“Clinical interventionists should be experienced therapists, trained to use their skills to navigate the challenging fieldwork we call intervention.”
–Jeff and Debra Jay
Intervention: The Event and The Process
As a foundation for the clinical intervention training and all subsequent advanced trainings, students will explore the complexities of intervention in holistic terms. We will differentiate between intervention as an event and intervention as a process. Intervention as a process occurs before treatment, during treatment, and after treatment. Participants will become skilled in training intervention teams to think differently about intervention, preparing them to take an active role in ongoing recovery. Participants will write intervention team commitment letters.
Assessment, Planning, Ethics
The primary objective is proficiency in assessing appropriateness of intervention as the next step for a family. Proceeding with intervention should occur once the clinical interventionist assesses the situation and is reasonably assured that the subject of the intervention is suffering from an addiction or other disorder appropriate for intervention. The interventionist must determine the following: Is there is an intermediate step the family should take before intervening? Will facilitating an intervention create a worse situation for the family? Does the family have the resources for treatment or can they access services appropriate for the addicted person’s needs? Is the interventionist certain he or she has the skill-set required to handle the issues the case presents? We discuss differences between a private practice model and a business model, and choosing a model that always puts the welfare of the client first. Participants learn ethical practices and proper professional appearance and decorum.
Advanced Negotiation Techniques
Participants become skilled in several different negotiation techniques, including spiritual negotiation, modified hostage negotiation techniques, and the ARC method for answering objections. Spiritual negotiation is based upon empathetic family relationships and a pledge to act with virtue and dignity. We discuss how addiction erodes the integrity of families, friends and colleagues. We examine how intervention restores a family’s integrity. Integrity is defined as taking action according to our principles and commitments. Participants learn to help families self-identify the ways their integrity diminished as enabling progressed. We look at the ways families and friends become dishonest with alcoholics: breaking promises and teaching alcoholics not to trust them. We explore using exercises of self-discovery to help family members identify enabling behaviors and how enabling is used for self-protection. We discuss how these exercises help reduce anger, increase empathy, and solidify the intervention team’s commitment.Participants problem solve the reasons alcoholics and addicts refuse treatment and how to effectively negotiate when faced with the adversarial negotiation style of alcoholics. We explore the types of negotiation styles families typically use and why they almost never work. Participants role play the identified negotiation styles and are trained to transform intervention team members into powerful, effective negotiators called ambassadors.
Understanding the Addicted Brain
Advances in science provide compelling evidence on how addicted brains are changed. Participants learn how the anatomy and function of the addicted brain differs from non-addicted brains. We study the latest research and how to use this information to educate family members: help them overcome myths and misinformation, facilitate a greater understanding of why alcoholics and addicts behave the way they do, and explore why intervention and appropriate levels of support are crucial for successful recovery.
Understanding Changes to the Family Members’ Brains
Participants learn how relationships with alcoholics change the non-addicted person’s brain. We examine learned helplessness, free-floating anxiety, and anger. We discuss how these traits sabotage the intervention process. We take a special look at the brains of children of alcoholics. We teach how to present this information to families in a supportive manner, which will help motivate them to participate in their own recovery process (12-step programs for families and friends). Students learn to negotiate with potential team members who resist involvement or are hostile to the process.
Questioning Our Assumptions
Common myths and misinformation are often stated as fact by some professionals and members of the general public. Participants are asked to challenge their own belief systems. We focus on dismantling action-stopping myths. Participants learn to engage members of intervention teams in the same process. Participants closely examine their communication styles and the unintended messages they send. Participants practice critical thinking skills and identify new ways of communicating.
Building an Intervention Team
The interventionist must be skilled in building an intervention team — and knowing how to turn them into a Recovery Team. Guidance is required on several levels: knowing how to create the right mix of relationships; identifying people by the leverage or influence they bring to the intervention; knowing when someone should not be part of the team; what to do when someone who is not ideal as a team member has a key relationship with the alcoholic; bringing reluctant participants onboard; when and how to involve children; how to include people who cannot be present; including people who cannot speak for themselves; overcoming team disharmony; building team commitment; and intervening when there is no team.
