Interventions 101

Addiction and substance abuse disorders are covert diseases that often thrive by convincing us that we have everything under control and there is no problem. For those outside looking in, watching a friend, family member, or loved one struggle with substance abuse is a painful and terrifying experience. What do you do when you know someone needs help but they may not see it for themselves? Interventions are more complicated than what you see on TV, which is why our host Noelle Carmen is sitting with a panel of interventionists and addiction recovery specialists to cover everything you need to know about interventions and what happens next.

Interventions 101 Podcast, Video and Transcript

CARMEN: 00:07[music] Hi, everyone, and welcome to our new substance use and mental health series called Recovery Out Loud. I want to welcome our guests, Chris McGuire. He is a substance use outreach clinical specialist. He is also an interventionist and the owner and operator of Sober Livings in Dallas and Plano. Correct me if I’m wrong, Chris, Arbor Park and Russell Freeman Foundation PRIDE House?
MCGUIRE: 00:32Correct.
CARMEN: 00:33He has 20 years in the addiction field. Welcome.
MCGUIRE: 00:37Well, hi there.
CARMEN: 00:38Yeah. Howdy. We also have with us Christy Powders. She has her master’s in counseling psychology. She has a CCMI specializing in intervention and recovery case management. She’s also completing her internship as a licensed chemical dependency counselor. Hi, Christy. Thank you so much for being on our show.
POWDERS: 00:59Hello. Thank you for having me.
CARMEN: 01:01Okay. So today we’re talking about interventions and what they look like and how they work. So, Chris, I’m going to direct the first question at you. Let’s just start with the basics generally. Everyone’s seen the intervention show. I’m not sure how accurate that is to what actually really happens. So talk us through the basics of just basically what an intervention is.
MCGUIRE: 01:25Well, to me, first, you need to figure out everything that’s going on. Everything that’s going on with the family, what they’re like. Everything that’s going on with the individual, what they’re using. What kind of maybe trauma they’ve had. What type of insurance they have or no insurance. There’s a lot that goes into how to prepare for the intervention and also deciding where to send the individual at, too, as well. Because not only is the individual relying on you to send them to a good ethical facility, but the family is also relying on the interventionist to send them to a good ethical facility as well.
CARMEN: 02:11So the whole point of an intervention – and we’re talking substance use intervention, addiction intervention – is what?
MCGUIRE: 02:23It’s to hopefully try to get the individual that needs an intervention to go to treatment and to also continue recovery once they get out of treatment, and also help guiding the family. Setting boundaries while the individuals in treatment. Setting healthy boundaries for when they get out of treatment. And then also maybe make suggestions on– depending on how bad it’s been, maybe the family might need therapy or to go to some kind of trauma or healing facility as well.
CARMEN: 03:03And I think that’s a really important point that I want to circle back around to as we progress through the conversation is the notion that addiction is a family disease. One person may use, but it hurts everyone in the system. How does a family understand when it’s actually time to get an interventionist, to get a professional in there? What kind of do you see typically is happening in the family system when they’re desperate enough to call and say, “Oh, my gosh. We need someone to help us. We cannot do this anymore”? Christy, can you address that?
POWDERS: 03:43Sure. So the family will typically start to see in the family member or loved one’s life, that their use of alcohol or drugs or their abuse of alcohol or drugs is starting to affect things in their [right?], such as their job performance, their financial standing, their relationships with coworkers, with friends, with people in the family. And the addiction and the use is starting to affect quality of life in all of those areas. So when the job performance starts to suffer, another is physical health and mental health. Is the use putting that client in a situation where they’re looking at diseases they’ve never had, such as liver disease, heart disease? Are they in trouble at work? Have they lost their job? Have they lost a significant other in their life? So things in their life are really starting to spiral downward to the point that people around them are noticing despite any type of cover-up they may be attempting. It’s just well-evident that things are not going well. And it’s at the point where they could be lost in some or any or all of those areas in their life.
CARMEN: 05:17Wouldn’t you say, at this point, if a family is desperate enough to come together that things are at rock bottom? Is that what you find, Chris?
MCGUIRE: 05:28Oh, definitely. What everybody’s rock bottoms could be different, though. And that’s a lot of people who don’t realize that everyone’s rock bottoms are different. So even though everyone’s rock bottoms are different, it doesn’t hurt to reach out and to ask questions to see if an intervention is needed or not.
CARMEN: 05:57And isn’t that what you guys do? So the family calls you and– is that the time right where you’re making your assessment? What kinds of things do you look for?
