Intervention (counseling)

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

Interventions have been used to address serious personal problems, including alcoholism, compulsive gambling, drug abuse, compulsive eating and other eating disorders, self harm and being the victim of abuse.

Direct and indirect interventions

Interventions are either direct, typically involving a confrontational meeting with individual in question, or indirect, involving work with a co-dependent family to encourage them to be more effective in helping the individual.

There are four major models of intervention in use today: the Johnson Model, the Arise Model, the RAAD Model and the Systemic Family Model.

The use of interventions originated in the 1960s with Dr. Vernon Johnson. The Johnson Model was subsequently taught years later at the Johnson Institute. It focuses on creating a confrontation between a group of supporters and the addict in order to expose the addict to the consequences of their addiction. The confrontation serves to precipitate a crisis in the addict's life that is not threatening, damaging, or fatal, and is used to compel them into treatment before they are able to suffer irreparable social or physical damage as a result of their disease.[1]

The Arise Intervention Model involves exposing the addict and their family members to a collaborative intervention process. Rather than being confrontational, the Arise Model is invitational, non-secretive, and a gradually-escalating process.[2]

The RAAD model focuses on using positive psychology and setting up the scene and removing barriers prior to the actual in person intervention. It uses Active listening and open ended questions in a sales process that puts the client in the drivers seat to make an educated decision. The process is quicker (5 hours) and creates less resistance on the part of the client. [3]

The Systemic Family Model may use either an invitational or confrontational approach. It differs from the Johnson Model in that the focus is on fostering a patient, firm coaching instead of creating a negative confrontation.[4] Rather than focusing on the addict, the interventionist fosters discussion with the entire family on how their behavior contributes to the addict’s continued abuse of substances, and how to approach the problem as a family unit.[5]

While some interventionists will prescribe to one of the above models over the others, many are able to blend the three models based on what will be most effective for the addict and their family.

Plans for direct intervention

Plans for an intervention are made by a concerned group of family, friends, and counselor(s), rather than by the drug or alcohol abuser. Whether it is invitation model or direct model, the abuser is not included in the decision making process for planning the intervention. A properly conducted direct intervention is planned through cooperation between the identified abuser's family or friends and an intervention counselor, coordinator, or educator. It is important to perform the intervention in an open, large space so as to reassure the abuser that they are not trapped or cornered. Ample time must be given to the specific situation; however, basic guidelines can be followed in the intervention planning process. (An intervention can also be conducted in the workplace with colleagues and with no family present.)

Prior preparation

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

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

Effectiveness

There are questions about the long-term effectiveness of interventions for those addicted to drugs or alcohol. A study examining addicts who had undergone a standard intervention (called the Johnson Intervention) found that they had a higher relapse rate than any other method of referral to outpatient Alcohol and Other Drug treatment.[6] "The Johnson Institute intervention entails five therapy sessions that prepare the client and his or her family members for a family confrontation meeting."[7]

One study compared Community Reinforcement Approach and Family Training (CRAFT), Al-Anon facilitation therapy designed to encourage involvement in the 12-step program, and a Johnson intervention and found that all of these approaches were associated with similar improvements in concerned significant other functioning and improvements in their relationship quality with the addict. However, the CRAFT approach was more effective in engaging initially unmotivated problem drinkers in treatment (64%) as compared with the Al-Anon (13%) and Johnson interventions (30%).[8]

Civil liberty and forcible intervention

Sometimes direct interventions involve physical force (for example, by family members or friends) to capture or confine the targeted person. In such cases the intervention may be illegal because it deprives the person of liberty without due process of law.

In popular culture

Real-life interventions

Film and television
  • The A&E television series, Intervention, follows participants who have addictions or other mentally and/or physically damaging problems, in anticipation of an intervention by family and/or friends. Each participant is given a choice: go into rehabilitation immediately, or risk losing contact, income, or other privileges from the loved ones who instigated the intervention.
  • The Bravo TV reality show, Thintervention, follows American fitness trainer Jackie Warner as she helps a group of eight clients lose weight. Warner's clients receive psychological, nutritional, and lifestyle counseling in addition to physical fitness training.
Literature
  • Faye Resnick reveals in the book Nicole Brown Simpson: The Private Diary of a Life Interrupted (1994), which she co-wrote with Mike Walker, gossip columnist for The National Enquirer,[9] that she learned about Brown's murder three days after Brown and her friends forced Resnick to enter a rehab clinic for drug and alcohol abuse.[10]

Fictional interventions

Film and television
  • In the "Private Practice" episode "Who We Are" (Season 5, Episode 8), the Seaside Wellness group stages an intervention for a defensive and volatile Amelia, who has resurfaced after disappearing on a 12-day drug binge with her boyfriend, Ryan. During the intervention, Amelia mercilessly attacks her friends one-by-one, and Addison, in particular, has trouble seeing her sister-in-law in her present condition.
  • In The Sopranos episode, "The Strong, Silent Type" (Season 4, Episode 49), Tony Soprano organizes a drug intervention for heroin addict, Christopher Moltisanti.
  • In the How I Met Your Mother episode, "Intervention" (Season 4, Episode 4), different interventions happen for various reasons, like magic for Barney Stinson, the English accent for Lily Aldrin, spray tan for Robin Scherbatsky, Marshall Eriksen's Seussian hat and Ted Mosby's fiancé. These are all accompanied by the character in question entering the apartment and finding the rest of the group standing underneath a banner which reads Intervention. As the interventions themselves become increasingly overdone and ridiculous, the group decide to stage and 'intervention intervention' to stop the practice. However, a number of subsequent episodes have reused the intervention banner and motif as a running gag, often when a character behaves ridiculously or obsessively.
  • In The Office (US) episode “Moroccan Christmas” (Season 5, Episode 83), Meredith’s coworkers arrange an intervention about her drinking after her hair catches fire due to her drunkenness. Afterward, Michael attempts to force her to enter rehab, only to find that he cannot legally do so.
  • In the Arrested Development Pilot, the Bluth family arranges an intervention for Michael, which he found to be more of an imposition.
  • The comedy film But I'm a Cheerleader is about a high-school girl that is sent to a residential inpatient reparative therapy camp to cure her "lesbianism".
  • In the Are you there, Chelsea? episode, "The Foodie" (Season 1, Episode 10), Chelsea's friends arranges an intervention for her.
  • In the Seinfeld episode, "The Pez Dispenser" (Season 3, Episode 14), Jerry hosts an intervention for an old friend with a drug problem.
  • In the Family Guy episode, "Screams of Silence: The Story of Brenda Q" (Season 10, Episode 3), Glenn Quagmire hosts an intervention for his sister Brenda who refuses to acknowledge her boyfriend Jeffrey Fecalman's domestic violence.
  • A Season 5 episode of It's Always Sunny in Philadelphia centres on the gang's attempt to stage an intervention on Frank because they feel it's no longer fun to drink with him.
  • In an episode of The Big Bang Theory, Leonard, Penny, Wolowitz and Koothrapali stage an intervention in order to force Sheldon (who doesn't drive) to get his learner's permit because they are all tired of having to drive Sheldon everywhere he wants to go.
Literature
  • There is a good-humoured account of a well-meant but perhaps misplaced intervention in Jayne Ann Krentz's All Night Long. The family of the protagonist (Luke) want him to abandon his "destructive" writer-lifestyle and return to the family business. Irene, his new partner, only learns of the intervention at breakfast, after it has already begun.
  • In James Joyce's short story "Grace", from his collection Dubliners, the alcoholic Tom Kernan is confronted by three of his friends and persuaded to take part in a religious retreat.

See also

References

Notes
  1. ^ "What is the Johnson Model? | Association of Intervention Specialists". www.associationofinterventionspecialists.org. Retrieved 2016-03-04.
  2. ^ "About ARISE Network". Drug and Alcohol Family Intervention | Arise. Retrieved 2016-03-04.
  3. ^ "The Addictions Academy ® - 800-706-0318 - New York - LA - Miami". The Addictions Academy ® 800-706-0318. Retrieved 2018-12-07.
  4. ^ "What is an intervention? - Southworth Associates - Drug and Alcohol Rehab Interventions". southworthassociates.net. Retrieved 2016-03-04.
  5. ^ "Intervention Techniques and Models - Intervention Support". Intervention Support. Retrieved 2016-03-04.
  6. ^ Loneck, Barry; Garrett, James A.; Banks, Steven M. (1996). "The Johnson intervention and relapse during outpatient treatment". American Journal of Drug and Alcohol Abuse. 22 (3}date=1996-08): 36. doi:10.3109/00952999609001665.
  7. ^ Miller, William R.; Meyers, Robert J.; Hiller-Sturmhöfel, Susanne (1999). "The Community-Reinforcement Approach" (pdf). Alcohol Research and Health. 23 (2).p. 119
  8. ^ Miller, William R.; Meyers, Robert J.; Tonigan, J. Scott (1999). "Engaging the unmotivated in treatment for alcohol problems: A comparison of three strategies for intervention through family members". Journal of Consulting and Clinical Psychology. 67 (5): 688–697. doi:10.1037/0022-006x.67.5.688.
  9. ^ Faye D. Resnick with Mike Walker (October 1, 1994). Nicole Brown Simpson: The Private Diary of a Life Interrupted (2nd ed.). Dove Books. ISBN 978-1-55144-061-3.
  10. ^ David Ehrenstein (January 22, 1995). "LA Times Book Review: All About Faye". LA Times.

