Intervention

What it is

An intervention is a planned meeting in which the people closest to someone who is using tell them, together and calmly, how the use has affected them and ask them to accept help. It is usually run by a professional interventionist, a person trained to prepare the group and steer the conversation, though some families do it on their own.

The key word is planned. An intervention is not an argument at the kitchen table. The group meets ahead of time, decides what each person will say, and arranges treatment in advance so that if the person says yes, they can go that day.

Who it is for

Interventions are for situations where someone's drinking or drug use is doing serious harm, they have been asked to get help and refused, and the people around them are ready to act together. They are most often organized by parents, spouses, adult children, and close friends.

They are not the first step in every case. Many people accept help after an honest one-on-one conversation, and a facility's admissions staff can often talk with a family about what to say. An intervention is for when that has not worked. It is also not a substitute for emergency care: if someone is in immediate danger, that comes first.

What to expect

With a professional, the process usually starts with a call or meeting between the interventionist and the family, without the person present. The interventionist learns the history, helps the group decide who should take part, and works with each person on what to say. The group also chooses a treatment option ahead of time, usually a specific facility with a bed or an appointment ready, and settles the practical details: travel, time off work, care for children or pets.

The intervention itself is a meeting in a private place. Each person speaks, usually from something written down. The interventionist keeps the tone steady and answers the person's questions about treatment. If the person agrees, they go to treatment right away. If they do not, the group has decided in advance what changes, and follows through.

Afterward, good interventionists stay in touch with the family for a time, whether or not the person went to treatment.

How long it takes

Preparation takes days to a couple of weeks. The intervention itself is usually an hour or two. The follow-up, and the treatment that follows a yes, is where the real time goes.

Cost and coverage

Professional interventionists charge for their time, and their fees are generally not covered by Medicaid, Medicare, or private insurance, since an intervention is not a medical service. Costs vary widely with the interventionist's experience, travel, and how much preparation is involved. Some facilities can suggest interventionists they have worked with, and some have staff who will talk a family through a conversation at no charge. The treatment that follows is covered the way that level of care normally is, and the facility should confirm that before the intervention, not after.

How it compares

An intervention is the way to treatment rather than treatment itself. The destination is usually medical detox or residential care, because a family that has reached this point often wants the person somewhere safe and away from where they were using. A partial hospitalization or intensive outpatient program can also be the plan when the person has a stable home. The facility's own assessment makes the final call once the person arrives.

How to choose

Questions to ask an interventionist:

• What training do you have, and do you hold a clinical license or a certification in intervention?
• How many interventions have you run, and how do you handle it when the person says no?
• How do you prepare the family, and how long does that take?
• What do you charge, and what does that include?
• Will you help us choose a facility, and do you have any financial ties to the ones you suggest?
• What support do you offer afterward?

That last question matters. An interventionist who is paid by a facility for the people they bring in is not giving you neutral advice. Choose the facility yourselves, on its merits. This directory lists facilities in every state with the kinds of care, settings, and payment each reports, and it is a good place to start: browse by state.