention this month, we thought it fitting to recognize a name that’s synonymous with the show: Candy Finnigan. Finnigan is a trailblazer in the interventionist field. Being in recovery herself for over three decades, she came to the profession after her children were grown. She was looking for something new and challenging. Finnigan obtained her certification from UCLA in Alcohol-Drug Counseling (CADC) and Alcohol-Drug Abuse Studies (CADAS) in a time when women weren’t commonly working in the world of addiction. In fact, one of her professors, Dr. Vernon Johnson of The Johnson Model of Intervention, once informed her that women didn’t have a place in this line of work. Finnigan didn’t agree, and eventually became not only one of the most well known and sought after interventionists in the country, but also a celebrated author with the publishing of her book, When Enough is Enough. 

    However, none of this would have been possible if it weren’t for Evelyn Finnigan, the mother of Mike Finnigan, Candy’s husband of over 45 years. Candy recalls in an interview that her mother-in-law once pulled her aside and informed her that she would not let her two grandchildren, Candy and Mike’s children, grow up with alcoholic parents. Mike Finnigan became a popular musician after college, and though they didn’t fall victim to some of the other dangerous temptations that musicians often face, their drinking became more and more of a problem. 

    Candy Finnigan credits her mother-in-law, Evelyn, for giving her a 60-day time limit to get herself sober. And though she admits it wasn’t until day 56 that she finally put a stop to her boozing, to this day she thanks Evelyn, and God, for her sobriety. 

    Candy Finnigan on Intervention 

    When Intervention first aired, it shocked households across the country. The show featured addicts at their very worst and really shined a spotlight on the disease of addiction. If watching individuals passed out on their front lawns while their children are standing there horrified and ashamed didn’t make someone want to avoid going down the same path, then not much would. 

    And while the show’s subject is indeed compelling, the heroes of the show—the interventionists—are what bring viewers back. Candy Finnigan has been involved with the project since its inception. 

    When it comes time for the family members of the episode’s subject to get together to discuss what will take place once the intervention is in motion, Finnigan enters with a calming presence and authoritative demeanor, that somehow manages to simultaneously lift spirits and manage expectations.

    Regardless of the intervention’s outcome, Finnigan breaks down the steps of the process for the family members, and is stern when someone waffles or hints about not sticking to their guns. Finnigan knows what she is doing, and captivates viewers. 

    Different Intervention Approaches

    Most people envision the process in the way it is showcased on the television series but there are different approaches when it comes to staging an intervention. Those who are seeking a career as an interventionist usually undergo training that involves studying the different methods. Whatever the style of intervention, the intended result is always the same—get the person the proper help before it is too late. 

    One of the most well known types of interventions is the aforementioned Johnson Model. This type is the one most often seen on the television show. An addict is invited into a room that is filled with family members and loved ones. One by one they tell the person how their addiction has affected their lives, and ask them if they are willing to get help. Along with this, each person in the room presents the individual with the potential consequences of refusing the help. This model has been shown to be highly effective in getting people into treatment programs. The intention is to convince the person struggling that first of all, they are loved, and secondly, they will not have resources to fall back on if they choose not to accept the gift of treatment. 

    The Johnson Model was at one time considered the most “popular” style of intervention. It relies on confrontation and the notion that the family should help “raise the bottom” for the addict. Its intention is to diffuse any possible threat or fight from the subject of the intervention by inviting him or her to make a choice, and have an open conversation about going to rehab. 

    The Johnson Model was the training that Ms. Finnigan received, and she eventually considered Dr. Johnson her mentor, despite his initial opinions regarding women in the field. Dr. Johnson, an Episcopal priest who was also in recovery, is also known for implementing the “Minnesota Model” and co-founding the Johnson Institute, which has trained thousands of professional interventionists. What is so unique about Dr. Johnson’s approach is the belief in early intervention, and disrupting the progression of the disease before it is too late. 

    Another confrontational approach is the “Love First” method. This is similar to The Johnson Model in that it generally takes place in a neutral zone, like a family member’s home, and there are consequences mentioned if action is not taken to seek help. When the Love First method is applied, those who are holding the intervention must remain calm, no matter the circumstances, and avoid any type of accusatory tones or behaviors. The intention of this style is to bombard the person struggling with love and support, as the family members remain compassionate and positive throughout the process. 

    Other intervention forms, like the ARISE method and CRAFT model, focus on creating a bond between the addict and loved ones. To facilitate this bond, the CRAFT model suggests that the individual battling addiction and the family members both seek help. These styles implement self-care for the entire family and aid in opening up communication and encourage healing for both parties. 

    The above examples rely on some pre-planning prior to the event itself. But there are plenty of times when a person is in crisis and it is clear that something needs to be done and fast. Crisis interventions can be tricky in that they are usually thrown together last minute, often as a last ditch effort. This is also a time when an intervention actually results in having the subject involuntarily committed due to the risk of them harming themselves or others, or in the case of neglect. 

    Finnigan’s Approach

    An interventionist’s goal is to not only get the addict into a treatment program, but also to help their families get back on track and on the road to healing. The role includes helping to prepare for the event, informing and educating the family members of what to do during and after, and staging the actual intervention services. 

    There are agencies that offer over the phone guidance for organizing an intervention, however it is recommended that if possible, a professional be present. 

    As it is often documented on Intervention, in her approach Finnigan usually shows up several days before the intervention takes place and gets the wheels in motion. As a viewer of the television show, Finnigan’s arrival is always an exciting element. One can see and almost feel the relief wash over the family members in her presence. 

    The prep period prior to the intervention is as important as the event itself. Interventionists like Finnigan have extensive knowledge of treatment centers around the country, and this stage is when they present the family with rehabs that will address their loved one’s issues. They then make a selection. 

    The pre-intervention is also the time when Finnigan firmly insists that loved ones establish boundaries and end their enabling behaviors. Family members write a letter to the person who is struggling with addiction, expressing how much they are loved and cherished, and how their addiction has affected them. 

