A look back at my comments concerning the Johnson Model of Intervention

We received an e-mail that questioned one point in my first blog posting. The e-mailer suggested that while he believes that some Johnson-trained interventionists have used a surprise approach, the actual Johnson model was not designed to be a surprise and is more caring than confrontational. That may be true but we are now looking at a market place where there are so many inadequately trained interventionists that they take an easier softer way and take the easiest approach possible. In so doing they actually forget the wonderful aims that Vern Johnson set down in 1973 and are more interested in getting the intervention done, the client into treatment and onto their next case.

The American Psychological Association did some research and found that the intervention team was not always educated well enough to the confrontation aspects of the intervention and so some families can become a bit discouraged and despondent during the planning sessions, and they may choose to cancel the intervention before it moves forward. In a study published in 1989 in the American Journal of Drug and Alcohol Abuse, 70 percent of groups cancelled the intervention during the planning stages. Families must be prepared to hear difficult statistics and plan for confrontation before they agree to a Johnson intervention. Individuals who undergo a Johnson Intervention are most likely to enter treatment, but the power of the Johnson Intervention to retain clients deteriorates over the course of treatment, as indicated by their diminished likelihood of completing.

As a result of Dr. Johnson’s model and his non-systemic approach, the Johnson model had a high rate of success in getting addicts and alcoholics into treatment.  However, it had an extremely poor rate of long term success for sobriety.  The Johnson model was very confrontational, focusing only on the behaviors of the addict and alcoholic. Not focusing on the family system and only on the addict is why the Johnson Model and non-professional intervention counselors should be very carefully considered before use. The surprise concept of this model was said to be aggressive in nature. Having said that all intervention models have some element of surprise.  Other intervention models do not invite a loved one to an “intervention,” they are invited to some type of family gathering or meeting.  This makes the intervention far less controversial in nature. For me it’s about bringing about meaningful change to the family system so that when the family member returns from treatment each family member has done their own work and the addict returns to a changed family system.

I have heard stories of interventions in which the interventionist created a negative, shaming environment. I have heard of interventionists coercing the identified patient into treatment. Recently I heard from a well informed source about an interventionist and his client arriving at a major treatment center with his client restrained! Unfortunately, this negative approach places addiction into the good-guy, bad-guy category versus supporting the medical model or the disease concept. This coercion approach gives the intervention process a negative image, an image sometimes exaggerated by cavalier interventionists calling themselves bounty hunters or headhunters. This barbaric approach both sabotages and minimizes the legitimate therapeutic component found in the intervention process. It leaves both the patient and intervention team participants with emotional scars.

So my experience tells me intuitively that I ask myself if I were the loved one how would I like to be communicated with?  The approach that well trained, caring professionals take is to present interventions in the spirit of love, care and concern. We present with care rather than confront and the intervention team is trained to talk about how addiction is impacting them rather than pointing fingers at the loved one. I talk about being sick of the disease and not sick of the addict. And so the loved one is being carefully prepared psychologically for the treatment experience ahead which results in much better outcomes for people staying in treatment once they get there. It also creates a safe and supportive environment for the start of the healing process for all intervention team members. It allows the interventionist to function as a case manager and a liaison between the treatment center, the family and the patient so that he/she can suggest participation in the family program component of the treatment program.

My own intervention agreement makes the following comments which are dear to me:

Intervention to us is:

•             not coercive,

•             not shame-based,

•             not hurtful or angry.

•             it is not an ambush or an uncaring attack

•             it is a planned interaction between an individual and a group whose sole purpose is to modify the individual’s dependence on a harmful substance or practice.

•             it is a process of invitation, education and preparing family and friends who make the commitment to initiate change in a loved one’s or coworkers life.

•             the goal is to return to healthy, productive living for addicts and their families.

•             The truth is that Intervention is a process founded on love and honesty.

Just by way of clarification I have very few original thoughts and do a lot of research on the internet. If you see ideas that you recognize please be aware that I may have used the thought or modified the thought.