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Addictions: Treating Family Manipulation, Mistrust, & Misdirection
1 CEUs Addictions: Treating Family Manipulation, Mistrust, & Misdirection

Section 2
Intervention on Addiction Affected Families

Question 2 | CE Test | Table of Contents | Addictions CEU Courses
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

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On the last track, we discussed the five different negotiation styles found in the families of addicts: Adversaries, aggressors, appeasers, avoiders, and analysts, as well as the constructive form of negotiation, the ambassador.

On this track, we will discuss preparing for a structured family intervention by discussing four key considerations. These are, the addict should not be forewarned of the intervention, many clients need to be reminded that the addiction, not the addict, is the adversary, family members need to learn skills for an intervention, and possible complications might require additional professional help.

As you know, a structured family intervention is ideal for a family that wants to take action against the addiction quickly and precisely. A structured intervention aims for immediate results. About 85 percent of family interventions motivate the addict to accept treatment the same day. Most of the remaining 15 percent eventually admit themselves within days or weeks. Only a small percentage resist treatment entirely.

As you know, family intervention is a team effort, but I find that some family members are resistant to working as a group. Andrew, 37, firmly opposed his family’s plan to intervene with his brother Robert, who was addicted to methamphetamine. He insisted that he would be able to convince Robert to get into a treatment program by himself. Andrew went to Robert’s apartment by himself, and with no firm plan, and tried to initiate a conversation about Robert’s addiction. 

When he realized Robert was not going to cooperate with him, he blurted out, "I’m doing you a favor! If you don’t get it together, the whole family is going to march in here and do an intervention!"  By doing this, Andrew not only failed to get Robert into treatment, he undermined the family’s plans and set everyone back.

4 Key Considerations for an Intervention

# 1 - The Addict Should Not be Forewarned of the Intervention
First, some family members will want to tell the addict that the family is planning an intervention. As you are aware, this is not a good strategy, as forewarning the addict gives them a chance to prepare for a fight. Do you have a client who needs to be reminded that in an intervention, we use surprise not as a deception, but as a way to disarm the disease of addiction?

# 2 - The Addiction, not the Addict, is the Adversary
Second, I have found that many clients need to be reminded that in an intervention, the addiction, not the addict himself, is the adversary. I ask these clients to visualize the addict as a hostage who has been brainwashed by his captors, who no longer can tell his rescuers from his captors. Thus, the addict does not know he needs saving. Intervention is a strategic ‘rescue plan’ designed to subdue the addiction long enough to convince the addict that his family is there to help. I also remind these clients that intervention is, essentially, an act of love.

# 3 - Learn Skills for an Intervention
Third, In my experience, it is important that family members learn the skills needed for an intervention before they attempt one. The families of addicts are used to coming up with their own solutions to the problems caused by addiction, and are often resistant to learning new information.

Rather than initially recommending professional interventionists to resistant clients, I ask them to consider what kind of help they need. Although most families involve a professional in their intervention, some are able to conduct fully successful interventions on their own by using guidebooks and other resources. The key is not what resources are used, but the family’s willingness to complete all the necessary preparations.

# 4 - Complications might Require Professional Help
Fourth, though many families of capable of proceeding with an intervention on their own, a family facing complications with the addiction needs professional help. If your client is dealing with an addict who is threatening suicide, has a history of mental illness, violent or abusive behavior, severe depression, or prior treatments followed by relapse, they are in need of professional help. The skills of a professional are also needed when an imminent crisis means there is no time for the family to prepare on their own. I also strongly recommend a professional interventionist when family relationships have become badly deteriorated. A professional can possibly help unite family members who are unwilling to combat the addiction.

If my client needs help, but is incapable of paying for a professional interventionist, I recommend that they seek the help of  their pastor, priest, rabbi, or other clergy. Other potential sources of help are a former coach or teacher, a colleague, a highly respected friend, or a recovering addict from the community. I have found that often, someone from outside the immediate family can command a level of respect from the addict that members of the immediate family cannot.

