Intervention. A&E television has a series on it. One of the most highly rated “Buffy the Vampire Slayer” episodes features an intervention. Jamie Foxx brought the issue to national consciousness in his Academy-acclaimed role as Ray Charles. Madonna’s American Life album has a track on interventions. And later this month, HBO will present a special on chemical addiction featuring a powerful episode on family intervention.

Yet although “intervention” has become part of the media lexicon, the term is commonly misunderstood. In large part, says John Seaman, a California Association alcohol and drug counselor (CADCII) who has performed more than 1,800 interventions, that’s because often people have two primary misperceptions about what interventions really are.

“First, people have to understand that an intervention is a very loving thing to do,” Seaman says. “What you’re doing is bringing together a group of people who care about the person with an addiction. And I always insist that people come together out of love. In other words, it’s about surrounding that person in a circle of love.”

Second, Seaman says, interventions are often as much about healing the loved ones – doing what some call an emotional intervention for family, friends and colleagues – as they are about seeking treatment for the addict.

“When people talk about recovery, they are usually focusing solely on the addict,” Seaman says. “But before we can do an intervention for the addict, we have to basically do an intervention for those who are significant in the person’s life. Think about it. The addict didn’t get to where he or she is without a lot of help from those around them.”

So what exactly is an intervention? When is it necessary? And who is a part of the process?

Dr. Vernon Johnson, an international pioneer in the intervention field, defines intervention as “presenting reality to a person who is out of touch with reality in a receivable way.” That is, presenting the addict with enough evidence of the harmful effects of his or her behavior in a way that the addict will understand.

Addiction or self-destructive behavior is not simply drug and alcohol abuse. It can include gambling addictions, sexual compulsions, eating disorders and/or severe depression. Johnson, author of I’ll Quit Tomorrow and Intervention: How to Help Someone Who Doesn’t Want Help, advocates a system in which a group of significant people in the addict’s life come together in a systematic way, often under the leadership of a trained intervention specialist, and plan to confront the addict or person in need in a formal manner.

The process has several stages, the first of which is possibly a period of apprehension on the part of those considering intervening. Some family members, friends and colleagues might fear the addict due to his or her behavior, while others might be angry. The goal is to move from this reluctance to a committed, cohesive and focused group.

Enter the intervention specialist.

Seaman, who performs about 100 interventions a year, explains the significance of having a well-trained professional to facilitate the process.

“People who are considering doing an intervention come from lots of different perspectives,” Seaman says. “And what these people need to do is write a script, give concrete examples, give data and information.”

Louise Stanger, a licensed clinical social worker and the director of Alcohol and Drug Services at the University of San Diego, agrees.

“It’s important to get a licensed, trained interventionist,” Stanger explains. “A lot of the process is going to depend on this individual, and you want someone who is fully qualified.”

She warns against seeking assistance from interventionists who work on a quasi quid pro quo basis – someone who works for specific centers and receives a referral fee from the treatment center. The selection of a treatment center is really the responsibility of the entire intervention team, Stanger says. Factors to consider include whether the addict needs medical detoxification, what resources are available to the addict and loved ones, health insurance and geography. The point, she stresses, is that an intervention is not about the interventionist, it’s about the addict and the family.

There are a number of questions those involved should ask the intervention specialist, Stanger says. For instance, what primary training in addictions and group therapy does he or she have, and where did he or she recieve training? What approach is used; for example, is it confrontational? What is the success rate?

Johnson gives seven basic guiding principles for a family intervention. (It should be noted that the term “family” is often broader in the GLBT community than simply blood-related relatives. As many experts point out, gays and lesbians often build families outside of traditional structures.)

First, only people significant to the addict should present facts. Second, describe specific events that occurred or conditions that exist. Third, the tone of the confrontation should not be judgmental but genuinely respectful and concerned. Fourth, link evidence directly to chemical use. Fifth, present evidence in clear detail. Sixth, focus solely on breaking down the addict’s denial system. Finally, offer two or three treatment options.

A time to intervene

North Park resident Janice Frazier says her younger brother was, “spiraling out of control in a fit of alcohol and depression.”

“For about nine months we watched Alan experiment with a series of self-destructive behavior,” Frazier says. “It got to the point where his health was in extreme decline. He wasn’t taking care of himself from a hygiene standpoint, from a mental health perspective and from a physical standpoint. Alan was always a bit of a loner, but he was quickly becoming more and more of a recluse, and it got to the point where he lost his job and was about to lose his condo. His boyfriend couldn’t take it anymore. He had long been working toward shutting [his family] out.”

