We don’t have a situation that involves drugs and alcohol; would an intervention even be appropriate?

Mental Health interventions towards treatment are the mainstay of what I do. Intervention becomes necessary due to erosion of function in relationships, self-care, and one’s work as a student or a professional. Intervention is not about “good” versus “bad” people.

How is mental health relevant if we know the problem is about drugs and alcohol?

In every use disorder situation, whether about substances or processes, whatever it is that’s going on is the smoke and not the flame. Smoke can even kill you, but the origin is about loss, grief, existential pain, physical pain, or trauma. People use because it makes sense. What makes it make sense is about human suffering and relates to Mental Health, whether it is a diagnosable condition or Life’s struggles.

We don’t have an angry or defiant person. Will this process be harsh?

Cruelty isn’t useful in any intervention. Also, Love is not an idiot. It can feel very hard to say no to old patterns, though no intervention is going to happen without you knowing what you’re doing, why you’re doing it, and choosing to tread this path.

What if we are worried that an intervention would cause trauma?

Firstly, the way trauma is talked about in culture is often inaccurate. Trauma is not an event; trauma is an involuntary response to an event. Take some Anxiety Disorders: if developmentally appropriate life tasks have become encoded as trauma, it would be strange not to expect a trauma response in an intervention that disrupts a pattern of retreat and avoidance. This reality is not license to be callous. Instead, we have to focus on what are normal responses to certain stressors and convey that though all feelings are valid, not all feelings are accurate.

What if this feels shameful or embarrassing for them?

When this is a concern, shame and embarrassment are already there. An intervention aims to deflate the powers of these emotions by concluding painful silences and realigning the family and friends as resources, as opposed to being anticipated critics or simply uninvolved.

What if we are a family in the public eye?

The family’, though often this question indicates added layers of complexity and vulnerability that surround the immediate context. Unpacking this is an important aspect of a family coming into alignment and making decisions about when, how, and what manner of intervention should occur.

I’ve seen interventions on reality TV. Is there a different way of doing it?

A lot of what is on TV is scripted. It’s certainly edited for maximum audience engagement. Essentially all of that is entertainment. The addition of cameras, itself, introduces a metaphorical Heisenberg Principle. There are a few different ways of approaching. The context of an individual case is what determines the approach, rather than it being a direct choice of the participants or even me.

How do we find a good program?

You want an independent professional whose expertise is in guiding families to the right program and carrying the case beyond a first placement. These are Educational Consultants. A number of them specialize in clinical programming. They are a family’s advocate. I can refer you.

What about the reviews of programs we see on the internet?

Psychological treatment deals in human suffering. Despite the marketing, “evidenced based” does not guarantee success, by any stretch! Part of most diagnostic conditions is an inability to truly see or act upon solutions. Blame is a mechanism to protect ourselves from shame and despair. Anyone can say anything they like about any program, no proof necessary that they even went. This sort of low-grade sabotage/attack can be a form of devotion to a celebrity or access to a community of grievance. Programs are imperfect. Programs and professionals make mistakes. Professionals are human, with their own suffering. And there have been very real grievances! It is hard to vet most of these complaints. The field has changed so much, even since the 1990s, that some practices that are criticized today were phased out over 25 years ago. In the 1990s many or even most programs were not even run by clinicians. The worry is real and legitimate. These are our loved ones! And the reference points are a kaleidoscope of mythology, falsehood, truth, partial-truth, decontextualized truth, and anachronism. (This is why it’s really key to have an Educational Consultant.)

How will you get them to choose yes when they are already saying no?

There is no power in trying to make anyone do what they don’t want to do. There is power in helping the willing align on a new course of action and support. If boundaries and limits are understood and recast for maximal functionality, the old situation will loosen up and Change has a new way of entering the picture. It’s about the willing staying within their boundaries and limits and so respecting their loved one’s autonomy and responsibility.

What is your success rate?

There are three factors that slow or even thwart this process. Understanding the presence and intensity of these factors is all part of an initial assessment in a first call. Because I work with mostly young adults from comfortable backgrounds, less attuned to crime underworlds, and from families who can afford opportunities, my numbers skew higher than normal. If a young adult refuses treatment but becomes legitimately independent and responsible as a result of the intervention, that is a success. The strongest determinant of success is a family’s willingness to plant and defend goal-posts they will not surrender later. If it becomes about negotiation, normally you’re not negotiating with your loved one but with the Problem that’s eating them. It’s a legitimate question but a real answer does not translate into percentages.

What kind of problems do you work with?

Anxiety, depression, other mood disorders, hypo/mania, psychosis, thought disorders, substance use disorders. I work with a lot of launch struggles that 20 somethings encounter with: entitlement, over-support, fear of failure, loss of motivation, ambiguous/unambiguous grief/loss, and ASD and other neurodiversity dynamics.

Are there any issues that you don’t work with?

It’s more a question of who I might not work with. Quite commonly, unfortunately, females have experienced things that can make working with males in this role contraindicated. To that, I’m not usually a good match for females struggling with eating disorders but can direct families to female professionals who would be. I do work with females; it’s only that the fact of my male-ness may be an obstacle for some.

Will you help us get to a program that we choose?

Educational Consultants are the experts in this function. Sometimes families approach me directly with a program in mind. If it’s a program that I can vouch for, I will work towards it. If it’s neither one that I know, nor other professionals I am confident in, then I will not. There are far too many pop-up programs by investment groups with big marketing budgets designed to make investors money with little interest in anyone’s actual progress.

Are you paid or anything similar by any programs or professionals?

I am only paid by families that contract with me. No kick-backs, no referral incentives.

We really don’t want to use involuntary youth transport for our under 18 kid. Can you do it instead?

There are many cases with kids under 18 that I pass on because they need IYT. I spend a lot of time as a pro bono apologist for those companies. Once we go through an assessment of the context as it stands and I deem my approach lacking, parents come to understand the value and safety that IYT provides. So, I am happy to work with under 18 kids, though my approach has to be valid.

We don’t know if we need an intervention. Will you work with us if we are not sure?

Yes. Sometimes I simply advise families. Sometimes I coach them without ever meeting their loved one.

Will you work with us after an intervention?

Yes. Most programs will have a family component and it is important that I do not double that process, but yes.

What do we do if they won’t go?

Before any intervention starts, you will know and will have planned exactly what that extended process will involve. Without your knowledge and agreement, no intervention is ready.

Is coaching the same as therapy?

Coaching is much more solution focused and task driven instead of process driven. Coaching is not a major delve into anyone’s past other than to understand where the present has come from. Coaching tends to be less on a regular schedule and is much more about assessing the present and achieving outcomes.