External links

Al-Anon/Alateen

Al-Anon Family Groups is a "worldwide fellowship that offers a program of recovery for the families and friends of alcoholics, whether or not the alcoholic recognizes the existence of a drinking problem or seeks help."Alateen "is part of the Al-Anon fellowship designed for the younger relatives and friends of alcoholics through the teen years".

Alcoholics Anonymous

Alcoholics Anonymous (AA) is an international mutual aid fellowship with the stated purpose of enabling “its members to stay sober and help other alcoholics achieve sobriety." It was founded in 1935 by Bill Wilson and Bob Smith in Akron, Ohio. With other early members, Wilson and Smith developed AA's Twelve Step program of spiritual and character development. AA's initial Twelve Traditions were introduced in 1946 to help the fellowship be stable and unified while disengaged from "outside issues" and influences.

The Traditions recommend that members remain anonymous in public media, altruistically help other alcoholics, and that AA groups avoid official affiliations with other organizations. They also advise against dogma and coercive hierarchies. Subsequent fellowships such as Narcotics Anonymous have adapted the Twelve Steps and the Twelve Traditions to their respective primary purposes.The first female member Florence Rankin joined AA in March 1937, and the first non-Protestant member, a Roman Catholic, joined in 1939. The first Black AA group was established in 1945 in Washington DC by Jim S., an African-American physician from Virginia. AA membership has since spread internationally "across diverse cultures holding different beliefs and values", including geopolitical areas resistant to grassroots movements. Close to two million people worldwide are estimated to be members of AA as of 2016.AA derives its name from its first book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered From Alcoholism usually referred to as the Big Book.

Calix Society

The Calix Society is an organization in the United States founded in the 1940s which aims at addressing the particular spiritual needs of Catholics recovering from alcohol addiction. It affiliates closely with Alcoholics Anonymous, and believes in the effectiveness of the twelve-step program, but focuses on enabling Catholics who may have abandoned or neglected their faith during active alcoholism to return and have the fellowship of other Catholics in recovery. It promotes total abstinence for those in recovery, taking inspiration from Matt Talbot, and is concerned with the spiritual development and the sanctification of the whole personality of its members. The organization's motto is "substituting the cup that stupifies for the cup that sanctifies". The group has expanded since the 1940s to have active groups in 19 US states and in the UK.

Children's Aid Society (Ontario)

Children's Aid Societies (CAS) in Ontario, Canada, are separate, independent organizations which have each been approved by the Ontario government's Ministry of Children and Youth Services to provide child protection services. The declared goal of CASs is to "promote the best interests, protection and well being of children".Their principal goals are to:

investigate reports or evidence of abuse or neglect of children under the age of 18 or in the society's care or supervision and, where necessary, take steps to protect the children

care for and supervise children who come under their care or supervision

counsel and support families for the protection of children or to prevent circumstances requiring the protection of children

place children for adoption

The societies receive funding from, and are under the supervision of the Ontario Ministry of Children, Community and Social Services. However, they are regarded as a Non-governmental organization (NGO), which allows CASs a large degree of autonomy from interference or direction in the day-to-day running of the Societies by the Ministry. There are There are 49 children's aid societies across Ontario, including 11 Indigenous societies. An oversight body known as The Child and Family Services Review Board exists to investigate complaints against a CAS and maintains authority to issue orders against the Societies.

Deprogramming

Deprogramming refers to measures that claim to assist a person who holds a controversial belief system in changing those beliefs and abandoning allegiance to the religious, political, economic, or social group associated with the belief system. The dictionary definition of deprogramming is "to free" or "to retrain" someone from specific beliefs. Some controversial methods and practices of self-identified "deprogrammers" have involved kidnapping, false imprisonment, and coercion, which have sometimes resulted in criminal convictions of the deprogrammers. Some deprogramming regimens are designed for individuals taken against their will, which has led to controversies over freedom of religion, kidnapping, and civil rights, as well as the violence which is sometimes involved.

