Intervention (counseling)

An intervention is an orchestrated attempt by one, or often many, people (usually family and friends) to get someone to seek professional help with an addiction or some kind of traumatic event or crisis.

Interventions have been used to address serious personal problems, including, but not limited to, compulsive gambling, compulsive eating and other eating disorders, self-mutilation, "workaholism", tobacco smoking, alcoholism, and various types of poor personal health care. Interventions have also been conducted due to personal habits not generally considered harmful, such as video game addiction, excessive television viewing, and excessive computer use.

Interventions are either direct, typically involving a confrontative meeting with the alcohol or other drug dependent person (the most typical type of intervention) or indirect, involving work with a co-dependent family to encourage them to be more effective in helping the addicted individual. In the same sense, direct interventions tend to be a form of short-term therapy aimed at getting the addicted person into inpatient rehabilitation, whereas indirect interventions are more of a long-term therapy, directed at changing the family system, and therefore promoting healing of addiction.

Controversy
The need for direct interventions is generally decided by a concerned group of family, friends, and counselor(s), rather than the addict himself. Often the addict will not agree that he or she needs the type of help that is proposed during the intervention. While denial is by far the most common reason why an addict does not believe they need professional help, interventions have taken place with the intent to eliminate behaviors considered normal by society.

One of the primary arguments against interventions is the amount of deceit on the part of the family and counselors. Typically, the addict is tricked into being present at the intervention by various lies from friends or family members. Once at the location, families are allowed to share their negative experiences associated with the target's particular addiction-based lifestyle. Prior to the intervention itself, the family meets with a counselor (or interventionist).

During the intervention rehearsal meeting, each group member is strongly urged to create a list of activities (by the addict) that they will no longer tolerate, finance, or participate in if the addict doesn't agree to check into a rehabilitation center for treatment. These usually involve very serious losses to the addict if he refuses. These items may be as simple as no longer loaning money to the addict, but most are far more alarming. It is very common for groups to threaten the addict with permanent rejection (banishment) from the family. Wives often threaten to leave their husbands during this phase of the intervention, and vice versa. If the addict happens to have any outstanding arrest warrants or other unresolved criminal issues, the threat is usually made that he or she will be turned in to the authorities. Every possible loss that the family can think of is presented to the addict, who then must decide whether to check into the prescribed rehabilitation center, or deal with the promised losses by family and friends.

This type of blackmail is another reason the practice is not completely accepted in the psychological field. Addicts generally choose to go to the treatment center rather than lose touch with their families, but long term studies with a control group have not been done yet. It is still unknown how interventionist methods fare when compared to other methods of getting help for a loved-one. In the uncommon event that the individual rejects the program, life becomes very difficult for both the addict and the family. If the family chooses to go through with the threats it has made, personal relationships with the addict end abruptly, and rarely recover completely.

Finally, perhaps the greatest point of contention within the psychological community is whether direct interventions should be attempted in their present form at all. It is generally recognized that the majority of families likely to seek an intervention are dysfuctional, and addiction is known to alter one's judgement as well. A direct intervention encourages dysfunctional families to threaten the addict with various losses if the addict refuses to submit. The addict, who has impaired judgement at the outset, is then required to make a decision that will likely affect the rest of his or her life. Long-term studies have yet to be performed on the ultimate ramifications for individuals who choose not to submit to treatment, or for the families involved. Reports of the outcome of direct intervention therapies are poor, with most addicts appearing to submit on the surface, but ultimately returning to their particular addiction. Relationships with families where the addict has refused to submit are also believed to be quite poor.