Frazier was chatting with friends one day when she heard about the concept of a formal intervention.

“At first it was really hard to understand because it seemed so clinical, so harsh,” Frazier says. “But after really investigating what it entails, I began to understand that if I wanted my brother back – and I did want him back, back for me, for my parents, for [his boyfriend] and for himself – I had to do this.”

Frazier contacted an intervention specialist and began a lengthy and heart-wrenching process to prepare herself for “the big day.” The process involved meeting with the specialist, listing the people significant in Alan’s life and bringing them together. The group then learned what alcoholism and depression are, how to confront Alan, and how to prepare for the formal intervention day. They also explored different treatment options.

“Because Alan is gay, we wanted to find a place where he could seek treatment that would be comfortable for him,” Frazier explains. “It wasn’t about saying, ‘We’re sending you off to some looney bin in Utah.’”

A large part of preparing was deciding what the group – comprised of Frazier, Alan’s former boyfriend, two former co-workers, his parents and another sibling – would say.

“The thing about preparing is that you really do have to be clear about what you are going to say,” Frazier says. “It’s really about writing a script, really, because once you get into the actual day of intervention, emotions start going, defenses are going to come up, your own enabling is going to want to kick in and you can’t let that happen. You have to be firm about what you are saying. In fact, we even did two practice sessions before the intervention day.”

Although this didn’t happen in Frazier’s case, there are times when an intervention specialist will have to remove a group member from the intervention team.

“Let’s say, hypothetically, that we have a young man who drives NASCAR and that he is completely financed by his dad,” Stanger says. “Now, this guy is doing cocaine, which could be a problem when you’re driving a car at 180 mph. During the course of preparing for the intervention, and in meeting with all the people who are significant to the young man, we meet the dad who simply isn’t ready to give up his dream of having a world-class NASCAR driver as a son. The dad actually might have to be removed from the team if he can’t come on board with the necessary structure.”

There are a number of other potential concerns with interventions. Stanger lists four major ones: First, interventions are often far too scary for families to go alone in the process. Second, the professional present during the intervention process should be objective. Third, ultimatums are often needed. And fourth, anger often results.

And Frazier’s day of intervention was no exception.

“Alan was livid,” Frazier explains. “But who wouldn’t be when you are in a state of denial as he was. He was screaming and yelling and accusing us of going around his back to gang up on him. All the things you would expect, really. And that’s where we had to stick to our scripts – our data and our rational arguments – and keep presenting all the things that were affected by Alan’s behavior. It was about breaking down his walls, about taking away the excuses and the blame, and about continuing to hammer home that we were there because we loved him, not there to persecute him.”

Frazier and the team had spent nearly two weeks getting ready, had to bring Alan into the intervention space – her living room – under false pretenses, and had to endure what Frazier says is the hardest thing she has ever done in her life: telling her brother that either he seek help or that he understand that she could not be a part of his life as it was now moving forward.

It wasn’t about threats. It was about inviting Alan to seek treatment in order to remain in her life, Frazier says.

“On the one hand I guess it was an ultimatum, but not in the negative sense. It was about saying, ‘Will you accept help? But unless you do, I can’t continue to experience this kind of pain.’ And the powerful thing was that my baby brother had no choice but to look around and see his lover, his parents, two of his sisters and his former co-workers all saying the same thing: ‘We want you back into the fold of our lives, but we want you to get help to be the person that you know you can be.’”

For Alan, seeing all the people in the room who had come together out of love and concern was hard to ignore. “[He] had no choice but to hear what we were saying and sit up and pay attention,” Frazier says. After all, “Where could he hide at that point?” But it wasn’t easy. The meeting took more than four hours.

Follow-through

Mark, 38, of University Heights, is a recovering drug addict. “My drug of choice? Whatever I had handy,” Mark says.

Like Alan, Mark’s family and loved ones came together to give him an ultimatum. Two family members, Mark’s boyfriend and his best friend, Paula, were on the intervention team.

“They didn’t even knock,” Mark recalls. “It was so surreal, like out of the movies. They just burst in, all of them, with these half-scared, half-angry looks on their faces. I thought they were going to throw me out of the house. My partner and I had been having troubles, and he kept threatening to leave. But he never followed through, so I just figured this was one more time people were going to give their little idle threats and then I could go back to doing my thing.”

Mark couldn’t have been more wrong. In fact, one of the guiding principles of an effective intervention is the follow-through. As basic as it seems, if you give an ultimatum, Seaman explains, be prepared to follow through.

