Before you read this article, we want you to know that our goal is not to shame or guilt families. Our views come from decades of experience working with families who have learned family-of-origin behaviors, taken on maladaptive family roles, and worked with loved ones affected by addiction and mental disorders. Almost every family we speak with behaves similarly, has acquired dysfunctional family roles, and asks the same questions for the same reasons. We have been able to help many families understand why they ask these questions and break down the meaning behind the questions, objections, and excuses for them. In doing so, we have been able to help families reclaim their lives and help their loved ones do the same.
Among the most significant challenges we face – and this includes clinicians, mental health and addiction professionals, and interventionists – are the manipulations and displaced emotional questions families and their loved ones ask. Often, neither the families nor the loved ones with substance use or a mental disorder are consciously aware of their displaced questions, objections, and manipulations. Families often ask questions to justify not doing something for themselves and their loved ones in need of help. We will explain why this is the case below in our family roles section. For now, we would like to offer some definitions and then, in the following sections, address the excuses and objections families make.
Merriam-Webster defines the terms Question, Rhetorical Question, Excuse, and Objection as follows:
Question – When used as a noun, it is an interrogative expression often used to test knowledge. To question something, when used as a verb, is used to doubt or dispute.
Rhetorical Question – A question not intended to require an answer.
Excuse – When used as a verb, excuses are used to make an apology for, to remove blame for, to forgive entirely or disregard as of trivial import, or to grant release to. When used as a noun, an excuse is offered as justification or grounds for being excused.
Objection – The act of objection. A reason or argument is presented in opposition—a feeling or expression of disapproval.
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Families often question us to express doubt and dispute us, often with an implicit objection embedded in the question. Some questions are direct with meaning, but frequently, there is an underlying objection or excuse in the question. Many times, families ask rhetorical questions to justify maintaining the status quo. They will ask questions but say their position will remain unchanged regardless of our response. An example is “What are your Success Rates?” To the layperson, that seems a legitimate question. Most of the time, it is not. We know this because if we told families that we have a 1% or even a 100% success rate with a money-back guarantee, their decision would be the same.
We have tested this theory frequently and always with the same result. We have said to families: “If our intervention success rate was 100%, and even if your loved one chooses not to accept help in treatment, we will refund all your money. Would you then be ready to move forward?” Nobody has ever taken us up on this offer. So, why do families even ask? They do so to justify not moving forward, even with that 100% guarantee. Having taken that objection off the table, we turned the conversation to the real issues, at which time families no longer spoke to us. As we will explore in the family roles section below, the main reasons people present obstacles are varied and include: fear, justification, selfishness, family roles, codependency, enabling, family secrets, ego, and not wanting to take a hard look at themselves. This is understandable to clinicians and professionals, but families do not like hearing it. Despite the guarantee, families still will not commit to an intervention. If an oncologist gave a success rate above zero, the response would be, “Let’s try it!
“More often than not, neither the families nor the ones with substance use or mental disorders are consciously aware of their manipulative and displaced questions, objections, and manipulations.”
Family Objections for Not Doing or Waiting to Do an Intervention
Most of the questions families ask as an objection can be found in our resources section on the “Intervention Help FAQs” tab. The most common of these questions will be explained in detail. Almost every single family asks the questions below at some point while working towards scheduling an intervention.
“Families often ask the questions below, meaning they question to doubt and dispute us, and there is often an implicit objection to the question.“
What if My Loved One Says No, Does Not Show Up, or Runs Away at the Intervention?
This question is by far the most often asked by families. The data suggests that families asking this question do not proceed with an intervention. The data also confirms that no matter our response, it does not convince the family to act. For families who ask for the right reasons, our response is accepted, and they understand that whether their loved one gets help is not the focus of the intervention. Asking “What if they say no?” is so common that we have an entire webinar dedicated to the topic and many other standard and relevant issues.
When families ask, “What if they say no?” we reply: “That is a question we should be asking you.” Families have been hearing “no” from their loved ones and have decided to reach out to us. For many substance users and those affected by mental health issues, what they hear from their family is YES. By this, we mean that families too often allow their loved ones to control the agenda with their mental health and addictive behaviors. When a family asks us the “what if” question, there are many layers to peel back when that question is a manipulative objection with implicit connotations. No matter how we respond, it does not change the family’s position. If anything, they would prefer our response to favor the family not wanting to help their loved one. Even if we guaranteed the loved one would say yes, the family would not commit to the intervention any sooner. We have tried this approach several times, but the offer is never accepted, just like the success rate analogy above.
- For the record, this was a clinical trial. We no longer offer that guarantee, and there are no money-back guarantees that your loved one will accept help. Had anyone accepted the offer during the trial, we would have honored it.
When a family truly understands the purpose of an intervention, they either do not ask the “what if” question or, if they do, our response is irrelevant as they know the intervention is not about that. Interventions are not about a family talking their loved one into treatment but rather about addressing the family’s dysfunction. Families who ask this question reveal their codependency and tell us who is running the show—and it is not them; it is the loved one with addiction and mental health issues. The loved one should be far more concerned about the family saying no to them than the loved one saying no to the intervention.
