Wednesday, January 7, 2009

Addiction Intervention Consulting for EAPs

Should you offer intervention consulting to employees who have family members or close friends with alcoholism or drug addiction problems?

You may mistakenly believe that intervention consulting requires going to where the intervention is being held, and passively being available in case expert guidance is needed at the event. The intervention industry, which is fraught with rip-off artists has promulgated the belief that intervention requires highly skilled professionals who show up on a Sunday morning after a pancake breakfast to surprise the alcoholic with a loving and supportive surprise meeting.

Nothing could be further from the truth. Intervention guidance does not require "specialists". The evidence for such an observation is in plain site. Addicts are admitted to treatment programs every day with only the hip-shot pressure placed upon them by family members or employers who accidentally, on purpose, said the right thing for the right reasons to motivate an addict to accept help. No intervention expert was present. And, I would imagine 95% of admissions to addiction treatment programs happen just like this--influence and leverage of those in relationships with addicts effectively applied.

Most admissions to chemical dependency treatment programs occur without an interventionist guiding the process, which is usually very expensive. The call to "have an expert" present effectively eliminates many people from the opportunity to ever consider an intervention. This not fair. To say to a family that they can't be just as successful without an intervention is one of the greatest disservices ever to be levied on addicts and family members.

How do you help these people? Despite attempts by interventionists to claim a high levels of artistry and to promulage fear if an expert isn't present, the reality is that the basic principles of successful intervention can be easily taught.

And, my argument is that success rates are higher if this "empowerment model" is used. That's because family members can try again if the first intervention fails, and they can become determined engines of change until it happens.

Most interventions (althought not called that) are completed by insistent family members with no interventionist present. In other words, people do say the right thing, perhaps accidentally, that motivates an addict to enter treatment. Usually these are family members who have decided to make treatment “non-negotiable.” The result is admission.

So, how do you add this expertise to your EAP?

The logistics. Such a meeting to educate an employee should include at the most four or five persons who have significant influence or leverage. More than that, and too much cross talk emerges dragging out the training of these individuals. (From experience and having done as many as 11 trainings in one week, the two major tools of intervention are helping family members IDENTIFY and USE tools of "Influence" and "Leverage".

Influence is the value or weight assigned to the relationship one person has with the addict. Leverage is something that can be given or taken away, which the addict greatly fears. Each of these are crucial tools in interventions, and they are used differently, and at different times, as I will explain. My argument in this blog of course is to argue that addiction intervention training skills should (and I would like to argue must) be a part of your scope of service. It is perfectly within bounds of the EAP Core Technology.

The instructional meeting will last about two hours. (This is not treatment or group therapy, although I know many therapists who have illegally/unethically bill for it through 3rd party reimbursement.)

A person with addictive disease has a medical illness. You are providing common sense principles of constructive confrontation to help family/friends motivate the addict to accept help. This is not therapy.

Your first task is to get information about the addict. Get the family to tell you the whole story. Get a feel for the situation. Next, enter a discussion about addictive disease. You must determine each of the participant’s knowledge about the disease and ensure that each of them understands the biogenic nature of the illness. Educate as you go. Any participants with “psychologically oriented,” or “willpower” models about the disease will sabotage the intervention.

Ultimately exclude such persons if they can’t come around. Coach them out of the intervention. Next, you must deal with guilt. Each of the participants will feel guilty about the intervention to some degree. These persons will also sabotage the intervention if they can't get past it. Help them see that they are not going “behind the addict’s back”.

Most of this guilt is based upon an enabling dynamic fueled by the addict’s direct or implied demands for loyalty in order to avoid confrontation over a period of years. Explain this to erode their mistaken beliefs. My next blog note: The Intervention Training Meeting Part I.

I know this is a bit gutsy, and that I am going against about 30 years of convention, but people need to hear the message. By the way, the movie "I'll Quit Tomorrow" will get your company sued fast if you ever try to duplicate what promotes--bringing the family into the workplace and surprising the employee in the office of the company's president to be confronted about their alcoholism. Burn the film if it is in your midst.

Feel free to e-mail questions or rebuttals as I continue this blog. I would like to respond to your comments: