“Clinical interventionists are 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
Intervention Team Assessment
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.
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.
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
Understanding and Preparing for Continuing Care
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?
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 20 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.
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.