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Intervention: It's not that simple

October 5, 2011
by Gary A. Enos, Editor
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Professionals talk about need for specialization and standards

Reinforced by a mass media coverage blitz and a perceived need to diversify services delivered by clinical addiction professionals, intervention certainly has been cast as a key growth area in addiction services. Yet two intervention experts with presently related career paths believe that a more crowded field and a lack of nationally accepted practice standards have created tough sledding for many interventionists, as well as a crying need to assess critically where the field is going.

“This is some of the most challenging work in the field. You're dealing with someone who is in active addiction-they are acute, reactive, unwilling,” says Jane Eigner Mintz, an intervention trainer who this year decided to take a break from intervention work to become director of professional services and development at a new California treatment center.

Adds Garrick Kreitzer, the northern Kentucky-based interventionist who has taken over as director of Mintz's Realife Intervention Solutions operation, “There is an undercurrent of a call for standardization of interventionists' competencies.” Yet there remains great uncertainty over whether this activity will occur on a national or state-by-state basis, and what the ramifications of that decision will be for what standards would look like.

For purposes of any regulation of operations, “In many cases you will have to ask, ‘Where is the service taking place?’” says Kreitzer. “Is it where the clinician is located, or where the client is?”

Clinical complexity

Kreitzer says he fully supports a move toward standardization for intervention services, as he says both the public and professionals are becoming more aware of the clinical complexities of the interventionist's typical client. Those complex presentations always have been there, he says, but some of the clients' needs have traditionally gone unaddressed or even unnoticed.

“Intervention has always been from a substance abuse model; the interventionist looks to place the client somewhere. But it doesn't stop there,” Kreitzer says. “You need a competency standard in order to properly assess.”

He foresees more specialization emerging among professionals in the intervention community, in areas such as family treatment and process addictions. He also thinks that because of economic factors, these types of services might be delivered in a fashion that differs some from the stereotypical intervention model.

“People today aren't necessarily able to pay for a big dramatic ‘intervention,’” says Kreitzer. “What it's turning into is the delivery of more component-based crisis intervention services. It might look more like consulting services.”

A typical example might involve the case of a client who is in recovery from substance addiction but never truly had other compulsive behaviors addressed during past treatment; an interventionist's work might focus on the narrower set of issues presently impeding the client's long-term recovery prospects.

Mintz believes interventionists need to have some form of trauma training, as well as an understanding of underlying process addiction issues in area such as food and love. “These are the core issues that fuel addiction,” she says. “For years we've been going after the symptomology. The medical issues are the easiest to treat-the underlying causes are harder.”

A further understanding of the multiple layers of issues affecting the client also will require the interventionist to develop relationships with a variety of treatment programs that address these needs, Kreitzer believes.

“Mine is not a huge, vast treatment network, but I look for who does what well for each client presentation that I see the most,” Kreitzer says.

Mintz says she has taken a similar approach over the years. “The more narrow the network, the more professional the relationships [with treatment centers] can be,” she says. “There is an ethical responsibility to establish profound relationships with treatment centers.”

She also believes that some form of clinical supervision that goes beyond the scope of mentoring is needed for interventionists.

Wide-open field

Yet while a call for standards has grown stronger in some circles, the landscape has remained virtually unchanged in the intervention community in recent years, according to Mintz. That has left many individuals unable to find a sufficient number of cases.

“The market is saturated with people using intervention as a second-income source,” Mintz says. Only a relative handful are able to make a living full-time as interventionists, she says. Also complicating the picture is some treatment centers' tendency to hire people to conduct interventions in the fashion of an outreach admissions process, she says.

“It's seen as the ideal second job,” Mintz explains. “The price of an intervention is $1,500 to $8,000, so imagine what you see if you're in a treatment center earning $35,000 as a tech.”

Members of the Association of Intervention Specialists (AIS) who are board registered interventionists have demonstrated receiving some specialized training, but this does not constitute a full-fledged license or credential.

While Mintz says there is a clearer understanding that there are probably too many unqualified people out there calling themselves interventionists, it may be challenging for interventionists to move in the same direction with credentialing that addiction counselors have pursued in recent years.

“There is not a lot of traction on establishing more standardization,” she says. “It's a big job, but a small market.”