Frequently Asked Questions About Addiction and Treatment
Every family I speak with has concerns about doing an intervention and the likelihood of long-term success following treatment. Here are some of those questions and the answers I provide for them:
What if my son refuses to accept treatment? The person being intervened on can refuse treatment; this is one of the inherent risks of doing an intervention; however, it's been my experience that successful interventions far outweigh unsuccessful interventions.
I rarely have a client that doesn't go to treatment. Sometimes that person goes within a couple of days of the intervention once they've had an opportunity to experience the consequences imposed by his family. A vast majority of people accept treatment on the spot and leave with me immediately following the intervention.
Several factors determine a successful intervention; the family's ability to uphold boundaries and implement consequences, sufficient preparation and pre-intervention training led by the interventionist, and the family’s ability to demonstrate their acceptance of an unfavorable outcome.
Addiction is the elephant in the room nobody wants to confront; as such, chances are your son or daughter has been ruling the roost for years and are not used to being questioned about their drinking or drug use. The intervention clearly indicates a power shift is happening, and they are no longer the ruling party. Over the years, they've used multiple forms of manipulation to push their weight around and continue their addiction uninterrupted.
Your son or daughter may need a hot minute to internalize the new order. This may require them actually experiencing the consequences before deciding to accept treatment. Every case is different and requires some form of customization.
I am known to advise families that the most powerful tool they have is acceptance. The family's ability to calmly accept an unfavorable outcome is a product of sufficient pre-intervention training. It is crucial to the process because it shows the person at the center of the intervention that they are no longer in charge. Flying off the handle when your son says he's not going to rehab only reinforces them being in charge.
The overall mood of an intervention should be peaceful. In the end, the addict is going do to what he wants; however, it should be made clear that the parents have an equal right and ability to do what they want. It's super important to show your son or daughter you're at peace with whatever they decide to do. That you're no longer waiting up all night for them or begging them to come home or that you haven't slept in years.
It's the interventionist's job to make sure you're properly prepared for the intervention and to postpone it if you're not ready. Going into an intervention with an under-prepared family and participants is negligence.
How much does treatment cost? A family's ability to pay for treatment is an essential piece of the recovery equation and something I previously wrote about in a recent blog called Paying for Treatment.
Putting aside insurance benefits treatment can range in cost from $300 per day to $1000 per day, depending on the length of stay (30, 60, 90 days), the number of private therapy sessions per week, amenities (equine therapy, private rooms, smaller caseloads and dinning), and location of the treatment center. As you would imagine, exclusive treatment centers can reach $3000 per day and well beyond that.
Most people use a combination of insurance and cash pay. Rarely does insurance completely cover the cost of treatment unless you are a union member, such as an airline pilot or another highly skilled professional. I have seen people who have been out of work for six months with good insurance and doctors in private practice with terrible benefits.
When shopping for in-network treatment, make sure you ask many specific questions, such as, what are my deductible and co-pay, what is my out-of-pocket maximum, and confirm the rehab center is in-network not attempting to use out-of-network benefits. You want to make sure you understand what your liability is. Having to pull someone out of treatment prematurely because insurance benefits crapped out or the family couldn't afford to pay in cash could have fatal consequences.
What happens if my son or daughter leaves treatment early? Leaving treatment Against Medical Advice (AMA) is another real consideration and happens all the time. If your son or daughter is an adult, eighteen or older, they have the legal right to leave treatment, and there's not much you can do about it. Treatment centers are not prisons or locked-wards; clients, regardless of how misguided they may be, possess the legal right to discharge.
With the above in mind, it's uber important to consider the possibility of your loved one leaving AMA before the intervention happens. For this reason, I typically use treatment centers that are far away from the client's home. For instance, I may place someone from South Florida in Utah because it's hard for them to take off spontaneously. Technically they could leave prematurely, but it requires them to jump through some hoops before getting home and, therefore, hopefully, a deterrent.
The second tool that helps keep people in treatment is knowing their family stands firmly behind the boundaries set forth during the intervention. If one of the consequences spoken about at the intervention is that your son or daughter will no longer be welcome in the family home if they don't accept treatment, it stands if they leave treatment prematurely. Leaving rehab AMA is the same as not going in the first place.
As long as the family maintains their commitment to recovery and holds the boundaries discussed at the intervention, the less likely it is for their loved one to exit rehab prematurely.
Can you make someone go to treatment? In some circumstances, you can make someone go to rehab; however, doing so is no indication of future success; then again, to be fair, either is an intervention.
I recently wrote about this in a blog post called Can You Make Someone Go to Treatment, which I recommend reading.
In some states, such as Florida, a law known as the Marchman Act allows families and professional mental health workers to petition the court to order someone to undergo an evaluation. Based on the findings of that evaluation, a judge can then order someone into treatment in the county in which the petition was filled.
There is second law known as the Baker Act that allows behavioral health professionals and law enforcement to place a person who is considered a danger to himself or others in a 72-hour involuntary hold.
If you are considering either a Marchman Act or Baker Act as a means of getting someone you care about into treatment, it's best to consult an attorney who specializes in the area of law. Two respected attorneys to consult in South Florida are Mark Astor and Joe Considine.
Despite the options mentioned above, getting someone into rehab who is treatment-resistant is difficult. Your best opportunity for change may be to work on yourself by immersing yourself in programs that treat codependency, such as Al-anon and Families Anonymous.
My hope for someone going into treatment via intervention or legal remedy is that they get a taste for sobriety and decide it's something they want for themselves and take ownership of their recovery.
I feel like I am betraying them? I hear this all the time, and frankly, it doesn't make sense to me. A betrayal or ambush is intended to cause harm to another person. An intervention or rescue mission is intended to save someone from injury and even death. So why is an intervention a betrayal - it's not.
I think what people say when they feel like they're betraying their son or daughter is that they are fearful of losing them or having them become so resentful as to cut them off from their lives. Even worse, people are often afraid their loved ones will hurt themselves or take their own lives if confronted.
These feelings are not without merit. People who are often addicted to substances such as drugs and alcohol or suffering from a mental illness will use manipulative tactics to keep parents and family members from interfering with their addictions and rituals.
We always take the threat of suicide and self-harm seriously so, please do not think I am diminishing their effect. Still, nothing is more effective than shutting down a conversation about rehab quicker than a child threatening their parents with suicide. It's an effective evasion tactic.
Taking on the responsibility of an intervention may mean your child is going to be angry with you. They will have resentments and attempt to manipulate you by saying things that make you feel guilty. They may say you "ambushed" them, or if you only just sat them down and spoken with them, they would have gladly gone to treatment. This is complete bullshit, how many millions of times have you tried talking to them while they blatantly dismissed you?
If your son, daughter, or spouse is still resentful about the intervention at the end of their treatment, they are not ready to come home! They haven't internalized why they are there. It's that simple!
Marc Kantor is a certified interventionist and the founder of South Florida Intervention.If someone you care about is struggling with drug or alcohol addiction, please visit southfloridaintervention.com or call 202-390-2273.