I find that some family members are highly resistant to intervention because of their ideas about conflict. Some honestly believe that conflict always leads to an end to a relationship. Family members of addicts are used to ‘no problem’ households; they deal with differences and conflict  by ignoring, denying, avoiding, giving in, coercing, forcing, or giving up. For these individuals, dealing with addiction through an intervention may seem terrifying.

3-Question Conflict Coping Exercise
Remember John and Betty from the last track? As they and their family prepared for an intervention with their cocaine-addicted son Ben, I introduced the Conflict Coping exercise to them. This exercise consists of three questions:

-- Question # 1
First, I asked John and Betty to think about how they usually reacted to conflict. I asked, "Do you usually give in? Do others usually give in to you? Do you avoid conflict by denial or ending relationships?" John and Betty agreed that they usually gave in to Ben.

-- Question # 2
The next question in the exercise concerns power plays. I asked John and Betty, "Have you ever gotten into power plays, trying to force the other person into behaving the way you want? How has this worked? Are you in a relationship with someone who tries to control you through power plays?" Betty answered, "When Ben says he won’t talk to us anymore if we do an intervention… that’s a power play, isn’t it?"

-- Question # 3
Finally, I asked John and Betty to think about times they had successfully negotiated conflict; times when both parties have entered into negotiations that resolve the conflict in a mutually acceptable way. I then asked them to think about how those conflicts felt, and what attitudes and behaviors they displayed. John and Betty were able to describe numerous conflicts with their two daughters that were resolved successfully. By asking John and Betty to reflect on conflicts they had handled successfully, I reminded them that some conflicts can be resolved in a mutually satisfactory way.

On this track, we have discussed preparing for a structured family intervention by discussing four key considerations. These are, the addict should not be forewarned of the intervention, many clients need to be reminded that the addiction, not the addict, is the adversary, family members need to learn skills for an intervention, and possible complications might require additional professional help.

On the next track, we will discuss the first five steps in making an intervention checklist: building a team, setting up a planning meeting, choosing a team chairperson, discussing the negative consequences of the addiction, and listing ways family members have unwittingly enabled the addiction.

Peer-Reviewed Journal Article References:
Acheson, A., Vincent, A. S., Cohoon, A., & Lovallo, W. R. (2019). Early life adversity and increased delay discounting: Findings from the Family Health Patterns project. Experimental and Clinical Psychopharmacology, 27(2), 153–159.

Ariss, T., & Fairbairn, C. E. (2020). The effect of significant other involvement in treatment for substance use disorders: A meta-analysis. Journal of Consulting and Clinical Psychology, 88(6), 526–540.

Church, S., Bhatia, U., Velleman, R., Velleman, G., Orford, J., Rane, A., & Nadkarni, A. (2018). Coping strategies and support structures of addiction affected families: A qualitative study from Goa, India. Families, Systems, & Health, 36(2), 216–224. 

Guyll, M., Spoth, R. L., Chao, W., Wickrama, K. A. S., & Russell, D. (2004). Family-Focused Preventive Interventions: Evaluating Parental Risk Moderation of Substance Use Trajectories. Journal of Family Psychology, 18(2), 293–301.

Li, L., Hien, N. T., Lin, C., Tuan, N. A., Tuan, L. A., Farmer, S. C., & Detels, R. (2014). An intervention to improve mental health and family well-being of injecting drug users and family members in Vietnam. Psychology of Addictive Behaviors, 28(2), 607–613. 

Spoth, R., Reyes, M. L., Redmond, C., & Shin, C. (1999). Assessing a public health approach to delay onset and progression of adolescent substance use: Latent transition and log-linear analyses of longitudinal family preventive intervention outcomes. Journal of Consulting and Clinical Psychology, 67(5), 619–630. 

What are four key considerations in preparing for a structured family intervention? To select and enter your answer go to CE Test.

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