Intervention Team Assessment
Intervention is probably the only time a professional therapist will meet with most – or all – of the significant people in an alcoholic’s life. Family, friends, coworkers candidly sharing their firsthand experiences. This information can be used in multiple ways. First, it provides the interventionist with a clear picture of the problem. Second, students learn how an interventionist can open-up team members who are reluctant to share. Team assessment gives families an opportunity to see the whole picture, perhaps for the first time. This helps solidifies the resolve of team members, especially those questioning the value of intervention. Finally, by documenting the information in a usable form, we can present the treatment team with an intervention team assessment – information gathered from lengthy discussions with as many as 10 or 12 people in the alcoholic’s life. This is information the treatment team would probably not access in any other way. Field materials, developed by Love First Institute, will provide a format for delivering information to treatment centers.
Practical Preparations
Success is in the details. Thorough planning is essential. Last minute snafus give alcoholics reason to refuse treatment. Students brainstorm the practical details that must be completed before facilitating an intervention. We discuss choosing a member of the intervention team to serve as planner – the person who records all the details. An interventionist field manual, developed by Love First Institute, helps organize the interventionist by providing checklists and other guidance.
Team Education
Participants learn to educate families about the disease of addiction and the process of recovery. Students practice active listening, communication skills, and refine their ability to promote fertile discussions that promote learning. Students test their own knowledge and ability to answer the myriad questions a family asks.
Writing Intervention Letters
Participants will learn the 7-point format for writing intervention letters, as presented in the book Love First. Discussions will include what is and isn’t appropriate to include in letters; how to spot hidden anger, blame or resentment; editing letters in a respectful manner; how to write the problem section of a letter when you don’t have first hand experience with the addiction; how to write the love part of the letter if the relationship is badly eroded; coaching families on ways to read letters during the intervention, determining the order team members will read letters, and collecting letters and delivering them to the treatment center.
All participants will be required to write an intervention letter as a homework assignment, preferably to someone they have known personally. Participants will work with one another to help them review and edit their letters. All participants will share their letters with their breakout group, talk about the process of writing it and ask for feedback. Participants will make changes to their letters based on group suggestions. Each breakout group will select one letter to share with the entire group. As a group, we will discuss the experience of writing letters, whether it matched their prior expectations and how the process affected them. We also share letters from actual interventions.
Brainstorming Objections
Participants are taught to think of objections as escape routes created by the addiction. Breaking into groups, participants are given case studies and asked to brainstorm all possible objections. They will determine the best ways to address each objection. Participants develop strategies to prevent the alcoholic from forcing the team into a defensive position.
Participants problem solve how to negotiate with alcoholics who refuse treatment, but do not vocalize objections. We discuss silent objections – objections the alcoholic is thinking but not saying. Participants are required to identify negotiation strategies to use when alcoholics use stall tactics or aren’t interested in reasonable problem solving. Additionally, we address objections too big to overcome and when to postpone an intervention. Finally, participants explore the art of knowing when it’s time to end a negotiation and use the bottom lines. Participants will be asked to defend their decisions orally.
Writing Bottom Lines
Bottom lines require answering 2 questions: How have I enabled the addiction in the past and am I ready to stop that behavior? How am I going to begin taking care of myself? Each participants writes a bottom line for someone they know, and then write a second bottom line using a sample case. Participants learn that bottom lines are not punishments, but an effective and loving way families communicate their decisions should the alcoholic refuse treatment.. Participants explore bottom lines as promises the family members are making to themselves as well as to the alcoholic.
Each participants is asked to test his or her bottom line by discussing willingness to follow through. If it’s determine he or she might not follow through, they rewrite their bottom line, selecting a bottom line they can honor. Participants learn to define bottom lines as sacred promises.
We explore writing bottom lines when someone doesn’t have leverage or first hand knowledge of the addiction. Each bottom line is a call to action designed to help the alcoholic clearly understand decisions made by each member of the team.