The same applies if your loved one flees or does not attend the intervention. When the “what if” question is asked, some families hope we do not have an answer. Running away or not showing up indicates the loved one is more worried about what you will do rather than what you think. Fleeing shows us the loved one’s state of mind. As far as not showing up, it is usually because a codependent family member or friend spilled the beans about the impending intervention. Confident individuals who do not need their family to help them stay sick do not run away. Rather, they show up to listen to the family and the interventionist.
On Families Using Mental Health Disorder Diagnoses as the Objection and Excuse to Overlook Bad Behavior, Treatment Resistance, Alcohol, and Drug Addiction
About twice a year, we experience an intervention involving someone with only mental disorder behaviors and symptoms. Why do families want to believe the problem is only related to mental health and not to an addiction? The main reason is the comfort and justification it provides the person asking. When the family believes the problem is primarily mental health, it opens the door to enabling by the family and the loved one seeing himself as a victim rather than having chosen the path to addiction.
Almost every case we take is a dual diagnosis case, meaning the presence of both a substance use disorder and a mental health disorder. It is not the family’s or the interventionist’s job to diagnose the primary problem at the intervention. Determining whether the addiction or mental health is the primary diagnosis is done by the treatment team after your loved one is stabilized and brought to baseline after arrival. You can watch our webinar on this topic in detail by clicking here.
Regarding mental health, we are not discounting or disregarding any previous mental health diagnosis. What we are saying is that alcohol and drug use, even at minimal levels, can and will exacerbate mental health symptoms. Many drugs and alcohol can and will cause behaviors and symptoms that check many boxes on several disorders listed in the DSM V manual (Diagnostic Statistical Manual) published by the American Psychiatric Association (APA). Some are self-medicating mental disorders with alcohol and drugs. Others are still experiencing drug-induced psychosis months after stopping the drugs and alcohol. And some have been misdiagnosed their whole lives by quick-trigger prescription-writing psychiatrists. Many people who seek mental health treatment are prescribed medication with little regard or consideration of traumas, experiences, or addiction history. Situations such as these are the result of being prescribed mental disorder medications by a family doctor with very little if any, training in mental health. At other times, the diagnosis is made during a flare-up crisis or a short stay at a stabilization facility.
“Interventions for mental health disorders and addiction do not intervene on the diagnosis; they intervene on the behaviors, the family system, the environment, and the resistance to treatment.”
What Are Your Success Rates?
Families usually ask about intervention success rates. Many families are taken aback and offended when we state that we do not determine success rates; it is the family and their loved one who determine them. There are too many moving parts to answer this question accurately, and the answer depends largely on the family’s commitment to follow through with the recommended strategies and suggestions. What we can tell you is the success rate of your loved one accepting help and attending treatment is significantly higher if the family doesn’t resist our efforts. The success rate of your loved one completing treatment and following directions in treatment is exponentially higher than a family doing the same in our S.A.F.E. Intervention Family Recovery Coaching. We do not say this to make families feel worse or inadequate. We say this because it is true. Families often believe that if their loved one goes to treatment, all will be well. Many families would prefer not to do anything besides have one of our interventionists inspire their loved ones to accept help. When the conversation turns to families having to address their role in addiction and mental health, many shut down. We understand this and the difficulty of having to manage the family side. We also know and understand that for many, this is not your first rodeo with your loved one, and you have experienced the same cycle repeatedly. At some point, family members must look at their roles, the family system, their loved one’s environment and comfort level, and family codependency/enabling as factors that contribute to the dire situation. Addiction and mental health treatment and intervention require all who are affected to participate and address anything and everything that can contribute to or compromise the success rate.
Families asking about success rates often pose the question with an implicit objection. We know this because of our repeated testing of the theory. As stated above, we have offered a 100% guarantee that if the loved one does not accept help at the intervention, we would refund all the money. Not one person in two decades has taken us up on the offer. We no longer offer that guarantee. As a clinician with twenty years of experience, we knew no family ever would. We knew this because asking our success rate wasn’t the real question, nor did our answer impact whether they moved forward. The question was their way of getting out of doing the intervention, never believing we would offer a 100% guarantee with all your money back. We did not do this to play games with people, and as we said above, it was a clinical trial we ran. We would have lived up to the offer had someone taken it; no one never did. The point was to help a family understand that it wasn’t their real question or objection, nor did our answer matter. What it did confirm is that asking questions with implicit objections is just a way for the family to try to get out of doing the intervention through psychological justification.