    It is very clear that Finnigan has an ability to balance assertiveness with the addict alongside shining a light on how some of the family’s actions may have contributed to the addiction. 

    At the same time, she is incredibly compassionate, caring and understanding. Finnigan usually mentions that she is also in recovery and realizes how hard this is for everyone involved. This acknowledgment instantly takes the shame and blame out of the equation, and helps everyone get to the root of what needs to be done. 

    The Moment of Truth

    On Intervention, Finnigan waits with family members in a little room until their loved one arrives. Other scenes reveal the addict, who is informed that he or she is heading to their final interview for what they believe is a documentary about addiction. Once the door opens and reveals the interventionist and the family, it suddenly becomes apparent that this is in fact an intervention. 

    This moment has high stakes both in the show and in everyday, non-televised interventions. The surprise element carries the risk of the subject running away, which does happen from time to time, or getting angry and lashing out. The tension is thick.

    This is when the interventionist steps in, diffuses the tension, and starts to calmly direct the room. In Finnigan’s case, she simply explains that all they’re going to do is sit down with their family, and listen to how much they are loved and cared for—that’s it. Incredibly, the addicted person usually obliges, and as the letters are read, emotions are expressed, and tears are shed, the person is given a second chance at life. 

    Assuming the person agrees to get help, a sober companion escorts him or her to the chosen rehab, leaving the family to begin their own healing and introspection. The interventionist provides resources such as referrals to Al-Anon meetings, therapists, and help in addressing codependency issues. An intervention is not just for the addict, but for everyone that loves them. 

    Why Candy Finnigan Makes Such an Impact

    Ms. Finnigan is extremely open and honest with the families and addicts. She is quoted as saying that she cries every time she leads an intervention. She makes it clear that she is not just in the business of recovery for the paycheck, but because she genuinely wants to help save lives. 

    Finnigan and Intervention report a success rate of about 71 percent. But what makes an even bigger impact is the nation’s newfound awareness of the actual issues that addiction presents, and how many people are affected by it. The show spotlighted the reality of addiction for the first time on a large scale, and it got people talking. 

    Addiction was no longer a taboo subject, and it certainly was not going to be swept under the rug any longer. Intervention opened the door for the conversation about the disease of addiction, and also made many feel like getting help, getting clean and sober, was a possibility. 

    Finnigan made it her mission to help those who were suffering from addiction and their families, and continues to do so with grace and humility. Because, as she so eloquently puts it, “It’s not just my work. It’s my life.” 

    Candy Finnigan maintains frequent speaking engagements and appearances all over the country. Learn more about Candy Finnigan and her body of work on her website, www.candyfinnigan.com. Find Candy Finnigan on Facebook, Twitter and YouTube.

    View the original article at thefix.com

  • "Dopesick Nation" Shows Reality of Treatment Professionals Who Struggle with Addiction

    "Dopesick Nation" Shows Reality of Treatment Professionals Who Struggle with Addiction

    Dopesick Nation explores addiction treatment and the thin line between interventionist and client, recovery and relapse.

    Note: This piece contains spoilers for Dopesick Nation

    As a former social worker in recovery from addiction, I was initially skeptical of the VICELAND Series Dopesick Nation because I thought it would follow the familiar formula of A&E’s Intervention and TLC’s Addicted. I was wrong. Dopesick Nation is different from these other shows for many reasons, but it’s especially good at illuminating the unique difficulties of being a recovering addict while also working with and helping other people struggling with addiction. Dopesick Nation explores the thin line between interventionist and client, recovery and relapse. This is a common struggle, as 37 to 57% of professionals in the addiction field are in recovery themselves. Due to stigma, there is sparse data on how often people working in this field relapse, but I found a preliminary study that found 14.7% of addiction treatment professionals relapse over their career lifespan. I can relate: I’ve relapsed twice while working in the field.

    Let me start by saying that I commend all people working in addiction and recovery treatment. While I have mixed feelings about Intervention and Addicted, I have deep respect for the interventionists who have made it their mission to help people with addiction while also navigating the daily struggles of their own recovery. The traditional interventionists of Addicted and Intervention appear so stable; each of their stories follow a typical trajectory from drug addict to helper. On the opening montage of Addicted, interventionist Kristina Wandzilak says: “By the time I was 15, I was addicted to drugs and alcohol. I robbed homes, I sold my body, I dug in dumpsters to pay for my habit. Today I am an interventionist…”

    Yes, Wandzilak and the other interventionists’ stories are all inspiring to people like me in recovery, but the reality is that many of us relate more to Dopesick Nation’s leads, Allie and Frankie. Both are candid about the difficulty of working in the field and later Frankie is open about his relapse. But we’ll come back to that.

    Addiction Treatment on TV: Intervention, Addicted, and Dopesick Nation

    One of the first stark differences between these shows is the more relatable, down-to-earth way that Allie and Frankie approach their clients. From my experience as a social worker with eight years of experience in the field, I know that the first step is building rapport and earning the trust of vulnerable people who are skeptical of helping professionals. Allie wears yoga pants and hoop earrings, Frankie is covered in tattoos and wears a backwards black hat and a t-shirt with the logo of his nonprofit, “FUCK HEROIN FOUNDATION.”

    This may seem surface level, but first impressions matter. Trust should be earned, not expected. I had a client who refused to open the door to staff for weeks, in part because she felt social workers were elitist and unrelatable. When she finally let me in, she said, “You’re not one of those preppy ass bitches.” My boss joked that all the staff should get tattoos, a lip ring, and blue hair like me even though technically it was against dress code policy.

    In Addicted and Intervention, the interventions are staged in the carefully controlled environments of beige hotel conference rooms. Wearing business casual clothes, neatly ironed polos and chinos, the interventionists sit on comfy chairs in a U-shaped circle, then conduct a carefully orchestrated, seemingly scripted intervention.

