Methods of Intervention in Alcoholism

With the growing burden of alcohol abuse on health systems globally contributing to more than three million deaths annually[1], it’s no surprise there’s a need for increased access to brief alcohol interventions.

An intervention usually occurs when a person’s alcohol use becomes a cause for concern or danger. Alerted to warning signs of the increased alcohol consumption harming the person’s life, family and friends may choose to mediate with an intervention.

Generally, an alcohol intervention is a professionally led pre-organised meeting for the friends and family of an alcoholic to discuss their worries, in a supportive and constructive manner. The main objective of the intervention is to allow the individual to understand that they have a problem and encourage them to seek proper addiction treatment.

Brief Interventions

A brief intervention refers to a quick, evidence-based, structured conversation about alcohol consumption. The aim is to motivate and support the person to consider the harmful impact alcohol may have on their lives, encouraging a change. Practitioners use various tools designed to establish a patient’s level of risk to alcohol harm, focusing on a personalised, supportive, and non-judgemental approach. [2]

Growing in popularity with the support system, brief intervention and brief therapy techniques are increasingly used as an essential tool to treat substance abuse problems. [3] Brief interventions help reduce the risk of alcohol misuse negatively affecting the person’s health. Similarly, this technique reduces the risk of accident, violence, financial ruin, family issues and problems with work or school.

However, the collective goal of brief alcohol interventions is to reduce drinking to the suggested low-risk patterns and levels and not necessarily encourage abstinence. [4]

How to Stage an Intervention?

Alcohol intervention usually involves several stages, outlined below:

1. Planning an Intervention

An intervention should never occur without adequate planning, forethought and consideration of the individual’s personality and circumstances. Therefore, the intervention should always be done in planning sessions. Sessions allow participants to decide on general goals, expectations, and the time and place of the intervention. GP’s, social workers, and therapists can aid in the organisation of these sessions.

Interventions are known to be dramatic, upsetting and emotionally charged. The person with the alcohol problem can see this intervention as an attack, no matter how supportive and kind their loved ones appear. Try to remember that the problem drinker may be addicted and faced with a compulsion no longer under their control.

Enlisting a healthcare professional in the planning stage will teach you how best to respond to these situations. Depending on the model of intervention used, the person with the alcohol use disorder is sometimes part of this initial planning stage through to the actual intervention.

2. Who’s Involved in an Intervention?

During these planning sessions, you’ll want to determine who will take part in the intervention. The following people will usually be involved:

  • The person with the addiction. Don’t be surprised if the person concerned refuses to participate or leaves when confronted. This is normal, and several interventions may be required.
  • Loved ones: The leader of the intervention is usually determined by the relationship to the person. When concerning a child, a parent typically leads the intervention team. If married or in a relationship, the spouse or a parent usually leads.
  • To increase the chances of success for the intervention, it’s vital to enrol a professional interventionist or mental health provider whose speciality is to treat addictive behaviours.
  • The person confronted may find living with an alcohol problem very isolating and frightening. However, if conducted correctly, the sight of numerous friends and family rallying around to support the alcoholic will hopefully fill them with optimism and drive them to address their drinking problem. First, however, you must approach the intervention from an angle of support and caring.

3. During an Intervention

You will probably find that the first intervention results in the person lashing out emotionally, rejecting the statements of concern or denying that they have a problem. The person with an alcohol problem may even walk away.

It’s best to meet this expected behaviour with the truth about the seriousness of the situation and the consequences of not taking part. For example, you could reiterate the potentially harmful effects of losing their job, children, relationship or marriage, car, home and even loved ones.

Once the person with the alcohol problem admits to discussing their drinking, everyone in the intervention team will have the opportunity to speak and share. This is essential in helping the alcoholic to truly understand and appreciate the concerns and feelings of their friends and family. This step is vital and will help the person appreciate the concerns over their health and well-being.

4. Staging an Intervention

An intervention should never be staged without a treatment plan suited to the individual’s needs and circumstances. When everyone has had a chance to share, the alcoholic should be presented with realistic and detailed recommendations for a treatment plan.

Unfortunately, it’s out of your hands after this, as the person with the alcohol problem will either accept the offer of help or may need some time to think things over.

The Different Models of Intervention

Interventions are more complicated than you might think, with several different approaches suited to the individual’s needs.

Below, we outline each of the main models of addiction intervention:

1. The Simple Intervention

A more personal approach is sometimes all that is needed. Sometimes all the loved one needs to do is share their concerns and offer support on a one-on-one basis, alone or with a professional interventionist. This can be more effective than arranging an extensive intervention.

2. The Systematic Family Approach

The family system intervention model refers to an intervention group consisting of family members and relies on the “family frameworks” hypothesis and treatment. Not only can this approach help the person with an alcohol problem start the recovery process, but it can also help with dependence and family ties.

Usually, all primary relatives are urged to participate in family guiding and training and allow the individual to see a different side to their families’ intentions and actions.[5]

3. Confrontational Approaches

You might recognise this approach from its popular depiction in movies, TV, and the media. These approaches follow the general intervention method, but in contrast, they attempt to force or coerce the addicted person into recovery. This is usually done without a healthcare professional or professional interventionist present. [6]

Unfortunately, but not surprisingly so, this aggressive approach is infamously ineffective. Moreover, the chance of successful treatment reduces if the problem drinker has been forced into recovery, and not by choice. [7]

4. Classical Approach

Classical intervention is slightly different to the standard intervention, as all parties bar the person with the alcohol problem needs to be present.

The Johnson Model of intervention, known as the first organised substance use disorder intervention model, is an excellent example of this approach. However, this model is relatively aggressive and, following the general rulebook for this approach, does not include the subject in the planning stages.

A reliance on educating and counselling all participants and family members and an honest discussion regarding each family member’s role is paramount. Without this, the intervention can’t begin. Furthermore, this approach is constructive for all participants as support is often provided to the addicted person and family members. Therefore, all participants are prepared for any positive and negative outcomes.[8]

5. The ARISE Model

A Relational Intervention Sequence for Engagement (ARISE) model has a different style to the other alcohol intervention approaches, as it focuses on different planning sessions. In contrast to the above models, this approach includes the person with the alcohol problem in the initial planning stages. Again, in comparison to the above models, this approach uses several meetings instead of one intervention meeting. [9]

The Goal of Alcohol Intervention

When arranging an intervention, it is crucial to remember the true goal of addiction intervention. Total abstinence or immediate admissions to rehab should not always the primary goal. Instead, the key objective of an alcohol intervention is to get your loved one to accept that they need to seek help and treatment.

Although many alcohol interventions end positively, don’t be surprised if yours does not, especially if it’s the first one. The individual may respond aggressively and are likely to disagree that they have a problem or need treatment.

Please remember your loved one can’t commit to treatment if they are forced. They must be fully invested in reaching sobriety for it to work. The final decision ultimately belongs to them, as unpleasant as that might be.