THE INTERVENER

As we have learned in class, only 10% of individuals with substance related problems visit substance related organizations for help. Although substance related organizations are beneficial they are not the only source of help available, similarly, as how a 28 day treatment program is not the only option when intervention in necessary. The intervener within substance abuse can have many roles, which differ substantially.

As we know, in Canada, we have a tier system of resources, which at one end, provides very intensive, specific and individual interventions while the other maintain a more broad, general and group-based interventions.  The role of the intervener is very much decided upon which tier is being targeted. Tier one is marked by health promotion and prevention for the general population; here the role of the intervener can include educating the population in mass such as can be seen with last years new cervical cancer advertisements on television.  The helper, in this stage, may be involved in school system programs (i.e. D.A.R.E.), work with family support groups, or self-care based prevention strategies.

In the second tier of services we see primary care and public health. These may be programs that are targeted at individuals at risk for substance abuse or addictive behaviors such as anger management or mental illness support groups. Here, the intervener may have the role of running seminars or workshops; they may see people consistently for a short while or be interacting with different people all the time. They may be responsible for presenting information, skills, running self-help groups, facilitating discussions or a variety of other tasks. The first two tiers mentioned are centered on the community as their prime user; these are not limited to an individual rather serve the population however they can have profound impacts on individuals.

The third tier of services is where we see outreach, methadone maintenance treatment, home based withdrawal management. In this capacity, the role of the intervener is to help structure an individuals treatment plan while allowing them room to fulfill it with minimal monitoring. The helper may see the client on a daily or weekly basis for short periods of time and offer support or assistance for the individual to complete their developed treatment plan. From here onwards, the helper’s role is more focused on the individual rather than on the greater community.

In the fourth tier of addictions based services in Canada, the interveners role is centred on outpatient counseling and day treatment options. Here, the intervener has a close and consistent relationship with the clients however; the clients do not live within the service. In many cases, the helper may be providing similar care as seen in an inpatient treatment option, which may include full days and a variety of different treatment methods (i.e. group therapy, individual counseling, education sessions, other therapies ex: animal, music etc.)

The final tier of services, the fifth tier, involves more intensive programing, which is usually specialized and provides an impatient or residential personalized treatment plan. Here, the helper is involved in a more one-on-one or focused treatment. The intervener is more apt to be working closely and frequently with individuals with substance use issues while the client lives within an organization/institution. Here, is where a 28 day program may be found; where a client is working towards treatment goals while being supervised 24/7.

No matter what role the intervener may be taking there are some factors which ideally should remain consistent regardless of what capacity the helper is involved; these include building a relationship, this means the approach should be client centered, however, there should be engagement on both parts. Furthermore, it is important for the intervener to withhold judgment or their righting reflex; it is not the helper’s job to tell the client what to do rather to support the clients’ realizations. Also, it is important for the intervener to be organized and prepared; a lack or organization can give the impression of incompetence to the client, which may bring out further feelings of ambivalence. Furthermore, in any situation where individual or group discussion is being used it is important to stay true to motivational interviewing techniques where the helper focuses on open-ended questioning, reflections, affirmations and summaries while evoking change talk with the client.

There are many possibly roles for an intervener within the field of addictions. Help is offered at a variety of differing levels within the continuum which makes choosing a intervener role or choosing a method of help much more open.