    In Dopesick Nation, Allie and Frankie meet their clients where they are, which is a foundation for building a helping relationship. The show takes place in sunny, touristy Florida, where glimmering sandy beaches are dotted with tourists in Hawaiian shirts playing shuffleboard next to the swirling tides of the turquoise ocean. But Allie and Frankie don’t meet on the beach. Instead, they talk to clients on park benches, and curbsides in bad neighborhoods, braving torrential downpours and scorching heat. This method of “meeting people where they are at” is supported by years of social science research and was a cornerstone of my work as part of an outreach team to help people with severe mental illness and addiction. We left our office bubble, braving blizzards and arctic cold, because we knew clients were more likely to go to detox or another facility after a course of meetings in their homes.

    Fast forward to Frankie admitting he’s relapsed and is taking Suboxone, a medication to deal with opioid cravings. Wringing his hands, itching his sweat-glazed skin, Frankie tells his sponsor Gary: “90 to 95% of my day helping other people find their recovery. Sometimes I’m not taking care of my own recovery. And how am I gonna help other people get something that I don’t have? A lot of people rely on me, that pressure weighs on me.”

    Gary encourages Frankie to go to detox. “When you’re working in treatment, you’re around sickness all day long and you’re absorbing it… You need to work a righteous program.”

    Treatment Professionals Who Relapse

    I want to tell Gary that even though Suboxone is sometimes shunned by the recovery community, many studies support its efficacy. Suboxone is a valid form of recovery. I want to reach across the screen, hug Frankie and tell him he deserves the same care and compassion that he gives to clients, that it’s okay to take a break from the field to take care of himself. I want to tell him that I admire him even more because he let his guard down and was honest. I want to tell him that more of us relapse than he may realize and assure him that he is not a hypocrite for relapsing and taking Suboxone. I want to tell him my story.

    Three years ago, I was working at a day center with people who had struggled with homelessness and addiction. I remember one day when a client who was an IV heroin and meth user told me about his struggles to get clean. My years of experience taught me the art of self-disclosure, specifically if and when it was appropriate to disclose to clients that I too was in recovery. Since I’d known him seven months and even been trusted to store his dead cat’s ashes (a story for another day), I told him about my addiction as though it was in the past tense, although it was very much in the present tense. Steeped in denial, I told myself that my nighttime and weekend benders wouldn’t bleed into daytime. Looking back, I feel ashamed, but I know that denial is also a powerful drug. For a while, I thought I juggled my work life and secret life well. I thrived at my job, until, surprise— the benders bled into my work days.

    One day this client told me he was worried about me. He’d noticed my weight loss, blue circles under my darkened eyes, and change in personality. That’s when I knew I needed help. It was time to take a break from being a social worker. I went to detox for five days, then resigned and decided to move home. Like Frankie in Dopesick Nation, I realized that I couldn’t take care of others until I took care of myself.

    Eighteen months later, I miss social work and helping people. I hope to one day return to the profession, but in the meantime I’m using writing as a means to fight the stigma of addiction and shame of relapse. The reality is that relapse rates vary between 50 to 90%, and even treatment professionals are not immune to the realities of addiction. My hope is that one day more helping professionals like me can come out about their relapses and be commended for our honesty.

    What are your thoughts on Dopesick Nation and Frankie and Allie? How should people who work in addiction treatment make sure they’re taking care of their own recovery? Let us know in the comments.

    View the original article at thefix.com

  • A New Addiction Intervention Book: INTERVIEW with Dr. Louise Stanger

    A New Addiction Intervention Book: INTERVIEW with Dr. Louise Stanger

    Addiction and Families

    Addiction affects an estimated one in three American families. So, how do these families get help? Some struggle along on their own. Other families seek help directly treatment providers: detox clinics, psychotherapists, addiction treatment centers, or addiction counselors. Still other families are just lost.

    Still, there is one group of professionals that bridge the gap between families and treatment…

    Interventionists.

    In the next decades, behavioral healthcare professionals will need to increasingly both identify and refer families coping with substance use disorders to treatment. And interventionists practicing solid principles taken from social work and family systems theory may hold the key to our collective progress.

    A Book That Can Help

    A new book called, “The Definitive Guide to Addiction Intervention: A Collective Strategy” introduces clinicians to best practices in addiction interventions. It literally bridges the gap between the theory and practice of successful intervention. Today, we speak with the originator of this strategy, Dr. Louise Stanger.

    Dr. Stanger has developed and refined her invitational method of interventions over decades of working with families. She has performed thousands of family interventions throughout the United States and abroad. And we’re pleased to have her here for a digital interview!

    ADDICTION BLOG: What was your inspiration for writing this book?

    DR. LOUISE STANGER: After growing up in a family with substance abuse and writing about many of these stories in my memoir and in the public sphere, I started to think about what message I’d like to leave for future generations of social workers in this space.

    I maintain that it is very important for the future generations of social workers, psychologists, marriage and family counselors, alcohol and other the drug counselors, doctors, nurses, etc. to not just read one book about one person’s methodology, but to be able to learn a variety of different strategies. Questions like where strategies come from, what is the evidence behind intervention strategies, how have these strategies developed and changed, etc. to inform the reader and open their eyes to the broader scope of intervention and its modalities. As such, I like to think of these strategies as “invitations to change.” The idea is to provide a textbook at your disposal to learn and teach from.

    The truth is that 155 people die from opioids every day – it’s a global crisis, and we need new ways to train professionals across many levels in schools and in practice to help people and their families.

    ADDICTION BLOG: What do you think is the most important message that clinicians can “take home” after a reading?

    DR. LOUISE STANGER: The most important message is that change is possible.

    The key to this, which is talked about in the book, is CIS or Collective Intervention Strategies. This means that in order for an intervention to be successful, a collective team of family members, friends, colleagues, associates, business partners, managers and co-workers must be assembled to bring change in a person’s life, which is the intervention part of it. And finally, strategies, in that nothing is set in stone, we adapt to the unique needs of each individual.

    As a whole, Collective Intervention Strategies is a powerful model for inviting change that readers can take home.

    ADDICTION BLOG: How do most people or families get help for addiction?

    DR. LOUISE STANGER: How do they get help? That’s a great question.

