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SPECIAL REPORT: The world of intervention: no regulations, no clinical requirements

July 29, 2013
by Alison Knopf, Contributing Writer
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(First in a three-part series)

Interventionists are the people desperate families call to persuade a loved one to get treatment for an addiction; they also are relied upon by many treatment centers to fill beds. Some interventionists have acquired celebrity status in the substance abuse field. Their fees are frequently paid by trust funds and rich people, but never by insurance.

Addiction treatment services are regulated. But intervention isn’t—there are no state or federal mandates around certification, licensing, or credentialing of interventionists. It’s not even a formally recognized service within the behavioral health field or the medical profession, so that makes it difficult to enforce standards. The only thing the field has been able to do so far is to create its own internal credentials—sometimes, for sale on the Internet.

“Who’s watching over this industry? No one right now,” says Shirley Beckett Mikell, who heads certification programs at NAADAC, The Association for Addiction Professionals.

“Some people spell out everything in their contract agreements,” Mikell says. But others don’t. At the heart of the problem, she believes, is a lack of clinical requirements for interventionists.

Interventions traditionally follow one of two models: the surprise model developed by Vernon E. Johnson and referred to as the Johnson model, and the invitational model, which focuses on the family system. Four years ago, Jane Eigner Mintz concluded that too many interventionists were wedded to only these two models, omitting clinical concerns.

“Nobody was teaching the clinical component – people were going in with a method first rather than doing the proper clinical assessment,” the Cleveland-based interventionist says.

The intervention field has been driven by “well-intentioned people who were using 12-Step Johnson-style paint-by-numbers” interventions, says Mintz, who holds a master’s degree in community counseling and is a Licensed Professional Counselor (LPC) and Certified Intervention Professional (CIP). This method doesn’t necessarily work well with “high-acuity, clinically compromised, resistant clients,” she says. “There was a gap in the industry.”

So Mintz developed her own training—a new model for intervention, called the “Field Model of Intervention.” The Field Model is designed to help train interventionists on the aspects of this service that are different from services provided in the typical clinical setting, including environmental and family dynamics. Mintz may have alienated some of the least clinically credentialed and best known interventionists, but she won the endorsement of NAADAC.

“Quite candidly, we’re not on the same page with Mr. Seeley and some others,” says Mikell, director of certification for the NAADAC-affiliated National Certification Commission for Addiction Professionals (NCC-AP), referring to Ken Seeley, founder of Intervention 911. NCC-AP is developing an intervention credential, and many interventionists don’t want to see clinical requirements for their field, Mikell says.

“That’s one of the reasons Seeley and our group have had a disconnect,” says Mikell, an NCAC II (National Certified Addiction Counselor, Level II). “They want the credential, but they want it to be a stand-alone. We don’t. We want someone who has at least five years in clinical practice.”

Clinicians first

Interventionists need to be clinicians, says Mikell, because they need to do on-site clinical assessments. “Even if you base the assessment on family information, the final diagnosis is made when the person is in the room,” she says.

But Seeley, whose Intervention 911 company became famous as a result of participation in the recently canceled A&E reality show “Intervention,” says interventionists don’t have to be clinicians. “Interventionists really aren’t there to assess or to diagnose,” says Seeley, who is based in Hollywood. “What we’re there to do is to get into a family system. Maybe there’s a primary eating disorder going on that nobody knew of.” That’s why Seeley makes sure there are several types of treatment programs to which he can refer people.

Mikell doesn’t see how it’s possible for someone to refer individuals to treatment programs without being a clinician. Even though information may be gathered from family members and others, someone with clinical training has to make the assessment, she says.

“How else do you tell a treatment service provider that this person is appropriate?” she asks. “I would send them a copy of my assessment, a diagnostic review, and a treatment plan—all standard clinical documentation. The person conducting the intervention is also conducting an assessment—and should make sure that the person ends up in the correct place.”

Wild Wild West

Michael Walsh, president of the National Association of Addiction Treatment Providers (NAATP) and an interventionist, believes the field needs “parameters” of some kind. “Right now it’s the Wild Wild West,” Walsh says. “There are no standards in the country, and none in the states.”

There are interventionists out there now who are good, but who wouldn’t pass any tests, says Walsh, who has a master’s degree and holds Certified Addiction Professional (CAP) and Board Registered Interventionist, Level II (BRI II) credentials. “And just because someone gets whatever license or credential that we put out there, that doesn’t ensure that they’re good,” he says. But he adds that at least it would ensure that the person went through the steps to get to that point. And if the interventionist is licensed, he/she will have liability insurance—an important consideration for those families that get harmed as a result of an intervention.

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Comments

Thank you so much for this very needed article! I tried to report an interventionist last year and I was told that they "would get back to me" and never did.

I am happy to report, however, that the California Association for Alcohol & Drug Educators (CAADE)is about to launch a certification for interventionists, the CAIC (Certified Addiction Intervention Counselor). It will require that one be a certified or licensed counselor in their own state (at least IC&RC level), have academic training in evidence-based intervention techniques, a full intervention internship with clinical supervision, and a supplemental, enforceable code of ethics.

I hope this is a move in the right direction.

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