Interventions are
not just for those with addiction issues. There are any number of reasons why
this may be a good option when a persons’ behavior is a threat to themselves or
others and they are in denial about it. Some examples: not taking medications;
living in an abusive relationship; inability to manage one’s life due to
illness and/or age; driving when they shouldn’t be.
Consider this
approach when talking to the person hasn’t worked and if the behavior, left
unchecked, will have negative consequences.
It is important to
recognize that a well-planned intervention can work quite well in helping
someone make better choices about their life. A poorly planned one can end up
with the person feeling attacked, isolated and may actually accelerate the
undesirable behavior.
What is an Intervention: After careful planning, an individual is
approached by a group of people that:
• Agree that a
specific behavior needs to change
• Provide
specific examples of destructive behavior and its negative impacts on self,
family, friends, work environment etc.
• Outlines a
pre arranged plan with steps, goals and guidelines as well as consequences if
they refuse to change.
Planning the Intervention: An individual or several individuals who
recognize the need for the intervention, meet with qualified professionals who
can help with the planning and give guidance. This can include: medical team;
condition specific organization (e.g. Parkinson’s Disease Foundation),
counselor, social worker, therapist, religious leader, or an
interventionist. As part of this
process:
- Gather information about the extent of the
person’s problem(s)
- Work with a condition specific group to help
identify resources and what approaches have been tried with people in similar
situations. For example-The local aging service can help with aspects of
planning an intervention with an elderly parent who should no longer be living
alone.
The Intervention Team: It’s a good idea to have a mix of family,
close friends and nonfamily. Often the
person has already heard from their immediate family about their behavior and
they’ve tuned it out. However, hearing from friends, community members,
co-workers etc. all at once can be the surprise that helps them accept the need
to change. Non family can help to diffuse the anger, resentment or sense of
betrayal someone can be experiencing as well as making sure the intervention
stays focused on the facts and shared solutions. If the individual has a history
of serious mental illness, violence, suicidal behavior and/or is taking drugs,
it’s important that a professional be part of the intervention team.
Team members need to
agree to the behavior change required, the plan itself, be willing to implement
consequences and are willing to attend rehearsals.
Write a Script, Rehearse and Stick to It: Knowing what people are going to say and in
what order is important. Sometimes a young child might be asked to speak first
to set the tone. Keep in mind if a child is going to be involved, they may only
need to do their part and then be excused. In addition to identifying concerns,
not arguments, and a plan for dealing with the problem, scripts should let the
person know they are loved and cared about; appreciated for what they’ve done
and are doing; that you are there for them; the proposed plan will work; and
things can improve. An example of a proposed script/letter is from a friend to a
Mom who refuses to stay on her medications:
- Statement of love and concern: I am here today because I love you and want
you to be healthy.
- Specific examples that illustrate the
destructive behavior: You couldn’t get out of bed for the last
three days to take care of your children because you have been off your
medication.
- A plea for the person to get help: You can have a much healthier life, and be
the exceptional Mom I know you are and want to by taking your medication as the
doctor prescribed it.
- Consequences if the behavior doesn’t stop: If you wont take your medication, I will
have to report you to social services for neglect of your children.
Note that these
letters can be left with the person after the intervention and can serve as
important reminders.
Part of the team’s
script will include who will do what if the person is ready to make the change.
The more concrete the better. For example: Mom agrees that she can no longer
live alone. The plan outlines:
• Date when Mom
moves into the apartment attached to her son’s house.
• A schedule of
dates and times when family/friends will help with packing.
• Date by which
her daughter will have the house listed with a realtor and any items left
disposed of.
While the number of
times you need to rehearse depends on the situation and the nervousness of team
members, it usually requires a minimum of two rehearsals. If someone is unable
to attend these sessions, it’s best to find a replacement. Role-play to prepare
for anger, argumentative behavior. Stick to the script during the intervention
because changing it can throw other members of the team for a loop and derail
the process.
Setting the date, time and place for the
Intervention: Use a private
but “formal” spot to hold the meeting.
The person’s home is not the best option as they can easily retreat to a
bedroom or bathroom, and it’s also likely that this has been the scene for many
heated discussions. Using a neutral space such as a therapist’s office,
conference room, church or community center, it’s a lot harder for people to
simply walk out and hide. Depending on the person, pick the time of day they
function best.
The Intervention: Keep it brief, no longer than 60-90 minutes. During the intervention:
- Avoid yelling, screaming, physical violence, shame,
blame and guilt trips.
- Stick to the facts and don’t argue with them.
- Use the script and don’t deviate if at all
possible.
- Be prepared to carry out outlined steps or
consequences at the close of the meeting.
Follow up: The plan developed prior to the intervention should outline steps for
follow up. If they are not willing to make the change, you need to stay
committed to consequences.
Resources