    Talking with and connecting with professionals that are trained in process addictions, substance abuse, chronic pain, etc. You can also get help. Addiction is always bigger than the families, so it’s always best to seek out professional help from a mental health clinic, substance abuse clinic, or clinicians. Help is available. Families don’t have to do it alone. Not alone. For example, they can do 12-step. But when their hearts are breaking, they call.

    ADDICTION BLOG: Do you find that people misunderstand the field of mental health treatment and/or the work that you do? Do you find professionals even have a bit of trouble when it comes to certain areas of your work?

    DR. LOUISE STANGER: I think people by far don’t understand how substance abuse and mental health interface and work hand in hand. They don’t understand the duality or triality of what happens. The two are not mutually exclusive, and as such, must both be assessed (along with any other influencers) to get the best possible picture of the person and begin to build a comprehensive treatment plan.

    For instance, I appreciate the ASAM definition of addiction – it’s a disease of the brain and causes changes in brain chemistry. As such, people are afraid to address the complexity of humans and all the aspects. Therefore, when helping a family or a loved one, it’s very important to understand and learn about that particular individual, you must do a retrospective – bio, psycho, and social – to understand how to help and what kinds of treatment will fit their life.

    As for the professional sphere, there are many people who claim they are pros but have not been properly trained. I don’t think a 5 day training makes one an interventionist. Sometimes it feels like the Wild, Wild West out there. I think there needs to be more education and schooling, professional classes and programs that illustrate intervention as a real treatment option. We need it in our undergraduate, graduate and doctoral programs, across fields of work including counseling, nursing, pre-med, etc. to build it out as a field of study.

    ADDICTION BLOG: How do you hope this book will impact the field of substance use disorder treatment? Where do you hope to see treatment advance within the coming years?

    DR. LOUISE STANGER: My hope is that this book is adopted by both training centers, colleges and universities and hospitals, behavioral health care treatment centers, the legal system centers, senior living centers, doctors, Nurses, Funeral Directors, etc.

    This book takes a deep dive and discusses clinical and reverse interventions, which can be performed in a variety of milieus, shedding light on aspects of intervention that aren’t always talked about in trainings and certification programs. I hope professionals will hire and cultivate staff trained in the strategies talked about in the book, so that knowledge, standards and practices are a part of their tool box.

    In coming years, we are going to see more telephone and internet-based treatment options, the use of AI and other technological advances. Though nothing will replace relationships, we will have higher standards based on improved educational qualifications and higher standards of accreditation for treatment centers – all good things for behavioral health care. The ongoing opioid epidemic will spur change by demanding robust and low cost treatment options to address this issue.

    We will also address ethical issues. For example, the hiring of professionals for treatment centers will need to address marijuana legalization. Questions will arise: do treatment centers have progressive abstinence? Or a firm baseline? Can hired professionals use one substance over another? The ethics of these questions will come to fruition as the issues play out over the next couple of years.

    ADDICTION BLOG: Would you offer a bit of insight for our readers as to how they can best handle trauma and addiction in their family? What are some of the best steps they can take themselves if facing a drug or alcohol problem within the home?

    DR. LOUISE STANGER: The first step is to define trauma as an overwhelming experience that cannot be integrated and one that elicits multiple defenses and dysregulates the person. Or, it can be described as a stress that causes physical or emotional harm that you cannot remove yourself from.

    Then, we may unpack the etiology of the trauma, which may be objective or subjective. Objective trauma is what took place i.e. I fell off a ladder, I was told I was no good, I would never amount to anything, my father was emotionally abusive, I was in a car accident, etc. Subjective trauma is how the person perceives what took place and the emotional aftershocks. This can come from adverse childhood experiences, and the effects of trauma is cumulative over time.

    Once this is understood, seeking out and talking with trained professionals who can put you on the path to recovery is integral to the process.

    Professionals must ask: how can we help clients who experience trauma and then substance abuse/addiction rise to their best possible selves? Also, it is important to give treatment recommendations to other family members so they too can be the best they are. This is a holistic approach to treating a wounded person, and it always comes back around to CIS or Collective Intervention Strategies as the best approach.

    Folks may also consider visiting a 12-Step group such as Alcoholics Anonymous, Al-anon, Narcotics anonymous, etc. And of course there is me in my own independent practice. I always tell my clients that help is just a phone call away.

    ADDICTION BLOG: Through the process of writing, did you learn any important lessons or come across information that you weren’t expecting?

    DR. LOUISE STANGER: I didn’t have any big surprises. I found it humbling that with all the research and time working on this book, I circled back to the one truth that has been consistent in my work – it is imperative to meet the client where they are at. It’s about understanding who they are, where they come from, their family dynamics, traumas, and their place in the world.

    The best theory in the world won’t take into account this human element. With unique people, a multitude of cultures, gender expressions and the changes in our genetic diversity, we must embrace difference as a teacher. That way, you can help plan a strategy that meets their unique needs.

    ADDICTION BLOG: Are there any future projects you’re currently working on and/or have in mind? What kind of impact are you hoping to leave on the mental health world with the addition of this book?

    DR. LOUISE STANGER: I continue to write public blogs – openly discussing the major topics in the behavioral health field. One thing I will wrestle with through public discourse, presentations, trainings and daily practice is ethics in the digital age. Specifically with marijuana legalization, how will this affect the workforce? There will be a multitude of implications and I’m excited to dive in and explore with my practice, clients and continued commitment to service of the behavioral health industry.

    Finally, my hope is that this book is adopted my many universities and schools across the globe. I’m excited about the e-platform, which will make it a living source of knowledge for professionals to keep up to date and relevant for future generations. Also, I hope that whatever my next writing venture is – whether it’s a book, a collection of blogs, or more thought pieces – that it will seep into the mainstream and become a larger public discourse than we’ve seen related to these topics. A wider audience would help ease the stigma of substance abuse and mental health in the public sphere.

    ADDICTION BLOG: Do you have some inspiration you can leave for our readers who are currently handling addiction for themselves or a loved one?

