What is intervention?

When is intervention over drug or alcohol use appropriate? One benefit of becoming knowledgeable about addictions is being able to spot, earlier and with more clarity, the signs and symptoms of developing substance abuse problems.

Here we offer some strategies to get help for people with substance misuse and abuse problems and their loved ones, and some options that are available specifically in the Capital Region to assist them.

SAIR believes that intervention is appropriate when someone has developed a pattern of drug or alcohol use that continues to progress despite negative consequences.

Intervention can take many forms. A parent confronting a teen-age child who comes home drunk or high on drugs after an evening out is intervening about their substance use. An employer who challenges a worker over showing up for work under the influence or over frequent absences from the job is also intervening.

Personal responsibility demands that people who see drug and alcohol problems developing in those they are close to not look the other way.

We offer detailed information about an informal intervention technique known as “FRAMES.” It has proven effective at making people think about the extent of their use of substances and the consequences, and about options for getting help. It requires no special training or expertise.

The “FRAMES” approach

A pattern of alcohol or drug misuse has surfaced, indicating an opportunity for the use of “FRAMES.” SAIR believes “FRAMES” is an effective way of getting people who are misusing drugs and alcohol to start thinking about the consequences of their behavior and about seeking help.

“FRAMES” is an acronym referring to a positive, constructive way for people to express their concern about another’s substance use and to try to motivate them to do something about it. A “FRAMES” intervention is not a confrontational exchange where the user feels they are on trial for their behaviors and habits. Rather, it should be a conversation where a person expresses their concerns about another’s use of drugs or alcohol, discusses the approaches they can take to change and offers hope and encouragement to get help. It should be done with empathy and support. Professional expertise is not necessary for a “FRAMES” intervention.

The “FRAMES” components are:

• F is for feedback. Encourage individuals to discuss their substance use and problems that may have occurred. 

• R is for responsibility. The responsibility lies with the individual to make appropriate, positive changes and choices.

• A is for advice. Recommend ways that individuals can get help. 

• M is for a menu of options. Suggest specific actions individuals can take to address problems. 

• E is for empathy. At all times, empathy should be shown toward the individual in need. 

• S is for self-efficacy. Reinforce the point that the individual is capable of succeeding.

If successful, a “FRAMES” intervention will give its subject more awareness of the potential consequences of their alcohol or drug use, the options for getting help and the support that will be available to them if they do so.

What now? What next?

An axiom in the recovery field is, “If nothing changes, nothing changes.” It is a way of saying that recovery is dependent on a person’s ability to change the behaviors and the attitudes that led to their misuse of drugs or alcohol in the first place. Another tenet of substance abuse professionals is, “Change is the foundation of recovery.”

Both expressions are based on the idea that in order to free themselves from dependence on drugs or alcohol, people must be motivated to change the way they think, act, feel and believe. The better a person understands and addresses the negative thoughts and behaviors that led to their misuse of substances, the better their chances for recovery.

The accepted stages of change progress from “precontemplation” (people are not even aware of their problem); to “contemplation” (they start to entertain the possibility or the need for change); to “preparation” (they have decided to make changes within the near future); to “action” (they actively begin to modify their behaviors) to “maintenance” (the replacement of old, destructive behaviors for new, positive ones). The final stage is “recurrence” or “relapse” (they resume their former, undesirable behaviors). Experts say that not everyone moves from one stage of change to the next in an orderly fashion, or that people are necessarily aware of the transitions as they are occurring. But they agree that behavioral changes need to occur if people are going to successfully overcome addictions.

The need for change also applies to those individuals who are attempting to help and support the abuser of drugs and alcohol.

Options for Treatment

A person has come forward on their own for drug or alcohol treatment. Or they have agreed to seek help during a “FRAMES” discussion or another form of intervention by others.

Where should they turn next?

Most people seek help through:

• Treatment providers licensed by the New York state Office of Alcoholism and Substance Abuse Services (both in-patient and out-patient facilities).
• Private treatment providers (psychiatrists, psychologists, counselors with master’s degrees in mental health and substance abuse and other state-certified professionals).
• 12-step programs for those in recovery (including Alcoholics Anonymous and Narcotics Anonymous).
• Faith-based support groups (including churches and synagogues).
• Communal support (associating with members of the community that can offer healthy support during the recovery process).
• 12-step programs for people supporting individuals in recovery (including Al-Anon and Nar-Anon).

The best options will vary according to the individual seeking help, their age, their families, their income levels, their access to private or public health insurance coverage, the depth of their drug or alcohol dependencies, and other factors.

Recovery plans may well entail being involved in two or more treatment options. It is common for people to need in-patient care at the detoxification stage of early treatment and to immediately explore a 12-step program such as Alcoholic Anonymous, so they will not be starting their journey to sobriety alone. Formal out-patient programs frequently offer basic information about substance abuse and the science of addiction while also urging participants to try 12-step programs to strengthen their sobriety. There are many paths on the journey to recovery. But isolation and a go-it-alone attitude are usually seen as major deterrents to achieving and maintaining sobriety.

SAIR urges people to beware of the recent proliferation of fraudulent, unregulated or ineffective treatment for alcohol and drug problems. Just as the misuse of alcohol and drugs has continued to grow, an increasing number of unscrupulous treatment vendors has surfaced to prey upon desperate individuals and families seeking help with their substance abuse problems.