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SPECIAL REPORT: Ethics and real life for interventionists

August 5, 2013
by Alison Knopf, Contributing Writer
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(Second in a three-part series)

(Read Part 1)

Interventions can be done for as little as $750 and as much as $25,000, according to Rebecca Flood, president of the Association of Intervention Specialists (AIS). “If someone says ‘I can only afford x,’ you should say, ‘Here is what is available,’ and give pros and cons,” says Flood.

It’s unethical for a private interventionist to be paid a fee by the treatment center for delivering a patient, says Flood. It’s also unethical for an interventionist to be paid by the treatment center and the family, she says. “These are black-and-white issues—you don’t do it, period.”

But beyond that, how can an interventionist structure a business? You essentially can’t have a regular job because you have to be ready to get up and go on an intervention for days, at a moment’s notice. The only way to do it is to get a lot of calls.

“It’s hard to make a living as a traveling interventionist,” says Michael Walsh, president of the National Association of Addiction Treatment Providers (NAATP) and a former interventionist. “You have to get your name out there; you have to keep your name out there.”

One model is for the interventionist to be on staff at a treatment center, working exclusively for that program, says Flood, who was on salary as an interventionist at Seabrook House in New Jersey for 26 years. Flood, who is now CEO of New Directions for Women in California, says Seabrook House never contracted out intervention work.

“If patients weren’t appropriate for us, we would refer them elsewhere,” she says. “People who are private interventionists will argue all day long that there’s something wrong with that model.” But there isn’t, she says, as long as the patient and family know about it.

Roster of treatment programs

Indeed, Ken Seeley, who founded Intervention 911, says he is opposed to the staff model for interventionists. He likes to have not only several treatment facilities in mind when he goes to an intervention, but several types of facilities.

“Maybe it turns out the individual also has an eating disorder—I want to have a program that can deal with chemical dependency and eating disorders,” Seeley says.

Interventionist Jane Eigner Mintz has created a roster of treatment centers, and she uses factors such as tracks and type of reimbursement when evaluating where a particular individual could go for treatment. Mintz also has a full roster of transport companies and sober companions.

“This is the kind of encyclopedia every interventionist needs to develop,” she says. Mintz is establishing a training program based on her Field Model of Intervention.

Carol Lawyer, an interventionist based in Pennsylvania, asks families if there is a treatment center they would like to use. Many families, however, don’t know much about treatment centers, she says.

“I didn’t make a dime on 80 percent of the calls I took as an interventionist,” says Walsh. “Most of the time I was just helping people find the right treatment center.”

Transparency

Transparency is important, Walsh believes. As long as the family knows how the interventionist is getting paid, it’s fair, he says. Some interventionists tell the family that if a patient goes to a certain program, they won’t charge for the intervention because the treatment center is paying them. The problem with that is that there is an inherent conflict of interest—the family is steered to a program that might not constitute the best match. “There are a lot of different ways to look at this,” says Walsh.

We spoke to Melissa Preshaw, community relations and outreach director for CRC Health Group, about the large for-profit treatment organization’s policy on interventionists. First of all, CRC does not reimburse interventionists. Each CRC facility has its own relationships, so that if a family member calls and says, “My son really needs help but I’m afraid of approaching him,” the facility will refer the family to three different interventionists, says Preshaw.

Preshaw recommends that facilities make sure an interventionist is ethical before referring him or her to family members—for example, that the interventionist isn’t getting paid a fee by a treatment program and the family, and isn’t getting secretly paid by the treatment program.

“It behooves the facility to investigate,” she says. “For the most part, interventionists are well-intentioned.”

Package costs

Sometimes families say they will pay twice as much if the person goes to treatment, and nothing if the person doesn’t go. “The first time I heard that, I said, ‘That’s not a good deal for me,’” says Walsh. “My ability to get them to go to treatment depends on whether the family can do what I say.”

It’s better to get families to invest in the whole package—the transport and the aftercare—because these things contribute to the success of treatment, Walsh says. “But I know some people take advantage of that and try to sell all the add-ons. It’s just like a car wash.”

Sometimes, money doesn’t solve the problem, says Walsh. “I don’t think you should go to the same treatment center five times—you have the education, something else is the problem,” he says. “I would tell trust fund families, ‘Send them to the best treatment center twice, and then send them to the Salvation Army.’” Clients have to know that they can’t count on their family to pay repeatedly for programs with a pool and a gym and great food, Walsh says.

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