Intervention Services
Nationwide Mental Health Disorder Intervention Services
The National Institute on Drug Abuse (NIDA) defines addiction as a brain disorder as well as mental illness. The Diagnostic Statistical Manual, 5th Edition (DSM-V) of mental disorders published by the American Psychiatric Association, categorizes substance use disorders as mild, moderate, and severe.
What is a Mental Health Disorder Intervention?
Many are of the mindset that an intervention is a gathering of friends and family in an attempt to address a problem. Others believe an intervention is what they have seen on television. These types of perceptions are not completely off base, and they are one way to look at what an intervention consists of. An intervention is a clinical tool or strategy used by clinicians as well as mental and substance use disorder professionals. Interventions use specific strategies to address a problem or behavior in order to meet a specific goal. Interventions for any purpose can change from minute to minute, as can the strategies. Whether a substance use disorder or a mental health disorder, interventions require a professional interventionist to facilitate the process effectively.
Mental Health Disorder Interventions use evidenced-based strategies to obtain willingness from the intended patient in order to seek treatment and advocate for their own care. Furthermore, they are designed to help the family step back and allow their loved one the opportunity to learn how to advocate for their own care, absent ineffective enabling and communication by family members.
Mental Health Disorders, Addiction, and Dual Diagnosis Intervention
Insofar as Alcohol, Drugs, Addiction, Mental Health, and Dual Diagnosis are concerned, a substance use disorder can be defined as a mental health disorder. We are neither discounting nor disregarding any previous mental health or substance use disorder diagnosis. Intervention is most effective when the harmful, destructive behaviors and resistance to treatment are addressed. Focusing only on the diagnosis (substance use disorder, mental health disorder, dual diagnosis), the lack of diagnosis, or the substance of choice but not on the behaviors diverts us from the goal of getting help to the family and the loved one. We ask that families keep an open mind and look at the behaviors of their loved ones as well as their own behaviors and not whether the problem is addiction, mental health, or both. The diagnosis for a loved one is determined by the treatment team—not by the interventionist, the loved one, or the family.
Many different organizations have different definitions as to what constitutes addiction. In addition to not agreeing on a definition, no organization can explain with detailed accuracy, outside of symptoms and a general or broad explanation, what a mental disorder is or its origins.
The National Institute on Drug Abuse (NIDA) defines addiction as:
a brain disorder as well as mental illness.
The American Society of Addiction Medicine (ASAM) defines addiction as:
a chronic medical disease.
The National Institute of Mental Health (NIH) states that:
addiction is a mental disorder that affects a person’s brain and behavior.
The Diagnostic Statistical Manual, 5th Edition (DSM-V) of mental disorders published by the American Psychiatric Association states that:
Mental Disorders are usually associated with significant distress or disability in social, occupational, or other important activities. It categorizes substance use disorders as mild, moderate, and severe.
(American Psychiatric Association, 2013, p.20).
The American Psychiatric Association (APA) defines a mental disorder as:
Any condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these. Such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors.
The World Health Organization (WHO) defines a Mental Disorder as follows:
A mental disorder is characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behavior. It is usually associated with distress or impairment in important areas of functioning.
https://www.who.int/news-room/fact-sheets/detail/mental-disorders
Mental Health Disorder Interventions
It is not uncommon for people to seek information about our services and find many references to addiction while doing so. Some believe that we are not equipped to help them or their loved ones with a possible mental health disorder. In our experience, it is quite rare to have a person with substance use or a mental health disorder who is not experiencing a dual diagnosis. Mental Health Interventions are very similar to other interventions, such as substance use and process addictions (e.g., gambling, sex, eating disorder, etc.).
Given that the protocol of an intervention includes having it conducted by a trained professional, then the format is similar. What can be different are the goals and the approach, depending on the particulars of the situation. The goal of a mental health disorder intervention, as with an intervention for addiction intervention, is to avoid coercive approaches and deliver the patient safely to a treatment facility to begin stabilization. While being stabilized, the goal of the integrated treatment team is to bring the patient to baseline, while the role of the interventionist’s team is to guide the family through the significant changes that have occurred. Mental Health Disorder interventions are just that and are not intended to treat the person’s disorder.
Mental Health Interventionists almost always encounter a dual diagnosis client. The question is and always will be what is the driver behind the behavior?
Many families insist it is only a mental health disorder. In our experience, it is rare while conducting an intervention to encounter a mental health disorder only. In the great majority of cases, the situation involves substance use. Until it can be determined otherwise, the interventionist must assume the behavior is a result of substance use. This is why it is so important to escort the loved one to a facility that can bring the client to a baseline and then build a treatment plan from there. Far too often, doctors, psychiatrists, mental health professionals, and the intended patient’s family make mental health disorder diagnoses too quickly and under less than desirable conditions. These conditions can be anything from a diagnosis made during a crisis or when the person is under the influence of drugs or alcohol.
When active substance use coexists with a range of other psychosocial impairments, the clinician should assume that these impairments are related to the client’s substance use until proven otherwise.