    DR. LOUISE STANGER: Keep doing what you’re doing. As I put in my memoir, keep falling up, which means that stumbles, detours and falls are part of the human experience, so long as you’re out there living and moving forward.

    I strive to look for strengths and goodness in people so everyone may rise to their best possible selves. I hope that readers and those out there struggling with these kinds of issues will do the same. Help is just a phone call away and hope is possible. Dig deeper, think harder, look further, rise stronger.

    ADDICTION BLOG: Do you have anything else you’d like to add?

    DR. LOUISE STANGER: Thank you for the opportunity to be a part of your blog. I appreciated working with you as an editor. Your contributions are immeasurable.

    In closing, I want people to know every day they are inviting people to change, help is available, solutions are possible.

    View the original article at

  • A Checklist for Hiring an Addiction Interventionist

    A Checklist for Hiring an Addiction Interventionist

    ARTICLE SUMMARY:This article offers guidelines on how to select a professional interventionist when you are ready to confront a family member about a drug or alcohol problem.

    ESTIMATED READING TIME: Less than 10 minutes.

    TABLE OF CONTENTS:

    Readiness for Help

    So, you’re ready to find an interventionist.

    Most likely, you’re at your wit’s end. You may not be sleeping at night from worry. You might feel like the world is spiraling out of control. And you may be angry, frustrated, and downright sick of the person in your family who’s using drugs or alcohol.

    Guess what?

    These are all normal feelings!

    Selecting and working with an interventionist might be the best thing that you can do for your family. The right person will have just the right combination of techniques and words to move your entire family into a new era. The right person will also have experience and a track record to show for it. Plus, the right person will not only get your loved one into rehab, s/he will guide your family on what to do next.

    So, the decision about WHO is best for your family should not be taken lightly. Your choice will be informed by your specific needs, situation, and case. And you need to do your research. We hope that this informative article will help!

    Credentials

    Currently, addiction interventionists are not required to attend university, pass certification exams, or be approved as “clinicians” before they begin to practice. In fact, it’s a bit like the Wild, Wild West.

    Still, a skilled interventionist should be highly trained in addiction interventions. The right person can help you and your family get unstuck. However, it can be tricky to make a decision on credentials alone. Some interventionists are licensed clinicians, some are trained by colleagues, while others have experience under their belt.

    Q: So, what should you be looking for, in terms of credentials?

    A: Basically, you need to know that the person KNOWS what they’re doing…and has the experience to back it up.

    Clinical skills are helpful and desired when looking for an interventionist. However, credentials are not a prerequisite. Experience matters. Plus, it can also help to work with other professionals who complement interventions. Trained attorneys, psychiatrists, psychologists and others who themselves are in recovery are excellent allies.

    THE BOTTOM LINE IS THIS: Regardless of the interventionist’s academic background, you need to figure out:

    1.  What they know.
    2.  Who they’ve been trained by.
    3.  What mentoring they’ve had.
    4.  What skills they bring to the table.

    How Much Do Interventionists Charge?

    Interventionists charge from $2,500 to $10,000 or more for their services. The price will depend on the level of service offered and the person’s experience with interventions. For example, some interventionists offer coaching to families for 3-6 months after the intervention is over. Others will end their work with your family when your loved one enters treatment, or after a family weekend.

    When interventionists partner with or work for treatment centers, the intervention may be lower priced than for someone who works independently. This is because the intervention may be just another service of the entire rehab process. Note also fees are not necessarily less if you pick an interventionist in your state versus across the country.

    When considering costs, keep in mind the ultimate value of the result. The upfront costs might seem high, but in exchange, you’re increasing the chances your loved one will attend rehab and get their life back on track. How much is that worth to you?

    As a comparison, according to the U.S. Bureau of Labor Statistics, as of 2017, the average annual salary of counselors working in the field of addiction was $43,300. Interventionists on the higher end of the earnings scale, or 90th percentile, earned $60,000 and those on the lower end of the earnings scale, or 10th percentile, earned $25,140.

    How to Find an Interventionist

    There are a few ways you can identify the best person for your family.

    1. Search member directories of the professional associations.

    It is important to find someone with experience, the appropriate licenses/certifications for your needs, and a strong code of ethics. Two professional guilds list members’ credentials, licenses, and certifications. So, where finances are concerned, be sure that you clarify fees and services up front.

    To look for an interventionist, search the member listings for the NII and AIS:

    2. Seek a reference from a mental health professional.

    Second, the National Council on Alcoholism and Drug Dependence recommends that you seek help from the following professionals for intervention services:

    •  An alcohol and addictions counselor
    •  An addiction treatment center
    •  Psychiatrist
    •  Psychologist
    •  Social Worker

    Some of these professionals may have experience in interventions themselves. Other times, a mental health professional can refer you to a colleague or someone with a good reputation in the field. The organization also suggests that you reach out to NCADD Affiliates to be connected to referrals.

    3. Call us for help.

    The telephone number listed on this page will connect you to a helpline. All calls will be answered by American Addiction Centers (AAC). Caring admissions consultants are standing by to discuss your treatment options, which can include family intervention specialists. The helpline is offered at no cost and with no obligation to enter treatment.

    Whatever route you choose, we recommend picking up the phone and interviewing at least three people that you want to work with. Use the checklist at the end of this article to guide your conversation. Finally, confirm references that the person offers and have conversations about the person’s methods.

    Do Interventionists Work?

    Yes, professional interventionists work.

    According to the Association of Intervention Specialists, research suggests that up to 90% of professionally guided interventions succeed at getting the person into treatment. Whether your loved one will find and maintain a drug-free life is more of a long-term investment. In fact, someone facing addiction needs to put in a great deal of effort to change their thoughts and behaviors.

    But if you’re doing an intervention correctly – and using the Collective Intervention Strategy outlined in the book, The Definitive Guide to Addiction Interventions – the family system will change. So, regardless of whether your loved one goes to treatment or not, the system will never be the same.

    Therefore, every addiction intervention has the possibility to be successful.