Why can’t we do the intervention/talk to them ourselves? (DIY Interventions)
This frequent objection is not necessarily asked directly. We know this because many families ask displaced emotional questions and objections during our calls, and we never hear back from them—that is until they try to do their own intervention, and it fails miserably. Families often research how to do an intervention or believe they can do the job of a professional interventionist by assigning a point person in the family to talk their loved one into treatment. We do not recommend this approach, but if you do, please understand that it will not be an intervention. If you would like to have a non-professional talk your loved one into treatment, consider asking members of Alcoholics or Narcotics Anonymous to assist you.
Interventions are not a series of speeches trying to inspire someone to check into alcohol, drug, or mental disorder treatment. If that is what you want, then as stated above, please go to your local Alcoholics or Narcotics Anonymous meeting and ask them to do it for free as part of their service work. If your interventionist operates alone with no support staff, paying any amount is too much. When considering hiring a professional interventionist, please keep that in mind. You can watch our webinar on this topic by clicking here.
Interventions require a tremendous amount of work on the front end and require even greater resources after the intervention. For a family to think or believe they can do the intervention themselves would be the equivalent of believing you can represent yourself in a criminal case by acting as your own attorney. Interventions require the family to look at themselves and identify how they arrived where they are and what needs to be done to overcome the status quo. Families rarely see how much they contribute to the problem, which is through no fault of their own. The largest department at Family First Intervention demands a great deal of our attention and consumes the majority of our staff resources, and that is our S.A.F.E. Intervention Family Recovery Coaching. The simplest part of the process occurs when the interventionist comes to your home, and yet this is what families worry about the most. The family cannot therapize and educate themselves on what needs to be done differently. DIY interventions allow loved ones with addiction and mental health struggles to address and correct their problems on their own. If you’re reading this, you know how well that has worked in the past for your loved one and your family.
Is there a guarantee? Do we get our money back if they do not accept help?
This is the most ridiculous objection to an intervention one can make. I wonder if family members or patients would ask their doctors, lawyers, and accountants if guarantees come with their services. Is there a guarantee they will be cured of their illness, not go to jail, and not be audited? Would a negative answer cause them not to go to the doctor, not seek legal counsel, or not do their taxes without a 100% guarantee? Would they find any professional willing to give such a guarantee? So why do they ask interventionists and addiction and mental health treatment providers this question? The question is asked in addiction and mental health matters because it is not the real question; again, it is a diversion, a manipulation, and a justification for maintaining the status quo.
As with the success rate objection above, we have tested the money-back guarantee theory similarly. We have overcome the objection by offering a 100% money-back guarantee that the loved one would accept help at the intervention, go to treatment, and get sober—and not one time has the offer been accepted. The question was not sincere, nor was it the real question. The family member asking never thought we would agree to a 100% guarantee. The question was asked to justify doing nothing, to choose the path of continued inaction, and to continue that person’s role in the family dysfunction (see below). When a person with pancreatic cancer hears an oncologist have a success rate of 11%, they are given hope and start treatment immediately. When a family is given a 100% success rate with a guarantee regarding addiction and mental health, they run in the opposite direction and never pick up the phone again. Not all, but most do. Here is the guarantee we can give the family:
“If the family continues in the same direction and chooses the path of inaction while waiting for their loved one to ask for help or hit bottom, there is a 100% guarantee nothing will change. If the family gets their loved one into treatment but does nothing differently after that, they will have their misery and heartache increased tenfold when their loved one returns.”
We are Going to Have Them Committed to Treatment (Coerced & Involuntary Interventions)
This objection, sadly, is the silent killer. Of all the actions families can take against our advice, this one has the most significant short- and long-term damaging effects. We call it the silent killer because families rarely let us know this is their intention. We frequently hear about the failed approach after the family has gone about things their way. At the same time, many families bring up the idea, at which time we provide feedback. We believe that upon hearing us tell them how mistaken an approach it is, they wouldn’t dare admit to taking that route. The science and evidence suggest that coerced interventions and having someone committed should only be employed as an absolute last resort.
“Involuntary interventions take away clients’ self-control, and both involuntary and coerced interventions can undermine clients’ motivation. Since motivation and self-control are strengths that dual disorder treatment aims to cultivate, the use of involuntary and coerced interventions requires particular care.”
Integrated Treatment for Dual Disorders, A Guide to Effective Practice, Mueser, K.T., Noordsy, D.L, Drake, R.E, & Fox, L. 2003, p.249
A family should always give intervention, addiction, and mental health professionals the opportunity to help their loved one before taking matters into their own hands. A family needs to make sure their loved one has the chance to go to treatment respectfully and willingly through the process of intervention. Families, at times, confuse boundaries and accountability with coercion, ultimatums, and involuntary commitment. Boundaries and accountability are not coercion; they are the ways a family says: “You can’t do this to us anymore. Anything that happens to you now is of your own making and doing.” Interventions also allow the intended patient to accept help willingly; involuntary and coercive interventions do not. Were a family to bring their loved one to treatment through coercion or involuntary commitment, he would rightfully believe he is in treatment, not by choice, but because of you. The coercive approach feeds the resentment narrative while confirming the false perception that everything that goes wrong is someone else’s fault.