POWDERS: 06:08Well, when I first talk to the family, the first question is pretty basic. In their words, “Tell me what’s going on. Tell me what you’re seeing with this family member or loved one, what you see that’s going on,” and just kind of getting a back story. You’re probably going to hear some instances, like Chris mentioned, of a bottoms or what they considered bottoms are. And like Chris said, what they consider a bottom may not necessarily be that client’s bottom. But you’re really getting that story and the feel from the family of what’s going on. And then with that information, you’re also going to want to have three things in consideration that you go over with a family. And that’s clinically, what type of services are we looking for? Financially, where– or what can the family afford? And then geographically. So those things really need to be worked out ahead of time so that when we get into the heart of the intervention, we’re not setting anyone up for failure. So we know basically where the client’s willing to go or the family, what kind of program they’re willing to work them into. Financial, again, like Chris was saying. So just basically getting a back story and then laying a foundation of the type of treatment that we’re all going to agree on.
CARMEN: 07:42Okay. So this is the interesting part which is, okay, you’ve got buy-in from the family. Now, it’s time to get this family that is actually part of the system, right, ready. And so you’re dealing with all different kinds of personalities you’re dealing with all kinds of triggers that could happen. You’re dealing with people who may or may not want to be a part of this. How do you parse through all of that? Chris?
MCGUIRE: 08:13Well, you know, it’s important to talk to each family member in determining if it’s going to be good for that family member to be there or not because sometimes it might be dangerous for that family member to be there for a couple reasons. One, it might trigger the person that’s needing the intervention to get really angry and it could go south or it could be the enabler that maybe convinces them that they don’t need to go to treatment and get help, and they could do this just on their own. There’s a lot of variables that go into determining who should be there and who shouldn’t be there, in my personal opinion.
MCGUIRE: 09:05Another thing, too, I think it’s important is to also kind of know the background of the individual. Are they dangerous or not? Do they have a history of being violent? And if that’s the case, you might need to go in there at a different approach or have someone else with you doing the intervention in case that does happen. For me, I’m a firm believer, too. If it’s a female, I personally am not comfortable doing an intervention on another female. I think another female should be doing the intervention on a female because more than likely. If there’s abuse or rape or anything of that nature, then she might open up or my personal opinion is she’s going to open up more to having a female interventionist there and feel more safe and comfortable than me being there.
CARMEN: 10:13Let’s talk about bottom line because isn’t that something the family needs to agree on? It’s something that everyone has to have buy-in walking into the intervention. And it really has to do with what is most meaningful to the person struggling with addiction. So, Chrissy, you tell us what the bottom line is, how it’s decided, and how to follow through with enforcing the bottom line.
POWDERS: 10:45Well, typically during a pre-intervention where we’re meeting with the family and like Chris was saying, we’re getting to know the family, who needs to be there, who maybe doesn’t need to be there after we’ve kind of heard some of the family dynamics, at that point we talk about what, according to the family or friends are, let’s say, the five most important things to the client that mean the most to the client. And we would discuss that. And looking at those things, we would start to look at what would each family member or friend commit to as far as a bottom line.
CARMEN: 11:28Give us an example of a bottom line.
POWDERS: 11:31A bottom line could be let’s say a significant other or a partner or somebody that the client lives with, they may have a bottom line that says if the client does not go to treatment and remain in treatment until he or she finishes the program, that that significant other is willing to or will commit to separating to having them leave the home, they can no longer live there, and the bottom line to go further out into separation, to divorce, and that would be one bottom line. Another–
CARMEN: 12:18And–
POWDERS: 12:19I’m sorry. Go ahead.
CARMEN: 12:20No, no, continue. Sorry.
POWDERS: 12:22Another one may be, it could have something to do with their work. A family member is willing to discuss with the employer, “Look, my brother works for you. He values his job. We know that he’s very good at his job, but he’s driving while intoxicated and putting his life and other lives at risk.” And are you willing to go to that employer and bring that to the front? The bottom lines are– they’re scary.
CARMEN: 12:55Yeah.
POWDERS: 12:56They’re serious. And the family has got to be committed to them from the get-go.
CARMEN: 13:05Because I want to bring out the point to your point. And, Chris, maybe you could address this a little more. This is serious, right? This is when, again, we go back to the point that families are in a desperate place. They are willing to separate by now. By the time you’re doing an intervention, most of the time the repercussions are this person looks like they’re about to die, basically, unless extreme measures are enforced.
MCGUIRE: 13:34I mean, they’re not only at the point where they could die but it’s also destroyed the whole family dynamic, too. I’m big on the bottom line and for younger individuals, too. That could be you’re being evicted from living with mom or dad, that could be no more cell phone, that could be you’re not going to get your trust fund unless you get your things together.