    A Printable Checklist

    It’s important for families who hire an interventionist to first check out an interventionist’s credentials and amount of time they have spent in the field. You’ll also want to know more about their services, costs, and personal experience with addiction. Here are is a checklist of questions that you can use to help you vet professionals. Feel free to write answers to the questions…or use the space for your own notes.

    □ Credentials
    □ Licensed Clinical Professional Counselor, LPC or LCPC
    □ Licensed Mental Health Counselor, LMHC
    □ Licensed Clinical Social Worker, LCSW
    □ Masters or Doctorate of Psychology, Masters in Psychology, Psy.D.,
    □ Marriage and Family Therapist, MFT

     

    Member of professional association (circle any of the following)

    • AIS: Association of Intervention Specialists

    • NII: Network of Independent Interventionists

    • American Hospital Association

    • NATAP: National Association of Addiction Treatment Providers

    • NAADAC: National Association for Alcoholism and Drug Abuse Counselors

    • NASW: The National Association of Social Workers

    • CARF: Commission on Accreditation of Rehabilitation Facilities

    • CADAC: California Association of Alcohol and Other Drug Counselors

    □ Is the interventionist independent or employed by a particular treatment center or centers?

     

    □ What is the person’s academic background, training, and/or experience background?

     

    □ Is the interventionist in recovery him/herself, or not?

     

    □ Does s/he work alone or have a team?

     

    □ What exact services does s/he provide? What is the cost?

     

    □ What services do they not provide?

     

    □ What are their professional affiliations?

     

    □ What do they specialize in (not all people can do everything)?

     

    □ What does their engagement offer? Length of service and actual services.

     

    □ What is the length of time for their engagement? Does the person work with you and your family AFTER initial treatment placement?

     

    □ How accessible is the person or their team to you? Can you reach the person 24-7? What’s the turn around time on phone calls, emails, etc?

     

    □ Does the interventionist have references you can call for verification?

     

    Your Questions

    We hope to have set you on the right path for getting help.

    But we understand you still may have questions.

    Please ask any question in the comments section below. We do our best to respond to each real-life situation with a personal and prompt reply. And if we can’t help…we’ll refer you to someone who can!

    We wish you all the best.

    —–

    Reference Sources: The Definitive Guide to Addiction Interventions, A Collective Strategy
    Available via Routledge Press or on Amazon.

    View the original article at

  • Can I Plan an Intervention on My Own or Do I Need Help?

    Can I Plan an Intervention on My Own or Do I Need Help?

    ARTICLE SUMMARY: This article reviews why most families need expert help during an intervention…and what planning is required. Your questions are welcomed at the end.

    ESTIMATED READING TIME: 10 minutes

    TABLE OF CONTENTS:

    Most Families Need an Expert

    Most families need outside help to get a loved one into rehab. I didn’t know this until I started working with expert, Dr. Louise Stanger on the book we wrote together, “The Definitive Guide to Addiction Interventions.” I learned that interventions are highly stylized conversations that require clinical skill.

    Why do most families need an expert?

    Simply, because it’s difficult.

    Trying to convince someone to get help for a drinking or drug problem requires experience and an understanding of common objections. Interventions can be potentially explosive, even if the person knows what’s coming. And you don’t know what’s going to happen. This is where experience can really help.

    Plus, loved ones who are using psychoactive substances are often in denial that s/he needs help. Denial is like a wall…with the right words, it can come tumbling down. But are you ready to talk with your loved one calmly, objectively, and rationally about addiction issues? If you’re honest with yourself…probably not.

    Additionally, we know that one form of addiction bleeds into another: co-occurring mental health disorders such as depression, anxiety, personality disorders, juxtapose with medical problems such as chronic pain, legal or school issues. The complexity of what’s really going on is a mystery to most families.

    Finally, consider this: Most people do not want to change.

    Creating movement and shifts within a family dynamic require thoughtful expertise. And while you might need to dish out anywhere from a few thousand dollars to many thousands…training, specialization, and experience are worth the money! In fact, moving someone to the point where they’re willing to change takes more than just the simple formula you’ll see on other blogs online: Write a letter – Speak the facts – Your loved one goes to rehab. It just doesn’t happen like that.

    Working with an interventionist can often get your loved one into treatment quicker and more efficiently than if you try to intervene on your own.

    Do You Need Help, or Not?

    So, are you at a point where you need a professional? Take a look at the following questions. You and your family might want to hire a professional addiction interventionist if:
    • You support (consciously or unconsciously) a loved one who is using mind-altering substances. This includes financial support or emotional support.
    • You have difficulty setting healthy boundaries or even knowing what boundaries are.
    • You experience somatic symptoms, lack of sleep, rage, endless tears, repeated illness, stomach aches, migraines, etc.
    • You have been unsuccessful in addressing a loved one’s substance abuse, mental health disorder, chronic pain, co-occurring disorder, legal trouble, or school and professional failures.
    • You have been unsuccessful convincing your loved one that s/he needs help.
    • You have a history of complex trauma, substance abuse, or co-occurring disorders in your family of origin.
    • You cannot function daily due to your fear of doing/not doing something different to change your loved one.
    • You think constantly about your loved one. Or, you have gotten to a point of disconnecting from the world around you; looking at the situation is too painful.

    What Does an Interventionist Do?

    An interventionist works with you, your family group, and the identified loved one (the person drinking or using drugs) to help that person accept medical treatment for addiction. In order to get to “Yes”, an interventionist should be able facilitate and guide the following:
    •   Team Formation
    •   Family Mapping
    •   Retrospective Bio-Psycho-Social Analysis
    •   Case Strategy
    •   Treatment planning and placement
    •   Aftercare recommendations
    •   Family engagement in the healing process

    Further, communication skills are essential to interventions. Interviewing skills and solution focused skills are critical. Throughout the process, the interventionist manages all team and third party communication. S/He serves as a liaison. For example, individual phone interviews with prospective team members may be required. Or, an interventionist may need to provide safe escort or transport to the selected treatment center.