“My partner had a suitcase with him, which kind of seemed weird, because he was walking into our house with a suitcase,” Mark recalls. “He began to explain all the reasons why he should leave, all the things that he was feeling because of my using, and then he said, ‘When you’re clean, I will come back, but I want you to watch me walk away, because I want you to know that I can walk away. But more than that, I want you to listen to what I am about to say: You need to know that I can – and will – come back, but only if you’re clean.’”

Mark and his partner are still together. While they don’t talk about the intervention much, Mark says he’ll never forget it.

“What was so bizarre – and I couldn’t even blame this part on the drugs – was that suddenly [my partner] was no longer arguing or pleading,” Mark explains. “There was no debate. There was just a choice. I could choose treatment or I could choose to lose the man who loved me, a man who stood there and stood firm saying, ‘I don’t sleep at night because of this’ or ‘My job is suffering because I can’t focus because of that,’ and really what he was saying was, ‘Here’s the choice, Mark, and here’s what I can no longer tolerate.’ I guess at the time I thought he was being an asshole, but when everyone there was saying the same thing, I just had to wake up, man.”

Besides loving ultimatums, another intervention tool is “I” messaging. It’s important, experts say, to phrase one’s message in concrete individual terms: “I am here today because I care about you.” “I think you are special because….” “I am hurt by your use when….” “Do you remember when you and I used to…?” “I want to be able to do that again.” And so on.

Any addiction

is fair game

Linda, 42, of City Heights, used to have a gambling problem. Three years ago, her partner and family performed an intervention and convinced Linda to get help.

“I was a mess,” Linda recalls. “I was missing work because I would be out all night at the casinos. My relationship was completely destroyed, and if it hadn’t been for the fact that we had kids together, my partner would have left a long time before then.”

Gambling, unlike drugs and alcohol, isn’t the typical focus for an intervention. But any addiction or impairment is fair game, according to Linda. She attends Gambling Anonymous, although when she is out of town and can’t find a meeting, she’ll attend Alcoholics Anonymous meetings.

“What’s the difference between blowing the cash on poker versus snorting it up your nose?” Linda says. “Basically, all addicts are probably relying on a system of lying and making excuses and borrowing money here or there. It’s all the same.”

What made Linda’s situation especially critical were her kids.

“My partner was doing everything she could to hold the family together,” Linda says. “She was covering the mortgage, the insurance and the groceries. And she spent a great of time covering for me.”

It wasn’t until the day of the intervention that Linda says she realized just how much her partner had been covering for her.

“When she began listing all the things she was doing – things that I used to do but had stopped doing – like taking the kids to the doctor or meeting with the teachers at school, and then she began talking about how much she missed doing those things together, it was a real wake-up,” Linda says. “And this wasn’t some gentle, nurturing conversation we’re talking about. I mean, she laid it down that day – just one thing after another, maybe 25 or 30 things that I was neglecting. I guess at first it was sort of overwhelming, but I could see how hurt she was, but how tough she was, too. I knew I needed her, and the only way she was going to stay with me was if I got up off my ass and got help.”

An intervention group must immerse the person in the reality of the problem, both Seaman and Johnson say, and it must be put in words that the addict can “hear.” It must provide viable solutions to the problem, while still “surrounding the chemically-dependent person in love,” Seaman says. Seaman also emphasizes spending significant time focusing on the needs of family and loved ones who are preparing for the intervention. The first intervention is the family, he says.

“In order to intervene for the addict, we have to intervene for loved ones,” he says. “Even though the behavior of the addict is medically diagnosed … we can’t ignore that the people around the addict have equally as troubling behaviors of enabling – we bail them out, give them money, make excuses, cover up for them at work or home, maybe a business partner who makes excuses for the addict. This can be a big part of the problem because it allows the disease to continue.”

“Every person needs to understand their enabling behavior,” Seaman says. “In other words, everyone needs to recover, not just the addict.”

Which is likely, say many experts, why interventions don’t happen soon enough.

“So many people wait, thinking that the addict needs to bottom out, that they have to wait until that person is ready to ask for help,” Seaman says. “But waiting for someone who is an addict, who is delusional, to say that they want help, it’s just too risky to wait. Waiting may be too late.”

Seaman conducts a free weekly seminar at the McDonald Center at Scripps Memorial Hospital every Saturday from 10:30 a.m. to 12 p.m.

“In order for a loved one to put together an intervention, they have to have information, data, and education,” says Seaman. “The seminar is open to anyone who wants to learn about chemical dependency signs and symptoms, as well as interventions. It’s a powerful first step.”