This intervention is aimed at catalyzing the substance-abusing person’s entry into a treatment program. Although there is no substantive focus on the caregiver’s well-being, caregiving burden may be reduced if professional help can be accessed and utilized.
The approach is to plan and implement a confrontation of the substance abuser by one or more caregivers. Planning initially engages the caregiver in help assessing the person’s social network and evaluating the likelihood of engaging other network members into a counseling session. Two sessions with the network follow to educate them about the dangers of enabling, the goals of the confrontational intervention, and problem-solving strategies to determine the needs of caregivers themselves, and how they would accomplish the planned confrontation. The final session involves the planned confrontation of the alcoholic by the social network in the presence of the therapist.
Family members who are actively involved in the lives and care of the person with substance abuse disorder and/or are impacted by the disorder. Intervention includes planning and the confrontation session which follows, with the goal of engaging the person in treatment.
Liepman et al. (1989) recruited 24 social networks associated with 25 alcoholics who had refused to enter treatment for this intervention, with better outcomes than a control group. However, across studies, the vast majority (70%) of networks do not implement the planned confrontation.
Outcome Research References
Liepman, M.R., Nirenberg, T.D., & Begin, A.M. (1989). Evaluation of a program designed to help family and significant others to motivate resistant alcoholics into recovery. American Journal of Drug and Alcohol Abuse, 15(2), 209-221.
Miller, W.R., Meyers, R.J., & Tonigan, J. (1999). Engaging the unmotivated in treatment for alcohol problems: A comparison of three strategies for intervention through family members. Journal of Consulting & Clinical Psychology, 67(5), 688-697.
Stanton, M.D. (2004). Getting reluctant substance abusers to engage in treatment/self-help: A review of outcomes and clinical options. Journal of Marital and Family Therapy, 30(2), 165-182.