A Coercive and Involuntary approach is justified when these three rules are met:
- When involuntary commitment would prevent harm to the person, harm so great that the person cannot rationalize the alternative.
- The person does not have a reason to suffer the harm the involuntary commitment tries to prevent.
- The harm will occur to the person if the involuntary commitment is not performed, and it will reduce the likelihood that the harmful act will occur.
Justification is dependent on these four scenarios:
- The seriousness of the harm to be avoided
- The extent of the person’s rational responsibility
- The likelihood of harm
- The likelihood the involuntary intervention will diminish the chance of harm
Integrated Treatment for Dual Disorders, A Guide to Effective Practice,
Mueser, K.T., Noordsy, D.L, Drake, R.E, & Fox, L. 2003, p.250
Medicine and Moral Philosophy, Culver & Gert, 1982
Please note: we are not saying that involuntary or coercive interventions are harmful. They are very effective and should be used when professionals deem them necessary. We are saying that automatic interventions and coercive approaches should be used as a last resort, not the first, when clinically suggested and performed by professionals as ordered by a court of law.
Families are incapable of navigating the solutions to addiction and mental health disorder treatment. The higher the emotions, the lower the intelligence, and the closer the family is to the person needing help, the further removed they are from the solution. For more information on coerced and involuntary interventions, please read the “What are Different Mental Health Intervention Strategies?” section.
We Can’t Afford the Intervention
We understand that money and finances can be a sensitive subject. We are also aware that not everyone can afford professional services. Whether it be the assistance of an attorney, a doctor, a therapist, or any professional service provider, not everyone can get the help they need. Sadly, too many families can afford the intervention and treatment but say they can’t. We know which families are sincere about finances being an issue. Families that genuinely struggle with money issues ask for help, they ask for options, and they ask questions. Families not struggling financially but saying they can’t afford our services do not ask these questions. We know whether the resolve to help yourself and your loved one is there. Were this any other medical problem, you would ask about options that are available. We are not interested in shaming or guilting anyone. Some people can’t do this, but most can.
Our addiction and mental health intervention services are remarkably affordable, given the scope of our curriculum. Please consider carefully who you hire because many interventionists charge a fee much higher than ours and offer nothing more than a quick visit with a speech to your loved one that somewhat resembles a twelve-step call. Keep this reminder in mind: twelve-step calls are provided for free by members of your local Alcoholics or Narcotics Anonymous group. Families often go this route because the interventionists, often local in their area, make promises they are not able to keep. If your loved one refuses help, they may not answer the phone afterward. If your loved one does accept help, they will rarely be available to answer any questions as you cycle through the turbulence of your family system.
Family First Intervention has a Family Recovery Coaching Department dedicated to supporting your family after the intervention. Knowing you will have questions and be on edge before the intervention, we have numerous intervention coordinators to help you schedule your intervention and hold your hand until your interventionist arrives. A solo interventionist who charges exorbitant fees could not do any of this, even if they wanted to.
One of our intervention coordinators previously worked for a large jewelry store with a nationwide presence. She recalls how often people would visit the store and finance jewelry they neither needed nor could afford, paying sums exceeding our service cost. We think about how many people finance things they do not need and how much money people spend on their loved one’s addiction and mental health. Most families have paid the costs of intervention and treatment several times over due to failed approaches, lost opportunity costs, and enabling that ended in complete inaction. We understand that addiction and mental health treatment comes with no guarantee of complete success. What we do know is that the only sure guarantee comes from doing nothing at all.
Family Excuses for Not Doing or Waiting to Do an Intervention
The more a family seeks approval from their loved one with addiction and mental health struggles, the harder it is to do something about the problem. Families appear unable to hear our solution; they only listen to us as we address their maladaptive family roles. The family dysfunction and fears are evident in the excuses families make not to do an intervention or address addiction and mental health problems. The enablers do not hear us helping the family or their loved one; they listen to us taking away their purpose and their belief that they are needed by their loved one. The person in the hero role in the family does not hear us trying to help the loved one; heroes only listen to us trying to take away their role as the family’s shining star. If the loved one gets well and with a plan that is not of the hero’s making, what happens to the hero? Martyrs do not hear us trying to help their loved ones; they only listen to what will happen to them if their loved one is away in treatment, concerned about their diminished role when the loved one returns. They only hear that the martyr won’t be able to take on the victim role any longer.
“Families do not hear our solutions because they are often unwilling to let go of theirs.”
The point is not to shame or guilt the family regarding its dysfunction. After all, you did not ask for the role; you acquired it to cope maladaptively with the addiction and mental health struggles of a loved one in your family, which is evident in the excuses given when you call our office. The roles family members take on almost always stem from the primary enabler reacting to and comforting the substance user or person with a mental disorder.