In breakout groups, participants read bottom lines and ask for feedback. They make changes based on group suggestions. We ask participants to share their experience of writing their bottom lines. What did they learn about themselves? We share bottom lines from actual interventions.
The Intervention Rehearsal
Participants learn to prepare all details required for a successful intervention rehearsal. Using letters, objection preparation and bottom lines, the breakout groups role-play the rehearsal. The planner goes over all details to be sure planning is complete. Participants learn the 4 segments of a rehearsal. Seating arrangements and letter order are determined, and students orally explain their rationale. Participants learn breathing exercises for reducing anxiety, bi-lateral calming techniques, and what to do if a letter reader is overwhelmed with emotion. We examine how to prepare intervention teams for unexpected events. After the rehearsal, students determine if any changes are necessary and discuss, as a group, the rehearsal experience.
The Intervention
This is a role-play experience. Each participants gets an opportunity to act as family member and as interventionist. Participants are given scripts as a guides. Scripts are written to mimic actual interventions, providing a sense of uncertainty and the unexpected. After role-playing, participants evaluate themselves and go through a peer review within their breakout groups. Each participants completes a self-evaluation form. Instructors offer feedback.
Understanding and Preparing for the Treatment Process
Most families see the intervention as the end of the process. Intervention, at it’s best, has an expanded role: it’s necessary to help families understand that intervention is an ongoing process. Once an addict is in treatment there are new challenges. Participants are asked to determine how to help families prepare for the treatment process. What are the possible objections to treatment? How can we respond to treatment objections? What if our loved one wants to leave against staff advice? What if they refuse to sign a release of information?Which team member is most easily manipulated by the alcoholic? How do we prevent manipulation? How do we continue working as a team? How do we communicate with the treatment team? What do we do if the addict refuses to sign releases? How are our intervention letters and bottom lines used in treatment? What is the interventionists role during treatment? What does a day in treatment typically look like? How can the family support a loved one in treatment? How does the family communicate the alcoholic: what’s good and what’s bad?
Understanding and Preparing for Structured Family Recovery®
Structured Family Recovery® is a comprehensive methodology presented in the book, “It Takes a Family,” by Debra Jay (2nd edition, 2021). Previously, interventions were focused on getting the subject into treatment. However, this strategy means the intervention team has an expiration date. By taking a larger view of intervention and broadening the goal to bring the entire family into recovery, we increase the support available for our beloved addict, decrease the likelihood of relapse and increase our chances for long-term recovery. Building an effective Recovery Team is part of the modern Love First intervention process.
Understanding and Preparing for Continuing Care
Everyone benefits when the family is properly prepared for continuing care recommendations. Participants learn to effectively explain different levels of aftercare and reasons why they are recommended. The interventionist needs to know how to discuss aftercare planning with both the family and the counselor at the treatment center. Today, most counselors welcome some input from the interventionist. The interventionist has information the counselor may not know, such as the finance restrictions of the family, what services are available locally, the degree of support provided by the intervention team. Bottom lines can be use to support aftercare recommendations. Participants brainstorm how to supply information to counselors and, when necessary, educate the counselor on using the families’ bottom lines, or by inviting members of the team to participate in conflict resolution.
Understanding and Preparing for Twelve Step Recovery
Each participants is expected to be personally knowledgable about the 12-steps and Alcoholics Anonymous. Each student explains A.A. to a mock family group in a role-play. They also answer family member questions. Important points of discussion are sponsorship, what it means to work a program of recovery, service work, home groups, different types of meetings and sobriety anniversaries. Myths about A.A. are debunked as well as learning to responding effectively to anti-AA rhetoric.
Intervening on Special Populations
Participants learn guidelines and techniques for intervening on people in special populations, such as adolescents, older adults, impaired professionals, and ethnic populations.