Eastern Oregon Correctional Institution

The Eastern Oregon Correctional Institution is one of 14 state prisons in Oregon, United States. The prison is located in Pendleton, Oregon. The facility was originally built in 1913 as the Eastern Oregon State Hospital, a hospital for long-term mental patients, but was converted into a prison in 1983. In addition to providing confinement housing, food service, and medical care, the correctional facility offers education, vocational training, and work opportunities within the prison. Inmates at the Eastern Oregon Correctional Institution produce Prison Blues garments, an internationally marketed clothing line.

Educational psychology

Educational psychology is the branch of psychology concerned with the scientific study of human learning. The study of learning processes, from both cognitive and behavioral perspectives, allows researchers to understand individual differences in intelligence, cognitive development, affect, motivation, self-regulation, and self-concept, as well as their role in learning. The field of educational psychology relies heavily on quantitative methods, including testing and measurement, to enhance educational activities related to instructional design, classroom management, and assessment, which serve to facilitate learning processes in various educational settings across the lifespan.Educational psychology can in part be understood through its relationship with other disciplines. It is informed primarily by psychology, bearing a relationship to that discipline analogous to the relationship between medicine and biology. It is also informed by neuroscience. Educational psychology in turn informs a wide range of specialities within educational studies, including instructional design, educational technology, curriculum development, organizational learning, special education, classroom management, and student motivation. Educational psychology both draws from and contributes to cognitive science and the learning sciences. In universities, departments of educational psychology are usually housed within faculties of education, possibly accounting for the lack of representation of educational psychology content in introductory psychology textbooks.The field of educational psychology involves the study of memory, conceptual processes, and individual differences (via cognitive psychology) in conceptualizing new strategies for learning processes in humans. Educational psychology has been built upon theories of operant conditioning, functionalism, structuralism, constructivism, humanistic psychology, Gestalt psychology, and information processing.Educational psychology has seen rapid growth and development as a profession in the last twenty years. School psychology began with the concept of intelligence testing leading to provisions for special education students, who could not follow the regular classroom curriculum in the early part of the 20th century. However, "school psychology" itself has built a fairly new profession based upon the practices and theories of several psychologists among many different fields. Educational psychologists are working side by side with psychiatrists, social workers, teachers, speech and language therapists, and counselors in attempt to understand the questions being raised when combining behavioral, cognitive, and social psychology in the classroom setting.

Eric Harris and Dylan Klebold

Eric David Harris (April 9, 1981 – April 20, 1999) and Dylan Bennet Klebold (; September 11, 1981 – April 20, 1999) were two American mass murderers who killed 13 people and wounded 24 others on April 20, 1999, at Columbine High School in Columbine, Colorado. They were seniors at the high school. The shooting rampage is known as the Columbine High School massacre. Harris and Klebold committed suicide in the library, where they had killed 10 of their victims.

Intervention theory

In social studies and social policy, intervention theory is the analysis of the decision making problems of intervening effectively in a situation in order to secure desired outcomes. Intervention theory addresses the question of when it is desirable not to intervene and when it is appropriate to do so. It also examines the effectiveness of different types of intervention. The term is used across a range of social and medical practices, including health care, child protection and law enforcement. It is also used in business studies.

Within the theory of nursing, intervention theory is included within a larger scope of practice theories. Burns and Grove point out that it directs the implementation of a specific nursing intervention and provides theoretical explanations of how and why the intervention is effective in addressing a particular patient care problem. These theories are tested through programs of research to validate the effectiveness of the intervention in addressing the problem.In Intervention Theory and Method Chris Argyris argues that in organization development, effective intervention depends on appropriate and useful knowledge that offers a range of clearly defined choices and that the target should be for as many people as possible to be committed to the option chosen and to feel responsibility for it. Overall, interventions should generate a situation in which actors believe that they are working to internal rather than external influences on decisions.

Interventionism

Interventionism may refer to:

Interventionism (politics) is a political term for significant activity undertaken by a state to influence something not directly under its control. It is an act of military, economical intervention that is aimed for international order, or for the benefit of the country. Antonym: Non-interventionism.

Economic interventionism is any activity in a market economy, beyond the basic regulation of fraud, undertaken by a central government in an effort to affect a country's economy.

Interventionism (medicine) is also a medical term in which patients are viewed as passive recipients receiving external treatments that have the effect of prolonging life.

Interventionism (group dynamics) is an activity that functions with conscious and active interferences to improve group/family/individual functioning.

