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Addiction & Treatment

The Efficacy of Interventions

Perhaps the most detrimental of all the phony techniques developed by Alcoholics Anonymous and drug and alcohol treatment professionals is the "intervention. " BRI researchers identified five components in a professionally conducted intervention: the conspiracy, the ambush, the guilt-trip, the hijacking and the treatment. In a professional intervention the conspirators are organized and scripted for a planned confrontation with the drug and/or alcohol user. The conspiracy is comprised of the people who are closest to the drug and/or alcohol user: father, mother, spouse, grandparents, children (sometimes young children), extended family members, friends, coworkers, employer, neighbors, clergy and so on. Even though some or all of the conspirators may interact with the targeted drug and/or alcohol user, perhaps on a daily basis, no one tells the target, the user, of the conspiracy of the impending confrontation. If this behavior by the conspirators strikes you as dishonest, you would be right. As the conspiracy progresses each conspirator writes a script that explains how the user’s alcohol and/or drug use has negatively affected each of their lives, respectively. In a well organized intervention the professional interventionist will probably review the scripts before the confrontation takes place to ensure that the scripts are negative enough to instill guilt (shame) and end with "I really want you to get the help that you need. "

Once the conspiracy is poised to strike, it is time for "the ambush. " A family member sets a meeting with the user at a family member’s home. There are all sorts of reasons given for getting together: we need to talk or Grandpa’s here to visit or please come over for lunch. Other arrangements are set around schedules, like coming home from work or coming home from school. There are as many different methods to get the user to enter into the ambush as there are families. As the user enters the house, the professional interventionist greets the user and explains that there are some loving family members (friends) waiting in the living room to talk with you. The interventionist explains to the drug and/or alcohol user that the user does not have to say anything, but everyone would be grateful if the user would listen. Walking into the living room, the drug and/or alcohol user is stunned by the number of people that are there, their solemn faces and the oppressive tension that blankets the room. The interventionist sits down leaving the only empty chair available to the user which has been strategically located in the room so that all the family members can make eye contact with the user and the user can make eye contact with them. At this point the orchestrated intervention is still under the control of the drug and/or alcohol user. The user has two options: leave or sit down in the designated chair. In the first option, the user may announce to the conspirators that this is "bull crap" (which it actually is) and simply leave. This reaction by the drug and/or alcohol user happens often. In well planned interventions, the professional interventionist has prepared the participants of the intervention for this "denial" behavior. When this happens, i.e. the user refuses to comply with the will of the interventionist, the ambush technique fails. The second option is for the drug and/or alcohol user to acquiesce, taking the designated seat for the next component of the intervention: the guilt-trip.

The guilt-trip is an organized collection of read testimony by family members that (1) start out by saying how much the family member loves the drug and/or alcohol user and what that love has meant to the family member, (2) the family member further explains how the user’s drinking and /or drugging has negatively affected the family member’s life and (3) how much the family member wants the user to get the help he or she needs. Some of these family members’ lamentations are multiple pages long and emotionally draining. Some are judgmental and demanding, while others are soft and even consoling. Some issue ultimatums. Regardless of the content, the purpose of the narratives is to impart guilt (shame) on the drug and/or alcohol user for the user’s drugging and/or drinking behavior. The drug and/or alcohol user may abruptly leave at some point in this process, often casting about disparaging remarks directed at the family members as the user exits. But if the drug and/or alcohol user stays for the entire guilt-trip, the hope is that the user will feel sufficiently guilty (shamed) to then listen to the professional interventionist’s solution. The implication being that the professional interventionist’s solution meets the desire of the family members’ repeated appeal for "the user to get the help he or she needs. "

At this juncture comes the hijacking. The professional interventionist explains that there is a solution that has worked for many others: drug and alcohol treatment. The professional interventionist further explains that family members have already made all the necessary arrangements for the user to attend a drug and alcohol treatment program, and further, these arrangements include the drug and/or alcohol user leaving with the professional interventionist and being admitted to the drug and alcohol treatment program that very day. Often, at this point in the process the drug and/or alcohol user objects claiming to need some time to think things over or just can’t leave work or some other excuse, but most of the time the truth is the user won’t go because he or she is really angry about the intervention and/or because he or she has developed a deep seated resentment against the professional interventionist and wouldn’t consider going across the street with the interventionist unless it was to give the interventionist a good thrashing. If the user is adamantly against going into a residential drug and alcohol treatment program then the interventionist may suggest attending a drug and alcohol outpatient program where the user may attend drug and alcohol outpatient counseling several times a week, which would not interfere with the user’s work schedule. Many times, however, when the drug and alcohol user is being coerced into making a decision on the spot, the user retaliates, inviting the family members and the professional interventionist to go have an unnatural sexual act with a wild Indian Yak, then storms out of the house and gets drunk, baked and/or high. Still, there are many cases where the alcohol and/or drug user acquiesces and agrees to enter a drug and alcohol treatment program.