Families have secrets and may exhibit dysfunction. Intervention may expose those secrets and dysfunction, so excuses abound. Please remember that no family is perfect, and everyone has secrets and problems, not just those with addiction and mental health struggles. We understand that excuses are defense mechanisms. It is our job to help you move beyond the excuses so you can help your family and your loved one. We will share with you the excuses families give themselves as the reason they can’t intervene or send their loved one to treatment. There are too many to list them all, and some may sound far-fetched. We assure you that not one is made up.
“Setting up an intervention takes significantly more time than the intervention itself. We spend far more time on the initial phone and conference calls addressing family objections and excuses than at any other time of the intervention process, excluding family aftercare. Families will make even more excuses and objections for not doing an intervention, and then their loved ones will raise objections and make excuses not to accept help.”
While reading these, please replace the terms Addiction and Mental Health with Cancer or any serious condition that would require medical intervention. Do these questions make sense, and would you ever ask these questions under different circumstances?
- This will upset them, or they will get mad
- This will push them over the edge, making things worse
- They are stubborn
- They will never talk to us again, never forgive us
- They will kill themselves
- They will say no
- They must ask for help or hit bottom; until then, there is nothing we can do
- They said they would get help on their own; they are turning a corner
- They said they would go to outpatient or check in somewhere
- They will leave treatment after they get there
- They say/we feel treatment doesn’t work
- They hate treatment
- They hate the 12 Steps
- They have a job, they need a job, they will lose their job, they just got a job, or they are too important, and the job will fall apart if they are not there
- They have legal problems, marital problems, or financial problems
- They are going through a divorce; going away for a while will lead to divorce
- They will lose their house and car; they can’t pay their bills while in treatment
- They have kids; they will lose their kids
- They need a gym membership, a church, a significant other, or a pet
- They looked better today, trimmed their beard, got a haircut, drank protein shakes, changed their diet, and so forth (YES! We have heard all these.)
- We know someone who can help: a landscaper, friend, church member, or other unqualified person. (YES! The landscaper excuse is real.)
- We are in a holding pattern
- We can’t afford the intervention or treatment
Whether you’re a stepmom making excuses not to have your husband in the same room with his ex-wife during the intervention or you’re a father making excuses to hide a childhood trauma from coming out at the family preparation day, or anything else, excuses obscure the real reasons. They are always a diversion to keep the truth, the ulterior motive, or the hidden agenda buried.
“When you make excuses not to intervene, you are making this about you and not about getting your loved one help.”
How Family Roles Are a Significant Predictor of Outcomes with Intervention in Mental Health and Addiction Treatment
Why families wait to do an Intervention or decide not to intervene has everything to do with dysfunctional family roles. We are not saying that unless you do an intervention through Family First Intervention, you’re just making excuses, raising objections, or lying. Our message is that when you hide behind displaced emotions and make excuses for yourself and your loved one while raising objections, you engage in unhealthy and downright dangerous actions. The closer you are to your loved one in need of addiction or mental disorder treatment, the less rational your ideas and solutions are. Dysfunctional families are incapable of seeing the forest for the trees. We perform a significant number of interventions each year for families who are professionals and well-versed in addiction and mental health. These families are aware of their inability to find the correct solution when it is someone they love or are close to. The higher the emotion, the lower the wisdom. Families do not like hearing that, but it’s true.
“Victims Say “Why Me?” Survivors Say “What’s Next?”
When we have a consultation call with a family to discuss intervention possibilities, each dysfunctional family role is represented almost without fail. We touched on some of these family roles above in the Family Excuses for Not Doing or Waiting to Do an Intervention section. It does not take long to identify who is playing which role by what is said and unsaid. Every family member is affected differently, and the opinions of the family members tell us who they are and where they are in terms of seeking help for their loved one.
Family roles also significantly impact whether a family can maintain boundaries for themselves. Boundaries can and will keep loved ones accountable for their behavior and choices. Below is a brief description of some family roles and the reasons behind the objections and excuses not to do an intervention.
The Primary Enabler – often provides the most comfort to the loved one with addiction and mental health disorder concerns. In this role, enablers make as many excuses and objections as possible not to do an intervention. They fear having their role of caretaker taken away or losing their purpose as the one keeping the loved one out of harm’s way. The enabler also fears that the person may get better in someone else’s hands, such as in a treatment center, and that perceived inadequacy often devastates the enabler. Primary enablers rarely, if ever, realize that they are largely responsible for the other dysfunctional family roles that result from their actions. Of the three family roles that raise the greatest number of objections and excuses, the enabler is the most rational and often comes around.
The Hero – is probably the most affected by the enabler’s abandonment. As the result of the enabler placing attention and focus on the substance user and his or her mental health, the hero suffers from inadequacy. Heroes have far fewer problems than the family members needing help, and they get little to nothing in terms of praise or acknowledgment. The heroes’ only way to cope is to ramp up their efforts to become perfectionist overachievers to prove to themselves, the enabler, and others that they are worthy of affirmation and praise.