Integrated Treatment for Dual Disorders, A guide to effective practice, Mueser, K.T., Noordsy, D.L, Drake, R.E, & Fox, L. 2003
What are Different Mental Health Intervention Strategies?
Two models are commonly used by the patient’s treatment team in determining a dual diagnosis. When substance use or mental health disorder symptoms are present, clinicians may use the Super Sensitivity Model or the Antisocial Personality Disorder (ASPD) Common Factor Model.
Intervention strategies most effective for Mental Health Disorders consist of increasing client motivation and instilling hope within the client.
Intervention strategies for substance use only, mental health disorder only, or dual diagnosis intervention strategies can and will benefit all involved if motivation and hope are the primary focus. While a mental health interventionist needs to use motivational strategies, there must be a family’s willingness to change, too. Many times, motivation to change comes by way of consequences and accountability. Although it is much harder for a family to hold their loved one accountable for a mental health disorder, it is still an essential strategy in the intervention process. Coercion tactics are always the last resort in mental health disorder interventions, but they may be necessary in order to prevent harm to the loved one.
Families often make the mistake of seeing no difference between coercion and ultimatums and accountability and boundaries. They are not the same. Coercion and ultimatums are often used with involuntary commitment strategies, whereas boundaries and accountability offer a voluntary choice for the loved one. In other words, your loved one has the right to do it their way, and the family has the right not to agree with, enable, or support that decision. A person with a mental disorder, substance use disorder, or a dual diagnosis has to have some level of accountability in order to advocate for their own care. Even in strategies of Close Monitoring, i.e., intensive supervision of a person with a mental health disorder, consequences should exist for negative actions or behavior. As tough as it is, no illness gives anyone the right to make another person miserable. Enabling can and does take place with mental health disorders. The impact of enabling a mental health disorder is equivalent to the negative effects of enabling a substance use disorder.
Intervention Strategies
The strategies employed in an intervention can and will change as the situation evolves. It is highly encouraged that the family retains a professional substance use and mental health disorder interventionist when attempting to provide help for their loved one. It is important to remember that the interventionist is not a clinician but rather is there to help your loved one accept help.
The aftercare team is part of the intervention process and provides the family with education, support, and assistance after the intervention. The interventionists’ aftercare team can and will work with your loved one’s treatment team in collaboration with the family to provide the best opportunity for a successful recovery for both the family and their loved one.
Many interventionists try to play therapist and clinician while adding on family recovery and coaching services. None of these interventionists is qualified or licensed to do that. Interventionists must stay in their lane after the person accepts help. The best outcomes come from your loved one’s treatment team and the treatment center’s family program. If you choose an interventionist who offers support services after a successful intervention, it will create friction and discrepancies in your loved one’s treatment; we have gone down that road, and it does not work.
— Mike Loverde, MHS, CIP
A Personal Experience with a Family Member Misdiagnosed Early on with Multiple Mental Disorders
A child in our extended family was struggling with a rare genetic disorder. As a result, the other child in the family suffered from a lack of attention and the stress brought on by her sibling. The other child who did not have the disorder was a straight-A student and was involved in many activities and sports. The child’s mother called us to speak about the situation. She stated that the child who was struggling with her sibling’s problem was herself diagnosed with four different disorders, including ADHD. Keep in mind she was a great student and did not struggle academically, as some do with ADD or ADHD. As the conversation progressed, the person at our house said to the distressed mother, “Mike is here, and he has the same credentials as the therapist who diagnosed her,” and then asked me, “What do you think?”
Knowing the girl personally and in complete disagreement with her diagnosis, I asked the mother if her daughter had insurance or was on state Medicaid; she replied yes. I gave her the following suggestion:
Tell your daughter’s therapist you no longer want to use the insurance and will pay for the appointments. That way, your daughter’s therapist will not need billable mental disorder codes in order to be reimbursed for the sessions. I also stated, “tell the therapist what I said.” A week later, we received a call from the mother saying the therapist became extremely angry (remember, anger is driven by fear) and told the child’s mom to tell us to mind our own business. The therapist then put the credit card on file, and the four mental disorders were never brought up again.
What if we had not intervened, and this girl turned to substances later in life? The diagnosis she received at age 11 would have followed her in and out of treatment centers and mental hospitals. Would diagnoses twenty years later be accurate when the ones twenty years earlier were not? Her family would be on the phone with us today, pleading the case of the daughter’s mental disorder struggles.
Sadly, this experience is all too familiar for many of our clients. Diagnoses are made quickly and for billing purposes.
This is not to say there are no mental health disorders. It is to say, however, that clinicians and psychiatrists should do a much better job of accurately assessing the situation.
The reality is, every single person at one time or another has some type of behavior or symptom that can be matched to a diagnosable disorder in the DSM-V manual.
Frequently Asked Questions
Co-Occurring Disorder
Refers to two mental health disorders taking place simultaneously. This can also include two mental disorders or a substance use disorder with a mental disorder.