The final component of what is considered to be a successful drug and alcohol intervention is when the drug and/or alcohol user is admitted to a drug and alcohol treatment program. While today there are more non-twelve-step based programs than there were in 1992, the number of twelve-step based programs still remains the most common drug and alcohol treatment and is conservatively estimated to make up 90% of drug and alcohol treatment available in the United States. That being true, the drug and/or alcohol user now admitted to a drug and alcohol treatment program has a 90% probability that the treatment will consist of confrontational therapy, group therapy and twelve-step dogma and meetings.

This is bad news and more bad news. According to professional counselors conducting twelve-step based drug and alcohol treatment programs, the most frequently claimed success rate is one in twenty (5%), while the most optimistic claimed success rate is one in twelve (8.3%) and the most pessimistic is one in thirty (3.3%). These low success rates should come as no surprise to anyone, inasmuch as these are statically the same success rates reported by twelve-step programs like Alcoholics Anonymous. But, what about the 10% that claims not to be based on twelve-step programs? Claiming not to be a 12-step based program and not being a 12-step based program is not the same thing. Most of these non-twelve-step treatment programs recommend that those leaving treatment must attend a twelve-step program upon returning home. As for the remaining non-twelve-step drug and alcohol treatment programs using methods such as psychiatry, medication, talk therapy, vitamin therapy, acupuncture, healthy diet therapy, physical fitness programs, aroma therapy, massage therapy, sweat lodges, hypnosis, meditation and the myriad other unproven techniques, none are supported by independently verified success rate studies.

In 1992 and 1993 Baldwin researchers participated in actual interventions with a professional interventionist for the purpose of understanding the technique and the efficacy of drug and alcohol interventions. Baldwin researchers cannot disclose any information about these interventions because of confidentiality considerations. However, the researchers did, based on firsthand observations, observe aspects of the process that appeared excessive and other aspects that appeared outright harmful to the participating family members, the drug and/or alcohol user, family dynamics and family relationships, subsequent to the intervention. For example, Baldwin researchers found the secrecy among family members and friends prior to the intervention to be excessive, dishonest and humiliating for the drug and/or alcohol user. Baldwin researchers also found that family members, in an effort to please the professional interventionist, were sometimes disingenuous with respect as to how the drug and/or alcohol user’s behavior hurt them. The most egregious technique is the family members reading from a script that each had written. Most family members used this opportunity for a catharsis, saying hurtful things that would otherwise not, and perhaps should have been said. Further, some family members, opportunistically, blamed the drug and/or alcohol user’s behavior for things that were going wrong in their own lives and that had nothing whatever to do the user’s behaviors. In summary, then, drug and alcohol interventions appeared to cause more problems for families than the families already had, and for what? Less than a 5% chance of success.

The previous discussions about the erroneous words, phrases and tactics contrived by Alcoholics Anonymous and the drug and alcohol treatment industry are a summary of studies spanning more than two decades. During that time BRI researchers learned from users and their families what actually worked for them, what didn’t work and what they found to be detrimental. For example, drug and/or alcohol users that attended drug and alcohol treatment and/or Alcoholics Anonymous complained bitterly about the abusive nature of these programs and were convinced that these programs did not work. BRI studies substantiated the conclusions of the drug and/or alcohol users and their families that Alcoholics Anonymous and drug and alcohol treatment programs don’t work. Furthermore, and during this time, it became obvious that the more willing drug and/or alcohol users were to accepting total responsibility for their behaviors, the greater the probability that the users would, at some point, abstain from using, or moderate their use. None of this happened in a "eureka moment;" it took years of listening, learning and understanding what was happening. That is why there are no specific dates associated with the rejection of individual terms, like disease, enabler, codependency and tough love. The rejection by BRI researchers of these and other detrimental terms and techniques evolved based on firsthand observations, thousands of interviews and information gained from hundreds of other researchers.