The hero almost always single-handedly sabotages the intervention unless it is the hero’s idea who then chooses to make the call and hire an interventionist. The hero must oversee everything and will shoot down other’s ideas. The hero is the easiest to spot at the consultation if he attends because he will do one of two things if he does not make the original call to us. The hero will either remain utterly silent on the call or, when asked how he is doing, will give a one-word response. The hero waits for the consultation to end and then calls other family members to contradict and undue everything discussed at the consultation. The second way he acts is to “overpower the call,” challenging the professional to make him sound or look foolish. If the call is the hero’s idea, it goes much differently.
The Martyr – can be equally damaging to an intervention as the hero. The martyr will do anything and everything to prevent the intervention as he basks in the attention of being the victim. The martyr will have an objection or excuse no matter what you say. The martyr’s biggest fear is the person with an addiction, or mental health will get better and change the loved one’s perception of the martyr. Martyrs are also selfishly concerned with what will happen to them while the loved one is in treatment rather than focusing on helping that person.
There are other family roles, including the scapegoat, the lost child, and the mascot. Although these roles have been known to raise objections, make excuses, and cling to their dysfunctional security blanket, they rarely present an argument big enough to derail the intervention. People often ask if a family member can have more than one role simultaneously, and the answer is yes. Family members can also cycle through roles at any given time. The substance user can also take on any of these roles in the pool of dysfunction. Example: The drugs of choice for the substance user are alcohol and/or drugs. The drugs of choice for the hero are control and perfectionism.
Those reading this may be offended or don’t agree, and the truth can often sting. This is not a Family First Intervention opinion; it is science. The family roles outlined above are always present, trying to sabotage the intervention. Please keep in mind that these roles also cycle in and out and sometimes intensify after the loved one is in treatment. It is not unusual for the enabler, the martyr, and the hero to sabotage their loved one’s treatment and derail the family during aftercare efforts.
“The most formidable challenge we professionals face is families not accepting our suggested solutions. Rather, they only hear us challenging theirs. Interventions are as much about families letting go of old ideas as they are about being open to new ones. Before a family can do something about the problem, they must stop allowing the problem to persist. These same thoughts and principles apply to your loved one in need of help.”Mike Loverde, MHS, CIP
The Consequences of Your Family Saying No or Waiting to Do an Intervention
You already know the consequences of inaction. Most families with a loved one suffering from a mental or substance use disorder are told or led to believe that unless and until someone wants help, nothing can be done. This is not only dangerous, it is also untrue. There must be an intervention for someone to seek help or make a change. Whether legal, medical, personal, or financial, something must occur for the loved one to see the need for change and move forward in the recovery process.
The top predictors of outcomes in mental health disorders and addiction treatment are the client-counselor relationship and the environment. The environment includes the family to the extent that the family impacts the loved one’s environment. If loved ones in need of help do not face consequences in the environment, they will not see the need to change. Waiting for your loved one to ask for help or hit bottom while your family stagnates in a holding pattern, clinging to their dysfunctional family roles, prevents growth and improvement for all. There are families who make attempts to help themselves and their loved ones by taking baby steps. This is rarely, if ever, sufficient to move the substance user or person with mental disorders in a positive direction. Taking baby steps only gives the illusion of acting when in fact you are not.
“What we hear most often as professionals is that families and their loved ones taking baby steps or the wrong steps go on to blame everything that goes wrong or did not work on the professional who helped them, or the agency their loved one went to.”
The consequence to the family for doing little or nothing is continued heartache. Not only will the family situation worsen, but so will your loved one. Sadly, this dire situation has become routine for some families. Excuses families and their loved ones make allows them to hold onto this way of life. For some, it is the fear of letting go of their dysfunctional roles; for others, it is the fear of change. Some family members are worried about exposing family secrets, and some don’t even know what normal would look like; some, out of guilt and shame, may not even believe they deserve a normal family. Whatever the reason, families fight hard to stay as sick as their loved ones. Addiction and mental health disorders in the family take them to places in their decision-making that not many other illnesses do. You were asked above to read the excuses families make and to replace the terms addiction and mental health with another disease. Who with cancer says I can’t go to treatment because of my job? When a family tells us they are going about this in a way that we know will fail, we must let them go that route, knowing they will eventually return to us. We do our best to help you understand why you’re doing things this way, and we remind you that we’ll be ready when you arrive at rock bottom as a family.
The Consequences of Your Family Not Following Through with the Suggestions of the Intervention Team
Some families say yes to the intervention but then do not follow through with our family aftercare. Families who do this most likely just want us to talk their loved one into treatment, notwithstanding how much we explain the real purpose of an intervention. Some families only hire us to learn how to control their loved ones better. Whatever the reason, families will see little to no improvement unless they follow through with aftercare. Your loved one accepting to go to treatment at the intervention does not mean the family is out of the woods and all will be well. A yes and acceptance of treatment by your loved one means you must do even more work than if they said no and refused treatment. Should your loved one refuse help at the intervention, you are still in somewhat familiar territory, and our aftercare department can work with your family on treatment refusal protocol.
