Article: Staging an intervention - It can work, but such confrontations by family, friends come with some risks
By Marilyn Kennedy Melia
Special to the Tribune
June 10, 2007
An addict must decide for himself
to quit.
But friends, relatives, even a boss may be able to push
him to that decision through an "intervention."
A reality TV show by the same name has popularized the intervention
idea, but some relatives and friends may glean unrealistic
expectations from the program, said Colleen Koncilja, director
of clinical services at the Renz Addiction Counseling Center
in Elgin.
"They show a professional meeting with the family,
and then together they meet with the addict, and then he's
usually whisked off to some famous treatment center," Koncilja
said.
That scenario does occasionally happen, but some families
can't afford the services of an intervention specialist,
or there are thorny insurance issues to work out when the
addict does agree to treatment, Koncilja said.
On the other hand, intervention specialist Bob Poznanovich,
president and CEO of St. Paul, Minn.-based Addiction Intervention
Resources, or AIR, said he can provide an initial screening
to decide if an intervention is appropriate and be able to
make an assessment of necessary treatment and insurance coverage.
While a successful intervention ends in the addict getting
treatment, a key part also involves family and friends defining
how they no longer can tolerate certain behaviors.
The Renz Center doesn't offer intervention services, Koncilja
explained, but does sponsor seminars "where we try to
work with the family members on how they can take care of
themselves. We talk about how they can set boundaries and
limits so they are not feeling crazy."
Indeed, even addicts who enter treatment after an intervention
may relapse, but the lasting value of the process is that
family members know how to cope better. For a 23-year-old
former addict from Chicago, an intervention last year via
AIR followed a scenario much like what viewers of the A&E
series hope for: After an emotional appeal from his older
sister and others, he went for a month of inpatient treatment,
followed by several months of after-care.
Without the intervention, he said, he never would have sought
help. "I knew I had a problem. But your brain is clouded.
I didn't want to ask for help, and I didn't even know about
things like NA [Narcotics Anonymous]."
An intervention can be valuable because "it can be
the one route to get someone to see a professional," said
Dr. Daniel Angres, a psychiatrist and director of Rush Behavioral
Health.
The subject makes for dramatic TV, but many practicalities
must be addressed. That's where Web links to intervention
resources such as the one run by The Partnership for a Drug-Free
America come in handy (drugfree.org).
Even at that, however, interventions carry risk. Although
strategies can vary, the scenario generally involves family
and friends meeting with the unsuspecting addict and telling
him how his dependency has wreaked havoc in his life and
theirs. They present an ultimatum: Seek treatment or face
certain consequences.
Such a confrontation can push an addict not into treatment
but further from friends and family, warned Ronda Dearing,
research scientist at the Research Institute on Addiction
at the University of Buffalo.
AIR, which charges $3,000 to $6,000 for its services, has
a counselor spend a day carefully rehearsing with family
members exactly what they will say and prepares them for
various reactions from the addict, Poznanovich said. The
counselor also attends the intervention, then serves as a
liaison between him and the family during treatment.
"Any intervention that is shaming and confrontational
is not a good intervention," he said.
For addicts who are business or professional people, a very
abbreviated form of intervention -- a boss who explains that
the addict's job is in jeopardy -- can be effective, Angres
said. "Someone who is addicted needs to have something
held over them. For someone who is gainfully employed, one
of the most [valued] things is their job."
Many companies, especially larger firms, offer workers access
to an "employee assistance program," which may
provide workplace interventions.
"What typically happens is that the employer notices
a change in performance [of the dependent worker]," explained
Dr. Richard Chaifetz, chairman and CEO of ComPsych, a Chicago-based
EAP provider.
A boss can receive coaching from EAP about how to approach
the worker, and he typically is advised not to mention the
possibility of addiction, just to simply insist that performance
must improve and suggest the worker contact the EAP.
In some instances, Chaifetz added, an EAP may arrange for
an intervention outside of the workplace involving the addict's
family.
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