CARMEN: 14:00Yeah.
MCGUIRE: 14:00When you start talking about the money part or their ears are opening up. But the main thing, too, about it is is you’ve got to stick to your bottom line. You’ve got to stick to your boundaries because us being addicts and alcoholics, and the reason I say us is because I’m in recovery too myself, is if you don’t stick to that, we’re very good manipulators. And we will try to twist things into making you think that you don’t need to go to treatment. And if you don’t stick to that, then once again, they feel like they’ve won and they’ve gotten over on the family or whoever is needed the intervention done, or the wife, or the dad, or whoever it is that’s wanting us to reach out and to have it done.
CARMEN: 15:00Chris, you mentioned earlier the enabler and you’ve also mentioned boundaries. So when you’re doing an intervention, are you looking at the enabler? The enabler is– describe for us what the enabler is and why are most concerned about boundaries and that enabler not sticking to the bottom line.
MCGUIRE: 15:24To me, the enabler is a lot of times it’s the parents. It’s the fear of losing their kid, but at that same time, if you don’t stick to your boundaries and if you don’t stop to enabling, you’re still going to lose your kid by an overdose, more than likely. So would you rather your kid be alive or dead? And at least by doing this you have the shot of them still staying alive [and in?] improving their life and being the kid that you raised or being the husband that you married or the wife that you married.
CARMEN: 16:14Okay. So let’s say we’ve discussed the bottom line. Everybody’s on board. We are all planning to get together. We’re going to have this intervention. Let’s talk about– some interventionist, Cristie, use something called the love letter, or they put together some thoughts for their loved one, whether it’s their child, their wife, their parent, that talks about things like how much they love them, how much they care, then move into times where this addiction has ravaged not only the family but hurt them personally. And then at the end is the bottom line. So can you kind of talk us through that just a little bit?
POWDERS: 16:59Sure. What I like to see is, going into– as a lot of people call the letter. The letter. I have the family talk about how much they love that person and really give some instances, two or three, of just some wonderful, loving, precious memories they have with that person. “Dad, the day that you walked me down the aisle. I’ve never felt so happy and so close to you and so proud to be your daughter.” Something like that. Just really getting that addicted person into the place in their mind and heart and soul of thinking about that love in that relationship and feeling that love from that parent, per se. So I like to start with getting them in that good place and then going on to talk about the hurt and the different times that they felt hurt and what that was like for them.
POWDERS: 18:07“When I saw this happen at this family event when you were intoxicated. And this is how it made me feel.” And really, again, putting them in that place. Putting that client [in?] their heart and mind in what they were going through during that traumatic time when they were intoxicated. And just kind of [caring?] that client from one spot to the other of, “Yes. We love you, and this is how much– this is how hurtful your behavior has been. And it’s so hurtful, and we’re so scared of losing you in so many ways that ‘I am willing to commit to this. And your anger or your disappointment or even feelings of betrayal you may have toward, say, me as mom, that’s not going to get in my way of the commitment I’m going to make toward my bottom line.'”
CARMEN: 19:03Chris, what are the kinds of things that you tell the family to be prepared for, walking into this intervention, in terms of things like– it may be that you as an interventionist seem like you’re siding with that individual who struggles with addiction or things may get heated or just making them aware that maybe you might ask one of the family members to leave. Because the whole goal, right, is to get that individual to treatment. But how do you prepare the family emotionally for, “Things may happen that trigger you, and you as a family need to remain the support system and realize, ‘Don’t take things personally?'” So how would you speak to that?
MCGUIRE: 19:54Well, the first thing is, the families got to remember that this is a sick they’re not well. They’re not their self. And if they can remember that, then I think it’ll go a lot smoother. They’ve got to be prepared for the person feeling trapped right off the bat with the intervention. I know I did. I wasn’t pleased with it. And they’ve got to realize all of that. Now, they’re probably going to hear things from the individual that they don’t like. They’re going to be defensive, but not all the time. You could go in there sometimes and they realize they know the gig is up. They’ve got to go to treatment. But at the same time, when we were just talking about the letters, at the end of the letter, you need to have the consequences ready and let them know if they choose not to go to treatment, what the consequences are going to be. And that could be them leaving the house that night.
CARMEN: 21:07Wow. Again, going back to that point, this is the real deal. When an intervention happens, it could be as severe as severing of those relationships in that very night.
MCGUIRE: 21:24And a lot of times it might go quick, or it might take five or six hours for the intervention to take place before the individual decides that they’re wrong and that they actually need to go get help.