“Families struggle more in our aftercare department when their loved one accepts treatment than when their loved one declines help.”
Families cite addiction and mental health as the major disruption. Most will not and cannot see that the problem is the dysfunctional family and the silence that comes with the loved one being in treatment. When families do not engage in our aftercare following the intervention, they carry their dysfunction into their loved one’s treatment. Doing this can and will prevent your loved one from getting better. Some families will sabotage the loved one’s treatment and bring them home early, while others will continue to enable them even during treatment. Our aftercare department too often sees families more concerned with what their loved one had for breakfast than talking about what the family has done for their own recovery. This is neither healthy nor helpful. Families must follow through with aftercare and engage in their recovery if they truly want to have things improve. If the family is only interested in the loved one going to treatment and nothing else, then we suggest they go to the local Alcoholics or Narcotics Anonymous meeting and ask the members to do a twelve-step program for them; that service is free.
“If you pay one dollar for an intervention that does not have an aftercare department, then you paid one dollar too much. Talking people into treatment is not an intervention but a twelve-step call, and they are free.”
Excuses that Addicts, Alcoholics, and those with Dual Diagnosis and Mental Disorders Use Not to Accept Help
During an intervention, if the intended patient is talking about anything other than accepting help, they are talking about not getting help. People with addiction, alcoholics, and people with mental disorders and dual diagnosis often make excuses not to advocate for their care. When families provide comfort or do nothing about the problem, it takes away loved ones’ incentive to ask for help and encourages them not to address it. People with these conditions do a remarkable job of manipulating others into believing what they believe. Addiction and mental health disorders are the only problems people can have when they fight to stay sick and convince their family and others to help them maintain the status quo through manipulation and other tactics. People with an addiction, alcoholics, and those with mental health and dual diagnosis lie to themselves to the point of believing their own lies. One of the things that makes people with addiction and mental health issues so convincing is their insistence that their lies are true. Having taken on maladaptive roles, family members live under the control of their loved ones’ manipulations.
“It is not a coincidence that the excuses families make not to intervene are almost identical to the excuses addicts, alcoholics, and dual diagnosis clients make not to accept help.”
Excuses loved ones make to not go to treatment during the intervention pale in comparison to the excuses made after the intervention, regardless of the outcome. If there is treatment refusal at the intervention, your loved one will put on a show you have not yet seen. The manipulation, the hurtful words, the guilt, and the shame he will use to try to convince you this was the worst thing you have ever done and how this is all your fault is nothing short of vile. When your loved one does accept help, he will inevitably act out during treatment. The excuses that will come out of his mouth at the treatment center will puzzle those who thought the problem with their loved one was only alcohol, drugs, or mental health. If you did not previously believe the problem was the behavior, you will after a week in treatment. There is nothing more manipulative than a substance user or person with mental health issues who has been detoxed or stabilized and hasn’t started addressing the accompanying traumas, thoughts, beliefs, and behaviors. At this point, the problem is on full display. Until the behaviors are addressed, you will not have a sober loved one; you will have an abstinent loved one, and there is an enormous difference. We cannot stress enough the importance of utilizing a professional interventionist along with an aftercare department rather than a single practitioner who promises to be there for you afterward. The most challenging part of the intervention is organizing it and helping the family later, not the face-to-face intervention.
The Consequences if Your Loved One Says No to Treatment at the Intervention
Families often ask what will happen if their loved one says no during the intervention. When a loved one says no, he is saying the family will not change, it will not get better, and it will not deviate from the path chosen by him. Looking at it that way, you may want to tell us what you will do if he says no rather than ask what we will do. If we must answer, our answer is: things should never have gotten to this point, but now that it has, let’s change it.
How you help a recovering addict or alcoholic is by knowing the difference between helping and enabling. A result of the loved one not accepting help is letting him face the consequences. If you believe your loved one must want help or hit bottom before doing something differently, now is your chance to let that happen. Families throw that phrase at us daily, yet are rarely willing to make the changes for this to occur. When families do an intervention, they are not proactively hurting their loved ones; they are stepping out of the way so they can be held accountable and face the consequences on their own. Until a family sets boundaries, the loved one has control of the family’s emotions.
“Boundaries are the family’s way of saying we are not walking away; we will, however, no longer walk on the path you have chosen.”
A popular treatment method based on operant conditioning, a method of learning that employs rewards and punishments, is the CRAFT intervention model. CRAFT is the acronym for Community Reinforcement & Family Training. While not every clinician, including us, agrees with every tenet of the CRAFT model, some parts are spot on, such as not encouraging harmful or inappropriate behavior. Much of the method focuses on encouraging positive behavior while holding boundaries to discourage the bad behavior that affects the family. The FT part of CRAFT stands for Family Training. This is in line with what we teach at Family First Intervention, along with other evidence-based methods. We believe, as does the CRAFT model, that the family plays a significant role in whether their loved one’s treatment has a positive or negative outcome. Any time a family is helped to see things differently, it will significantly impact whether their loved one sees things differently as well. When families learn the difference between enabling and helping and recognizing the difference between negative and positive reinforcement, it can benefit everyone involved.
