Dealing with drug addiction, as an addict or as a family or friend of an addict, can be an extremely trying time of life. While it may be tempting to ascribe a standardized set of treatment protocols onto every addict, it’s not a productive route to take.
In fact, drug treatment programs, specifically with regard to intervention techniques, require an individualized approach that addresses the unique needs of the patient.
What Constitutes Effective Addiction Treatment?
According to the National Institute on Drug Abuse, no one treatment is effective for every addict. However, there are several factors that generally make up the parts of a cohesive treatment program:
- The prescribing of medications to ease the symptoms of detoxification and allow addicts to adjust to a life without drugs.
- An understanding that drug treatment does not stop with the detoxification process. Rather, it is merely step one in a long journey.
2. Testing & Evaluation
- Evaluation and treatment for mental health disorders (if applicable).
- Regular drug testing to ensure a relapse hasn’t occurred.
- A thorough health evaluation to detect the presence of communicable diseases like HIV/AIDS and hepatitis C, and counseling in harm-reduction practices.
- Acknowledgement that drug treatment must address all aspects of the person, not just their drug use or addiction.
- Counseling in both individual and group settings that addresses coping mechanisms and allows addicts to understand their addiction and rise above it.
- Continual reevaluation of the treatment program for effectiveness.
Before treatment can begin, an addict must be brought into a program. This can happen either voluntarily or involuntarily, often through the use of an intervention model.
Major Intervention Models
The idea of the intervention is now ingrained in popular culture. With shows like A&E’s Intervention, more people have at least a cursory understanding of the process. It typically goes something like this: an unwitting addict is lured to specific location where she’s surprised to find her friends and family, along with a therapist, waiting to confront her about her addiction. This is effective in some cases, but it doesn’t describe the best tactic for every situation.
The Johnson Intervention Model
The Johnson Model is what most people think of when they hear the word “intervention.” This model is confrontational. The addict is called to a meeting at which time his friends and family confront him about his behavior and how his addiction is causing harm to himself and others. The participants are to offer their full support to the addict should he agree to go through treatment. However, there is also a threat made of what will happen if the addict refuses treatment. The strategy here is to pull the addict out of his self-denial and see directly what his addiction is doing to his loved ones. An interventionist oversees the process.
While this method can work well for some addicts, it has the potential to cause severe problems. According to Psychology Today, confrontational models like the Johnson Model don’t always work, and the usage of shame and pressure could cause more harm than good, including relapse or forcing the addict to cease all contact with family.
The Invitational Model is fairly straightforward and lacks the element of surprise the Johnson Model imposes. The family and friends of the addict schedule a workshop or meeting with an interventionist. One person invites the addict to the workshop, providing full knowledge of what will occur at the meeting. It’s left up to the addict to decide to come or not. However, the meeting always occurs regardless of whether or not the addict agrees to go.
The Field Model is a combination of the Johnson Model and the Invitational Model. It’s designed to be easily adaptable to the situation. So if the addict has the potential to be violent or the intervention must be put together hastily, this model is useful in mitigating negative responses. Its name is derived from the notion that it is applied “in the field” and allows the therapist to make decisions based on the given circumstances.
Systemic Intervention Model
Confrontational approaches are not always the best option for interventions, especially with hostile or overly defensive addicts. The Systemic Intervention Model is a good choice in these cases. During meetings with a therapist, the entire family discusses how everyone contributes to the addict’s continued abuse of substances.
Instead of forcing the addict to confront their denial that there is a problem, the focus is placed on how to encourage the person to cease the use of drugs or alcohol. Only behaviors and interactions that encourage positive abstinence are emphasized.
This intervention technique is focused much less on strategy than it is on thorough counseling that focuses on conversation with the addict. According to The Essential Handbook of Treatment and Prevention of Alcohol Problems by Nick Heather and Tim Stockwell, the goal of this technique is to encourage the addict to make positive behavioral changes by engaging in conversation.
The therapist aims to guide the addict by understanding his or her point of view, offering empathy and building trust on which to base goals for changing negative behavior like drug abuse. While this technique lacks the confrontational aspects of other intervention models, it can still provoke feelings of denial and resistance within the addict.
While some addicts will need to be enrolled in an inpatient program to go through detoxification and receive around-the-clock monitoring, many treatment plans occur on an outpatient basis.
Even those who start out in an inpatient program will eventually transfer over to an outpatient plan that focuses on behavioral modification and applying coping strategies to daily life.
Beyond the intervention models described above, therapists use some specific strategies to help addicts understand the origins of their addiction, overcome obstacles and maintain positive coping mechanisms to prevent a relapse.
- Cognitive Behavioral Therapy: A form of treatment that helps addicts understand what situations are most likely to trigger addictive behavior and how to avoid these situations in the future.
- Contingency Management: The use of positive reinforcement to give addicts incentives to avoid drug abuse.
- Multidimensional family therapy: A treatment program that includes the entire family in the process of identifying the causes of drug abuse and triggers, and helps the family learn how to cope more effectively to decrease the likelihood of a relapse.
Though the use of intervention models and therapy techniques have a positive effect on stopping drug abuse, it is estimated that between 40 and 60 percent of addicts will relapse at least once, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
A continued treatment program following the initial detoxification period is essential for preventing relapses and ensuring that the addict remains on the sober path. This typically involves individual counseling sessions, family therapy, group therapy, or some combination of the three.