Intervention (counseling) is an orchestrated attempt by one person or many people (usually family and friends) to get someone to seek professional help with an addiction or some kind of traumatic event or crisis, or other psychological problem.

Non-aggression principle

The non-aggression principle (or NAP; also called the non-aggression axiom, the anti-coercion, zero aggression principle or non-initiation of force) is an ethical stance asserting that aggression is inherently wrong. In this context, "aggression" is defined as initiating or threatening any forceful interference with an individual or their property. In contrast to pacifism, it does not forbid forceful defense.

The NAP is considered by some to be a defining principle of libertarianism, especially natural-rights libertarianism. It is also a prominent idea in anarcho-capitalism, classical liberalism, and minarchism.

Oppositional defiant disorder

Oppositional defiant disorder (ODD) is listed in the DSM-5 under Disruptive, impulse-control, and conduct disorders and defined as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness" in children and adolescents. Unlike children with conduct disorder (CD), children with oppositional defiant disorder are not aggressive towards people or animals, do not destroy property, and do not show a pattern of theft or deceit.

Port Authority of New York and New Jersey Police Department

The Port Authority of New York and New Jersey Police Department, or Port Authority Police Department (PAPD), is a law enforcement agency in New York and New Jersey, the duties of which are to protect and to enforce state and city laws at all the facilities, owned or operated by the Port Authority of New York and New Jersey (PANYNJ), the bi-state agency running airports, seaports, and many bridges and tunnels within the Port of New York and New Jersey. Additionally, the PAPD is responsible for other PANYNJ properties including three bus terminals (the Port Authority Bus Terminal, the George Washington Bridge Bus Station and Journal Square Transportation Center), the World Trade Center in lower Manhattan, and the PATH train system. The PAPD is the largest transit-related police force in the United States.

Rape crisis center

Rape crisis centers (RCCs) are community-based organizations affiliated with the anti-rape movement that work to help victims of rape, sexual abuse, and sexual violence. Central to a community’s rape response, RCCs provide a number of services, such as victim advocacy, crisis hotlines, community outreach, and education programs. As social movement organizations, they seek to change social beliefs and institutions, particularly in terms of how rape is understood by medical and legal entities and society at large. There is a great deal of diversity in terms of how RCCs are organized, which has implications for their ideological foundations, roles in their communities, and the services they offer.

In the United States, the National Sexual Assault Hotline (1-800-656-HOPE, operated by RAINN) is a partnership by over 1,100 rape crisis centers.

Sexual Assault Nurse Examiner

A Sexual Assault Nurse Examiner (SANE) is a qualification for forensic nurses who have received special training to conduct sexual assault evidentiary exams for rape victims. SANE nurses are specially trained in the medical, psychological, and forensic examination of a sexual assault victim. There are two different credentials available under the SANE designation: SANE-A for adult and adolescent examiners, and SANE-P, which is specifically for pediatric victims. Not all, but many SANE programs are coordinated by rape crisis centers in place of a hospital. Some programs are employed by law enforcement and conduct their exams at stand alone sites, not in an emergency department (ED). SANEs are on call 24-hours a day and may arrive at the hospital ED within an hour of a sexual assault victim’s arrival. Some programs will wait until the patient has had a medical screening exam (MSE) and subsequently have law enforcement bring a stable patient to the sexual assault response team (SART) site for their exam. If the patient is in critical condition and admitted to the hospital, the SANE can perform a 'mobile exam' and bring their exam supplies and camera to the hospital. In addition to the collection of forensic evidence, they also provide access to crisis intervention counseling, STI testing, drug testing if drug-facilitated rape is suspected, and emergency contraception. A SANE will also supply medical referrals for additional medical care or possible follow ups to document how they are healing.

Telephone counseling

Telephone counseling refers to any type of psychological service performed over the telephone. Telephone counseling ranges from individual, couple or group psychotherapy with a professional therapist to psychological first aid provided by para-professional counselors. In-person therapists often advise clients to make use of telephone crisis counseling to provide the client with an avenue to obtain support outside of therapy if they cannot be reached in an emergency or at the conclusion of a therapeutic relationship.

Wilderness therapy

Wilderness therapy (also known as outdoor behavioral healthcare) is a controversial adventure-based therapy treatment modality for behavior modification and interpersonal self-improvement, combining experiential education, individual and group therapy in a wilderness setting. The success of the Outward Bound outdoor education program in the 1940s inspired the approach taken by many current-day wilderness therapy programs, though some adopted a survivalist methodology. Clients typically range in age from 10–17 for adolescents, and 18–28 for adults.

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