CARMEN: 21:41Okay. So let’s just agree in this scenario the individual struggling with addiction has agreed, what does transport look like? And, well, first of all, tell us what that transition looks like because that has to be a very precarious moment, right, where like are they wanting to change their mind at any second? So is the idea to quickly get them in the car, get them to treatment? Again, they’re not in their right mind. They’re not in a decision-making space. Talk us through that, Christi.
POWDERS: 22:22Well, you would definitely have everything already worked out. And what we talked about with the clinical fit, the financial fit, the geographical fit. So that has already been worked out with the family. The treatment facility is already aware of the intervention. The transportation is already set up. The family has already packed the bag. So as soon as that, “Yes, I will go,” comes around, we are immediately getting the bag, walking the client to the car. If you are transporting or have someone else, going straight to the airport, getting on the plane, or driving straight to the facility. So everything is laid out ahead of time. It’s immediate. You don’t want that timelapse for any anyone’s minds to change. And the less time for bargaining, the better. So it’s definitely already set up and we’re ready to go.
CARMEN: 23:28Chris, the final stage of, at least, the intervention, certainly not for the client in terms of finding sobriety and recovery but the family is what’s happening to the family now? All of a sudden it was a success. All of a sudden that individual is not off in the car. What’s happening emotionally to that family during that time? And then kind of what are they going through while that individual is in treatment
MCGUIRE: 24:01I think, honestly, the first thing is that the family can finally breathe again for a minute or two. Because they know that their loved one is in a safe place that we’ve recommended that they go to, and that they’ve trusted us to recommend the place. So they can finally breathe again. And at the same time we’re communicating with the treatment facility. And depending on the scenario, the treatment center is also giving updates to the family letting them know how their individual is doing to, as well. As long as there’s an ROI sign with the facility, and the family. And at the same time, you’re still kind of coaching the family while the individual is in treatment, preparing them for when they get out of treatment. The next boundaries that they’ve got to start holding. And a lot of times when someone goes to treatment, they’re going to be out within 30 to 90 days, sometimes six months. But there’s still a lot of healing that’s got to go on, and a lot of times they might not trust that individual because of all of the damage that they’ve caused. And that it might take time for that trust to come back, or it may take time for that individual to heal, and to be who they were before they started drinking and drugging.
MCGUIRE: 25:42And I’ve shared this a lot of times that in my story that my mom always used to say, “My son’s dead.” And in one of the 12-step literatures it says that we were reborn, and in order to be reborn there’s a part of you that has to die. So hopefully with the new rebirth of the individual, depending on how bad they want it, it’s possible, and it’s going to take a lot of hard work on both sides. On the family and on the individual, but it can happen if you’re willing to put in the work, and have faith.
POWDERS: 26:21And I just want to add to that, going with a scenario that the client says, “Yes. I’m going to go.” So we’ve had a pretty smooth intervention. Those bottom lines carry on as well throughout the recovery program or the recovery contract. So the family has to stick to those bottom lines, and that may involve, “You are not allowed to leave treatment until your programming is complete or leave against medical advice. You have to follow through with your aftercare plan and your recovery contract. And if you do not do these things, those bottom lines still will apply.” And the family has to be willing to commit to that throughout the whole period of their initial recovery as they are new to recovery. So it does not end that night, in other words.
CARMEN: 27:24It’s a process. Chris, final word. What if I’m a family, I’m watching this interview. I’m scared. The family is scared. They don’t know if this is even something they should do. What is a message of hope you could give them, some kind of encouragement to actually move forward, make the call, get help.
MCGUIRE: 27:51My message of hope is that I’ve not only been through it, but I’ve put my family through it. And it’s something that I never would have imagined that could have happened, but it happened. And I have the greatest relationship with my family. I was a monster during my addiction, and I terrorized my family. And it took my mom calling the cops on me, and having me arrested. But that’s what she had to do in order to hold her boundaries, and it was a part of what opened my eyes to what I was doing to her and what I was doing to everybody else. And I wasn’t the Chris that she’d raised. And she kept her boundaries for when I got out of treatment. I didn’t get a key from her for my first year to her house, but that’s what she had to do, and I don’t blame her. But there’s hope.
CARMEN: 28:56There’s hope. I want to thank you both. Thank you, Chris. Thank you so much, Christie, for coming on and just sharing some of your wisdom, some of your experience. I want to thank our audience. We really appreciate you tuning in. Be on the lookout for our next video. We will be talking about the words that we use, and how we talk to ourselves and others, and how this shapes the relationships that we have. Thanks for joining us. This has been Recovery Out Loud. [music]