What if the Intervention Fails?

When a Loved One Refuses Treatment

Don’t give up hope on what’s best for them. A successful treatment outcome will depend greatly on your loved one’s motivation to recover. So, as painful and deflating as it can be to hear “no” in the face of your appeals, remember that your loved one’s reluctance to get help means that even if you could drag them kicking and screaming to the nearest rehab facility and force them to receive treatment against their will, their chances of recovery would remain low in the absence of a personal motivation to change.

If the intervention fails to result in a “yes” to treatment, don’t despair. Here are some tips for what to do:

• Stick to your original bottom line of inpatient treatment. Your loved one may seek to leverage the refusal to enter inpatient treatment as a bargaining chip of sorts. For example, they may insist that all they need to kick their habit are a few meetings with a therapist or local 12-step group. Don’t compromise. You can gently and firmly insist on the intervention that will be in your loved one’s best long-term interests—namely, a structured and individualized residential treatment plan of at least 30 days that addresses the physical, spiritual, behavioral and psycho-social dimensions of an addiction.
• Follow through with what you’ve said would be the consequences of refusing treatment. You’ve likely already aired what these consequences will be in the course of the intervention, as part of a pledge to your loved one that you will no longer support a drug or alcohol habit. Now it is time to keep your word, as heartbreaking as that may be. If you’re a parent who has just said you’ll be obliged to withdraw financial support should your child refuse treatment, now is the time to withdraw that support, gently but firmly. If you’re a spouse who has just spelled out how an untreated addiction is ruining your marriage and, in the absence of immediate treatment, will compel you to file a notice of separation, now is the time to follow through with your word.
• Aim to learn what, if anything, may have gone wrong in the intervention and could have contributed to your loved one’s refusal of treatment. Your loved one’s reasons for refusing treatment may be discernible from a review of the intervention process.

On the one hand, it’s possible that nothing in the encounter could have gone differently to elicit a better outcome. If that is the case, let yourself off the hook: remind yourself that if the intervention missed its mark this time (of getting your loved one into immediate treatment), all of the hard work and deep expressions of care and concern were still a step in the right direction of recovery. Your loved one may walk away in angry denial only to recognize a need for treatment further down the road.

On the other hand, evaluating what might have gone wrong in the intervention may turn up some valuable insights that may ensure the future success of efforts to intervene with a drug or alcohol abuse problem. Did your loved one show up to the meeting under the influence? Did the interaction lose focus because of what one or more of the participants said in hurt or anger? Did your loved one stomp out angrily during the process? If so, why? How, if at all, could a second intervention be better prepared for these sorts of contingencies? A painstaking review of what went wrong and what might be done differently next time can thus be very beneficial to the key stakeholders in a loved one’s recovery.

• Stage another intervention, this time with the help of a professional interventionist. Once you’ve identified what went wrong in the first intervention, it may be well-worth your time to “try, try again,” as the saying goes, this time with a better plan in place for how to intervene. A professional interventionist can be of great help in staging a second intervention. They are often better positioned to help you troubleshoot and prepare for issues that can arise before, during or after the intervention.
• Avoid the term “failure” to describe this intervention. Instead, reframe it as a step forward toward your ultimate goal of recovery. Yes, the intervention may have failed to generate a “yes” to inpatient treatment this time around, but recovery from drugs or alcohol is a long-term process that benefits greatly from the investment of family and friends. Your show of support and involvement is still a big leg-up in your loved one’s eventual recovery, regardless of this speed bump on the road to get there. The studies suggest that at every stage in recovery, family involvement in the treatment process boosts outcomes. Your participation and your investment are in themselves a positive form of intervention.