Dual Diagnosis
Describes when Co-Occurring Disorders are determined and diagnosed.
Comorbidity
Occurs when medical complications exist with a substance use disorder, a mental health disorder, or both. Alcohol Use Disorder, along with Anxiety Disorder and a failing liver, would be an example of comorbidity.
The challenge for professionals is to uncover the cause of the problem. Is the mental health disorder being exacerbated by substance use? Is substance use causing the mental health disorder symptoms? Is the person using substances while taking prescribed mental disorder medications? When substance use is present, even in small amounts, it is not possible for the professional to make an accurate distinction between the substance use disorder symptoms and the mental disorder symptoms, even when there is a medical history of a past diagnosis. Someone who turned to substance use later in life after an earlier mental disorder diagnosis may now be medicating the unwanted feelings and thoughts. The symptoms of the mental disorder may be seen as the patient acting out maladaptive thoughts and coping skills before escaping with drugs or alcohol.
The theory behind interventions for mental health disorders and alcohol as well as drug addiction is the same. What can separate the two are the different strategies and goals based on what is observed in real time during the intervention. Even with the information and background the family provides, it cannot be guaranteed the intervention will go as expected. Many people have advice and expectations in regard to the way they think the intervention should or will unfold. Volatility can occur, and because of it, strategies and goals can change, as can the outcome.
Interventionists mostly deal with a dual diagnosis of substance use and a mental health disorder. As a result, professional interventionists are not able to determine with accuracy the cause or diagnosis at the time of the intervention. The professionals at the treatment center need weeks to make an accurate diagnosis, and it follows that the interventionist cannot do it in a day. What the professional interventionist is able to determine are the most appropriate strategies to achieve the goal of bringing the person in need of help to a facility for stabilization and a much more thorough assessment.
The interventionist performs triage and is a bridge for both the family and the patient. The interventionist is neither the family’s therapist nor the patient’s treatment team. Interventionists are there to listen, build strategies, instill hope and willingness in your loved one, and to educate the family. In addition to this, they are ready to deliver your loved one safely to the facility (or to a representative from the facility) and prepare the handoff to the aftercare team. The interventionist acts as the nexus to everyone and everything at the intervention. Your interventionist’s aftercare team will help the family in its recovery as their loved one navigates the healing process and recovery.
We have learned this about mental disorders and addiction: drug or alcohol use on any level can and will exacerbate mental disorder symptoms. The level of alcohol and drug use that can affect mental disorder symptoms does not have to be abusive in order to do this. The recommended and most effective way to rule out drug-induced psychosis influencing mental health disorder symptoms of any kind is to stabilize the patient or client in a controlled environment over the course of several weeks to bring them to a baseline. Once this baseline is achieved, an integrated treatment team can start the process of accurately determining the appropriate diagnoses, medications, and evidence-based treatments.
Throughout our information, it is indicated that when a dual diagnosis of both a substance use disorder and mental health disorder exists, the clinician assumes the impairments are the result of the substance use until it can be proven otherwise. That said, a facility that employs three approaches, Sequential, Parallel, and Integrated, should receive preference.
Sequential Treatment Approach
Each problem is addressed one at a time. This makes it difficult, if not impossible to treat one disorder without having to address the other.
Parallel Treatment Approach
Both disorders are treated simultaneously but by different professionals at different facilities. The parallel approach is ineffective if a lack of communication or differences of opinion exists between the professionals and the other facility.
Integrated Treatment Approach
One treatment team, one facility. The integrated approach is the most common today for dual diagnosis clients. Integrated treatment approaches are far better suited to effectively address a dual diagnosis of both a substance use disorder and a mental disorder.
Testimonials
“We reached out to Family First because we have a loved one who was on their way to the grave due to multiple addictions and mental illness. We had tried everything we could ourselves to help, and unfortunately, no matter how hard we tried, we couldn’t get through to them. Addiction is such a powerful disease, and it shreds families apart. This isn’t something anybody should try to go up against without professional help. We all needed help, and Family First was able to help us accomplish what we could never have accomplished ourselves. The interventionist was highly educated and empathetic, aiding all of us throughout the entire process. Our loved one is currently in treatment, and we have hope for a healthier future once again.”
Amy Gerardi
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.
Professional Mental Health Interventionists with Family First Intervention
One of the hardest parts for family members is acknowledging a loved one’s drug or alcohol use. Many families default to a mental health disorder as being the driving force behind the problems. Although that may be the case, far more is involved in determining the causes and conditions of the dual diagnosis. Even when mental health disorder symptoms are present before any substance use has taken place, there may still be discrepancies in the diagnosis.
Experienced Intervention Counselors Are Here to Help
In order to provide families and the substance user with effective solutions, a team approach is a necessity. Our experienced team works collaboratively, and each member builds on the strengths, knowledge, and motivation of others. We all have different experiences and varying degrees of education that we can bring together. No one person can accomplish these goals alone.
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