Recovery from alcohol, drug addiction, and mental health disorders entails addressing trauma, horrification, and experiences while changing behavior, thoughts, beliefs, and perceptions. A sober person knows how to identify what he did wrong and what put him in that position. When sober, blaming others, and harboring resentments subside, selfish behavior becomes unselfish, and thinking about others becomes the norm.
What Is the Purpose of Family Intervention?
“Families can unintentionally contribute to or maintain clients’ ongoing substance use disorder.”
Integrated Treatment for Dual Disorders, A Guide to Effective Practice,
Mueser, K.T., Noordsy, D.L, Drake, R.E, & Fox, L. 2003, p.195
The purpose of Family Intervention is to incorporate Behavioral Family Therapy (BFT) into our procedures and to encourage family collaboration. BFT aims to educate families on addiction and mental health issues while helping them acquire better coping, communication, and problem-solving skills. When we do interventions, our goal is to focus primarily on the family’s and their loved one’s behaviors and resistance to treatment. Interventions that focus on addiction, the drug of choice, and a mental disorder diagnosis often fail in the short term and almost always in the long term. This is why a solo interventionist should not be doing interventions, nor should clients be charged for them. Think of your interventionist as a person conducting triage; an interventionist is not a clinician, a treatment team, or a hospital.
Family interventions address family roles and dysfunction, enabling, codependency, reactivity, fears, and so forth. Interventions are about how to move the loved one out of the second stage of change, also known as the contemplation stage. During this stage, the person needing help is at a crossroads and is not necessarily in denial of the problem. The stage before contemplation is called pre-contemplation; paradoxically, it is rare to be in this stage. Do not confuse refusing help or not wanting help with not knowing there is a problem. To move out of the second stage, the person needing help must see a significant benefit to be derived as opposed to maintaining the status quo or staying the same. Nowhere in textbooks or evidence-based treatment does it say you have to make a diagnosis or know the drug of choice to address resistance. Resistance generally comes when there is a comfortable environment, which is nearly always influenced by a family system. Whether the family is enabling in an “over the top” way, looking the other way, or doing nothing to help your loved one, all these choices have consequences that compromise your loved one’s ability to move out of the second stage of change. The purpose of family intervention is to help you see this.
How To Set Up a Family Intervention for Addiction
Setting up an intervention is far more complex than the actual face-to-face meeting with an interventionist, family members, and the intended patient. None of what we have discussed here is meant to guilt, shame, poke fun at, or make light of your family, your loved one, or the situation. Everything stated here is accurate; it is experienced daily by our team and the families that call us and allow us to work with them. As previously noted, addiction and mental health are the only two potentially fatal illnesses where patients fight to stay sick, and their families make excuses to keep them sick. If your family is struggling with a loved one experiencing alcoholism, drug addiction, mental disorders, or a dual diagnosis, please call our office to set up a family intervention.
Interventions are designed for families to learn how and why they have allowed the situation to get this far.
It is difficult to resolve a problem when you play a significant part in it. Interventions benefit families by making an impact and drawing attention to the situation in a different way from what has been done in the past. We know that the substance user is going to have an intervention at some point. The family can choose when that happens before it is imposed on the loved one. Understanding which behaviors have been helpful and which have been counterproductive allows the substance user to be held accountable and to see the need for change. The substance user is going to make a choice as to what to do. The family is the only one with both a clear choice and the ability to make a rational change. The substance user is most likely not going to change because of a speech; it almost always requires a change to the environment that has been an impediment to change. This environment is the family system that often reacts counterproductively to the substance user. Intervention can benefit a family by taking the first steps with the likelihood that the substance user will follow through with change, too.
Connecting with a Professional Interventionist
At Family First Intervention, we understand the heartache that addiction and mental health causes a family. Some families may have forgotten what life used to be before the addiction and mental health concerns took over. Others may not believe they can get back to a healthy way of living, but families can recover just as a substance user can. Like the substance user who tries to fix, manage, and control the addiction and mental disorder but to no avail, the family also fails to fix, manage, and control the substance user.
Family First Intervention has helped thousands of families achieve their goal of taking back their lives and beginning their own recovery program. It is OK to think about and at times be concerned with your loved one’s actions. It is not OK to be overwhelmed with the chaos and confusion by attempting to control his or her actions.
An intervention is not about how to control your loved one with a substance use or mental health disorder; it is about learning how to let go of believing you can.
Thankfully, families don’t have to host interventions alone. They can call in a trained professional to help ensure success and make the process easier. Find out how
Intervention Help FAQs
At Family First Intervention, it’s our mission to help families understand how they can help save their loved ones from addiction. Get the facts.
Intervention Success Rates
One of the most commonly asked questions is, “What is your success rate?” But there is more to it.