    Case management is also required for the evidence-based interventionist. Treatment center matching and referrals are necessary. Likewise, follow-up and regular case management with treatment centers while clients attend rehabilitation programs is critical. Finally, consultation and coordination of aftercare as well as Solution-Focused Family Recovery Coaching for all team members ensures lasting change.

    Not all interventionists have these skills. You can download our Checklist for Hiring an Interventionist to learn what criteria are best as you choose the right person for your family.

    Logistics

    There are a few things that an interventionist should coordinate both before and during the intervention. This includes:
    • Set date and times for meetings.
    • Select a neutral, safe venue(s) for the Pre-intervention and Intervention Meeting.
    • Book the venue in advance.
    • Identify who will be present.
    • If someone is not present, decide how you will include them (by Skype, phone, or letter).
    • Communicate the time, date, and location to all accountability team members.
    • Arrange for food to be present at the venue.
    • Review entrances and exits to venue.
    • Identify pets, if any, and care for them during the Intervention.
    • Make sure there are enough seats available (round tables if using are better than rectangles).
    • At homes, pull chairs and couches around to create a safe setting.
    • Identify other places where one may go and speak with the identified loved one in a less formal setting.
    • Arrange for photographs to be present. What photographs might be helpful? For example, if the ILO had a close relationship with a grandparent that has died, one might put a photograph in an empty chair or have to share to help move someone to change.
    • Work with a lawyer, medical professional, counselor, medical nurse, or treatment center representatives when necessary.

    Security

    • Make sure you have access to a phone always, even in remote locations.
    • Hire same gender transport professional(s), when needed.
    • Hire a medical nurse to accompany the identified loved one to the treatment center in cases of extreme drug dependence to prevent withdrawal.
    • Complete a full security check upon arrival at the venue.
    • Lock down (under lock and key) any firearms, weapons, or knives, etc.
    • Gather home keys, car keys, IDs, and phone from the identified loved one upon arrival.
    • Gather keys of interior and exterior areas of the home from the family.
    • Call in the help of executive protection professionals, when needed.

    Travel

    • Make sure that tickets are open and flexible.
    • Book tickets to the treatment facility on a “loose” return itinerary to allow for missed flights.
    • Make sure that if using safe transport services that escorts are gender specific or if you use two people for transport one has to be same gender.

    Review

    • Review entire plan with team mate and other outside professionals.
    • Review plan with the accountability team.
    • Review who you want to give invitation to attend meeting.

    Q: What happens when you go one-on-one with someone in active addiction?

    A: You lose!

    Adding an interventionist to your team can help ensure success and get your loved one into treatment quicker and more efficiently than if you were to try to intervene on your own.

    To learn more about addiction intervention, please give us a call. Or, leave us a question in the comments section below. The telephone number listed on this page will connect you to a helpline answered by American Addiction Centers (AAC). The helpline is offered at no cost and with no obligation to enter treatment. Caring admissions consultants are standing by to discuss your treatment options, which can include family intervention specialists.

    If you’re ready for help, pick up the phone.

    You don’t need to hold an intervention on your own.

    Reference Sources: The Definitive Guide to Addiction Interventions, A Collective Strategy
    Available via Routledge Press or on Amazon.

    View the original article at

  • How to Find an Interventionist Near You

    How to Find an Interventionist Near You

    ARTICLE SUMMARY: A guide to finding a professional interventionist in your city or state. We also review how you can broaden your search to include out-of-state experts.

    ESTIMATED READING TIME: Less than 10 minutes.

    TABLE OF CONTENTS:

    Not Everyone is a Good Interventionist

    So, you’re ready to hire a professional interventionist?

    This person can and should help you get a loved one into alcohol or drug rehab.

    First, we’d like to acknowledge the difficulty in making this decision. The upfront costs might seem high. However, the Association of Intervention Specialists states that the numbers suggest up to 90% of professionally guided interventions succeed at getting the person into treatment. So, not only are you increasing the chances your loved one will attend rehab…you can also have hope that they’ll get their life back on track. How much is that worth to you?
    In fact, an intervention might be the most important thing you do for your family! However, please be advised:

    Not everyone is a good interventionist.

    No matter who they are – whether Ph.D., MD, social worker, a marriage and family therapist, or have only a ‘hard knocks’ degree – training is necessary. Taking a weekend course or joining a supervision group does not make a person effective as an interventionist. Further still, even if the person is in addiction recovery…that does not mean that s/he is a clinician or knows about addiction treatment, nor does it mean that they know how to conduct an intervention.

    Interventions require training, ongoing supervision, and experience!

    Experience is Necessary

    Q: So, what should you be looking for when you spend $3,000+ on a professional intervention?
    A: A professional interventionist must know what they’re doing and have the experience to back it up.

    In fact, credentials are not a prerequisite. Experience matters. Regardless of the interventionist’s academic background, you need to figure out:

    •  What they know.
    •  What skills they have.
    •  Who’s trained them.
    •  What mentoring they’ve had.

    You can be sure to vet the person correctly by downloading and printing this Checklist for Hiring an Addiction Interventionist.

    For even more advice, you can check out The Definitive Guide to Addiction Interventions, a book that synthesizes the 30+ years of clinical work of Dr. Louise Stanger that has been edited by Addiction Blog Editor, Lee Weber.

    How to Find an Interventionist

    An intervention can change everything. It can give you hope. It can restore a sense of harmony to your family. And, the person struggling with an alcohol or drug addiction can finally get the medical attention that they need. How can you find the right person?

    There are a few ways you can identify the best person for your family.

    1. Search professional associations.

    It is important to find someone with experience, the appropriate licenses/certifications for your needs, and a strong code of ethics. Two professional organizations exist that collect this information: The Network of Independent Interventionists (NII) and the Association of Intervention Specialists (AIS). These organizations list members’ credentials, licenses, and certifications. You can search member listings here:

    •  The NII website, the Network of Independent Interventionists.
    •  The AIS website, the Association of Intervention Specialists.

