/ 2 November 2010

Desperate times, tough measures

Desperate Times

Around 50 people gathered in a small conference room in a hotel in west London recently to hear two former drug addicts speak.

John Southworth and Ken Seeley both run their own interventionist companies in the United States and were there to train people in the tactic: effectively taking a person with an addiction (drugs, alcohol, gambling or any kind of compulsive behaviour) and putting him or her in a residential rehabilitation centre. Interventions have a higher profile in the US.

“The United Kingdom is going through what the US did many years ago,” said Southworth, largely thanks to a reality television show called Intervention, in which Seeley starred.

The series won an Emmy award last year, but it has been criticised for exploiting the vulnerable because the tactics used are so tough.

People have been thrown out on the street to see how they cope once their family is encouraged to stop “enabling” their addiction; others are chased by the camera as they try to run away.

“You can lead a horse to water, but you can’t make it drink,” said Southworth, “but we can make it damn thirsty. It’s about creating consequences.”

Addiction and crime
This can be anything from threatening those who have stolen from their families with reporting them to the police, or making them realise that without getting help for their addiction, they could lose a professional licence.

“I had [a client] who waited three days. She slept in the street,” says Seeley. Doesn’t it worry them that vulnerable people are being put in a potentially dangerous situation? “Yes,” says Southworth, “but if nothing else works, what are you going to do? It’s called tough love.” If they believe someone is genuinely in danger, said Seeley, “we have police checking on them, or a private investigator or interventionist in visual contact with them”.

In the UK there are relatively few professional interventionists. Bill Stevens, a former addictions counsellor for the Priory group of hospitals, set up his company Red Chair two years ago and feels that “it is bound to grow”.

Stevens has carried out about 45 interventions. Would he advise a family to throw the person with an addiction out on the street?

“An intervention should be based on love and dignity. Why chuck a sick person out on the street? I think the idea of intervention being aggressive … it should be the opposite.”

Aims of the conference
One of the main aims of the conference, Stevens said, was to set up a self-regulating body in the UK.

There are people, he said, who work on a type of commission paid by private treatment centres to feed patients to them. “If you are paid a referral fee, then you are in a huge ethical dilemma,” he said, pointing out that Red Chair charges the family for the intervention — usually about £750 — not the treatment centre.

“Family members will ring up and say their loved one has a drug or alcohol problem and I’ll work through the pre-intervention screening process: Is it right to do something, who is affected, what are the consequences, what will happen if you do nothing? It’s about treating the family as well.”

Then he will often bring the family together with the person and ask them to go into treatment. Faced with that, he said, very few refuse. In most cases the person is treated privately, but for those who can’t afford it, Stevens assists them to go through the NHS process.

Paying for an intervention is partly what worries Andrew Horne, the director of operations in Scotland for the addiction charity, Addaction.

“I have a little bit of concern about interventionists in that I know people who have paid for residential private care when they couldn’t afford it, but they did it because they felt desperate. They didn’t know they could have got it for free. [Intervention] is very much an American model because of the American healthcare system, which is pay as you go.”

There is help out there
If there is a fault in the existing system, he said, it is in not making people aware that there is help out there. In England the system is fast. The target is to go from referral to treatment in three weeks.” But don’t people use interventionists as a last resort? “The idea of working with involuntary clients is not alien to most drug charities and treatment systems,” he said.

Horne is also concerned about the reliance on residential treatment. “There are fantastic services in the community and while people like residential care because it gives a certain amount of safety, the efficacy of that care is sometimes not as good as if they remained in the community.”

A vast proportion of interventionists are former addicts themselves. Seeley was addicted to crystal meth, Southworth to cocaine; both have been clean for more than 20 years.

Many interventionists are fuelled, Southworth said, by a desire not to allow other people’s lives to be ruined by addiction. —