Intervention and Co-occurring Disorders
Participants explore intervening on individuals suffering from co-occurring disorders: mental illness, eating disorders, compulsive gambling, sex addiction, compulsive spending. We also discuss aging issues such as asking an older relative to relinquish his or her driver’s license. Students learn different skills necessary for intervening on various disorders and evaluate their clinical capabilities.
Intervention and Chronic Pain
Participants learn how to effectively intervene on an addict who claims to be suffering from chronic pain. We focus on educating the family about chronic pain, addiction and the preferred management methods. We will examine the Pain Management to learn how it works, alternatives to opiates, addicts’ experiences as they progress through the program, and the final results. We will discuss chronic pain, aftercare needs and relapse prevention.
Intervention Result: The Next Steps
Throughout intervention planning and rehearsal, it is the interventionists job to prepare the team for all possible outcomes and appropriate follow-up plans. Participants work in groups to brainstorm various intervention results and choose corresponding plans. Discussions include how to implement methods for keeping intervention teams united. Each breakout group shares 2 scenarios with the training class and then asks for feedback.
Team Cohesiveness Throughout Treatment and Into Recovery
Participants are provided with case studies of different ways intervention teams unravel. For instance, team members who turn against the treatment process and begin supporting the addiction again. In breakout groups, participants problem solve and develop strategies to reunite the team and renew the commitment to recovery.
Relapse and the Intervention Team
Participants collaborate to present ways an intervention team can: a) support relapse prevention and b) quickly move the alcoholic back into treatment after a relapse. We will discuss and write relapse agreements.
Special Considerations: Financial, Team Members, Special Needs
Finding treatment resources is difficult for individuals with limitations or special needs. Interventionists must be resourceful, identifying the right level of support. A common block is financial limitations. Other blocks include cognitive problems, inability to perform daily living tasks, psychiatric instability, hearing or vision impairment, illiteracy, childcare needs. In breakout groups, participants are provided with a sample case and asked to use computers and cellphones to identify appropriate treatment resources, develop a list of questions to ask for evaluating the selected program(s) before recommending it to the family.
Science and Current Research: How to Use It Effectively
Brain scans and other up-to-date research can help move a resistant addict to “yes” on intervention day. Participants discussion revolves around the best ways to use science during an intervention. How can technology help the process?
Family Recovery
Participants learn to educate and motivate families to participate in the recovery process by attending a family program and a 12 step program. We examine how working a program of recovery together can rebuild relationships and create an environment that reduces the probability of relapse. Special attention is given to helping children. Parents and other relatives often discount the effects addiction has on young children. We will strategize how to enlighten family members as well as obtain commitments to enroll children into a program.
Developing a Professional Intervention Practice
Jeff and Debra Jay have built a national intervention practice over the last 30 years. Learn their techniques for connecting to treatment centers, offering added value and using technology to reach out to families and other professionals. Discussion will include: working with admissions departments, building an effective website, marketing and giving back to the community. Jeff Jay will present a special workshop Friday afternoon on building your practice. This workshop is optional, but most participants find it invaluable.
More…
Placing the focus beyond intervention, we explore working with families and treatment teams to develop long-term recovery plans. We also explore how increasing your clinical skill set and the use of technology helps build a private practice.Participants learn how united intervention teams can create accountability for newly recovering alcoholics and addicts. Participants work out problems, which can lead to increased compliance and increased probability of successful sobriety post-treatment. Skill development includes: determine the proper level of recovery support; educate the family on needs associated with ongoing recovery; facilitate communication between the intervention team and the treatment team; assist families in making a commitment to support continuum care recommendations; identify appropriate levels of support within a family’s financial limitations; work through objections to continuing care recommendations; use leverage and influence to overcome an alcoholic or addict’s resistance; develop a relapse agreement between family, the newly recovering person and the treatment team.
Each participants will be asked to write a plan for working with the family, the treatment team and the recovering person that encompasses the continuum of care planning process.
Participants are introduced to a progressive approach for creating a Practice of Excellence. Each student will write a mission statement and a clinical vision for their practice. The goal is to bring excellence and consistency to all aspects of our work.