    2. Seek a reference from a mental health professional.

    The National Council on Alcoholism and Drug Dependence (NCADD) exists as the nation’s premier advocacy group for addiction treatment. This NGO recommends that you seek help from the following professionals for intervention services:

    •  An alcohol and addictions counselor
    •  An addiction treatment center
    •  Psychiatrist
    •  Psychologist
    •  Social Worker

    Some of these professionals may have experience in interventions themselves. Other times, a mental health professional can refer you to a colleague or someone with a good reputation in the field. The organization also suggests that you reach out to NCADD Affiliates to be connected to referrals.

    3. Call us for help.

    The telephone number listed on this page will connect you to a helpline answered by American Addiction Centers (AAC). The helpline is offered at no cost and with no obligation to enter treatment. Caring admissions consultants are standing by to discuss your treatment options, which can include family intervention specialists. So, if you are ready to get help for you or a family member, reach out and pick up the phone.

    My Area or Out of State?

    So, should you be looking locally….or should you consider someone who’s out of state?

    Contrary to popular belief, a good interventionist is NOT LIMITED TO REGION. The right person is ready and able to travel…and has experience working with families of all types. In fact, their fees may not be incredibly different from someone who is local. Further, an out-of-state interventionist may have a broader outlook than someone who is near you. Here are some of the PROs and CONs of each.

    A local interventionist may:

    •  Be able to travel quickly to you or meet frequently.
    •  Be connected to local behavioral and mental health care providers.
    •  Be connected to local city/state agencies, including social services.
    •  Be limited in their referrals for treatment.
    •  Refer to local rehabs or treatment centers.

    An out-of-state interventionist may:

    •  Be available 24-7 on the phone or via email.
    •  Be connected to national behavioral and mental health care providers.
    •  Bill for travel expenses.
    •  Bring a fresh perspective to the situation.
    •  Have a broader network of referral sources.

    Local Search Tips

    If you’re looking for an alcohol or drug addiction interventionist near you, it can help to search for the right person via referral. Start with your family doctor and work your way out to other connections. For example, you can seek referrals from:

    While you may be concerned about anonymity, also know that Americans are increasingly destigmatizing addiction, especially through advocacy groups like Facing Addiction. In fact, an estimated one in three American families experiences addiction through one close family member. So, your friends and family can also be a source of help.

    National Search Tips

    If you’re interested in hiring someone who may have a wider view of the addiction treatment landscape, it can help to search nationwide databases for references to resources. Non-government organizations are especially helpful. Again, you’ll want to refern to the NII website, the Network of Independent Interventionists, and the AIS website, the Association of Intervention Specialists.

    Otherwise, we recommend that you look for an interventionist using the following websites:

     Clinical Qualities to Look For

    Again, not all interventionists offer the same level of expertise. For this reason, we suggest a quality check before hiring someone. You’ll want the person to demonstrate the following qualities outlined in part of Chapter 10 of The Definitive Guide to Addiction Interventions:

    1. Boundaries.

    A good interventionist will establish clinical boundaries between themselves and clients. These boundaries address the length of a counseling relationship, self-disclosure by a counselor, giving of gifts, and the limits of touch or personal communication between counselor and client. A boundary will also define or limit personal benefit of money or services that the interventionist receives. The emotional or dependency needs of a counselor should also be in check.

    NOTE HERE: Hiring an interventionist is like working with a contractor. So, it is helpful to vet the person you want to work with via a Google search or by talking with colleagues about her/his reputation. Also, ask for a very clear contract and terms of service at the beginning of your contractual relationship.

    2. Competence.

    A good interventionist will be able to reference achievements of professional competence. S/He should also exhibit cultural competence when working with specific groups…but not overstep abilities.

    NOTE HERE: You can ask for all professional qualifications before you sign a contract with an interventionist. You might ask for a resume, a CV, or for 2-3 professional references.

    3. Confidentiality.

    Keeping private information private is the hallmark of a therapeutic relationship. HIPPA Forms attempt to clarify the confidential nature of the work of addiction interventionist. However, strict confidentiality should be from the first phone call. The principle of confidentiality should govern record keeping, accounting, informal and formal conversations, treatment decisions, and the person’s progress notes. The right person will also be familiar with state laws about confidentiality and have necessary consent forms, signed, and on file. Mandated reporting, the “Duty to Warn” laws, and exceptions to confidentiality law (drug court, federally assisted treatment programs, confidentiality and minors, age of consent) vary by state.

    NOTE HERE: Ask potential interventionists to provide you with a statement describing the extent to which confidentiality of records will be maintained, including an explanation on limits of confidentiality, plus who to contact in emergency in my official documentation.

    4. Avoid brokers or unethical referral services.

    Treatment centers have been known to pay bounties to for referrals. This leads to a practice called “patient brokering.” In return for referring a patient to a drug treatment facility, the broker receives a generous compensation of $500 to $5000. Brokers will offer to share this money with patients or entice them with drugs to leave an existing facility and qualify for another because they have relapsed, leading to a revolving door syndrome.

    Additionally, federal laws such as the Anti-Kick Back Statute make is a criminal offense for anyone to give a kickback with the intent of influencing referral of patients. Some examples include trips, hotels, or gifts. Further, the Stark Law tries to prevent physician’s self-referral, or when a physician refers a patient to a facility s/he owns or family has financial interest.

    NOTE HERE: Ask an interventionist directly about monetary relationships s/he has with treatment centers. If the person works for the treatment center, this is not necessarily a bad thing. However,know whether you’ll be contracting with the center or the individual directly.

    5. Informed consent.

    You need to officially grant an interventionist permission to carry out an intervention, in full knowledge of the possible consequences, risks, and benefits. An informed content should include a description of any reasonable foreseeable risks or discomforts (consequences of early withdrawal), a description of any benefits to the subject or others, as well as disclosure of any alternative treatments, including medications.

    NOTE HERE: Ask to sign consent forms at the beginning of your relationship with an interventionist to manage your expectations and set the guidelines for the clinical help you’ll receive.

    Your Questions

     We hope to have given you a good, solid place to start looking for help.

    We also understand that you may still have questions. Please leave your questions in the comments section below. We try to respond to all questions with a personal and prompt reply.

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