What an Intervention Is (and What Helps More)

Quick answer

An intervention is a structured conversation in which family and friends address a loved one's substance use and encourage treatment. SAMHSA describes two approaches: CRAFT, which teaches positive reinforcement and is well studied, and the Johnson model, a rehearsed confrontation. Research favors the supportive approach.

You have probably rehearsed the conversation in the shower a hundred times. You love someone who is drinking or using, and you are exhausted from watching it happen. An intervention is one attempt to change that. It can be done in more than one way, and the differences matter, so it is worth knowing what actually helps before you gather everyone in a room.

If someone is in danger of hurting themselves or others, or having a medical emergency, call 911 first. For a mental health or substance use crisis, call or text 988.

What an intervention is

An intervention is a planned conversation in which the people closest to someone with a substance use disorder share their concern and encourage the person to get help. It is not the same as treatment; it is an attempt to move someone toward treatment.

SAMHSA's TIP 39 describes family-based approaches as supported by empirical evidence and effective in promoting long-term change. Family involvement, it notes, can motivate a person to enter or stay in treatment, improve overall family functioning, and help family members heal from the consequences of a loved one's substance use.

Two approaches, and they are very different

The word "intervention" gets used for a wide range of things, but two approaches come up most often.

CRAFT stands for Community Reinforcement and Family Training. TIP 39 describes CRAFT as a structured, family-focused, positive-reinforcement approach, usually four to six sessions, that teaches family members strategies for encouraging a loved one to change their substance use and enter treatment. Its focus is the family. The person using substances does not have to agree to anything for it to begin, and the counselor works with family members to change how they interact, which in turn shapes the person's behavior.

The Johnson model is a different tradition. The Johnson Institute Intervention was developed in the Minnesota Model tradition and was designed to prompt treatment entry by setting up a family confrontation: members of the person's social network confront them about the damage their drinking or drug use has caused, and the actions they will take if treatment is refused. SAMHSA's motivation protocol notes that the field has moved away from aggressive, "denial-busting" confrontation, that the Hazelden Foundation renounced that approach in 1985, and that clinical studies have linked worse outcomes to more confrontational styles. The Johnson Institute now describes a supportive, compassionate way of holding the conversation.

What the research shows

The best-known head-to-head study, by Miller, Meyers, and Tonigan, compared three approaches for worried family members of people who were not yet motivated to change. The results were striking: CRAFT engaged 64 percent of the problem drinkers in treatment, compared with 30 percent for the Johnson intervention and 13 percent for Al-Anon facilitation.

Two details from that study are worth holding onto. First, most families assigned to the Johnson arm, 70 percent, decided not to go through with the confrontation at all. Second, among the families who did, most succeeded in getting their loved one into treatment. A confrontation can work. It is simply not the only way, and the gentler, skill-based approach did better for the person and the family at the same time.

None of this means one method is a guarantee, and no approach works for every person or every family. It means the evidence points toward support and communication skills over a showdown.

When to bring in professional help

An intervention is a real conversation with real stakes, and it is reasonable to want help running it. SAMHSA's family therapy advisory says providers should consider a person's situation before using a family-based approach, including withdrawal status, co-occurring mental health conditions, legal involvement, and any history of violence in the family.

Those last two points deserve attention. If there has been violence in the home, a group confrontation can escalate, and safety comes first: call 911 if anyone is in danger. If the person is drinking heavily or using certain drugs and wants to stop, withdrawal itself may need medical supervision. Stopping alcohol or benzodiazepines suddenly, after long, heavy use, can be dangerous, so talk with a clinician before you make stopping part of the plan.

For a family who is unsure where to start, SAMHSA's guidance generally points first to the least intensive options, such as counseling or a family program, and only then to more intensive steps.

A next step you can take today

You do not have to choose between doing nothing and staging a confrontation. There are smaller moves available tonight.

Look into a family program or CRAFT-informed counselor, which teaches you skills you can use at the kitchen table, not just on intervention day.
Search FindTreatment.gov for family counseling and treatment options near you, or call SAMHSA's National Helpline at 1-800-662-HELP (4357), free and confidential, 24/7.
Call or text (800) 653-9376 to talk through what treatment would look like and what your options are. Calling is free, and the referral service is paid for by treatment providers.

If someone is in immediate danger, call 911. For a mental health or substance use crisis, call or text 988.

Sources

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Questions about What an Intervention Is (and What Helps More)

What is a family intervention for addiction?

An intervention is a planned conversation in which the people close to someone with a substance use disorder share their concern and encourage the person to get help. SAMHSA's TIP 39 describes family-based approaches as supported by evidence, and notes that family involvement can motivate a person to enter or stay in treatment.

What is CRAFT, and how is it different from a traditional intervention?

CRAFT stands for Community Reinforcement and Family Training. TIP 39 describes it as a structured, positive-reinforcement approach, usually four to six sessions, that teaches family members new ways to interact with their loved one. Unlike a confrontation, CRAFT starts with the family, and the person using substances does not have to agree to take part.

Is the confrontational Johnson model still recommended?

The Johnson Institute Intervention was designed to prompt treatment entry through a rehearsed family confrontation. SAMHSA's motivation protocol notes that the treatment field moved away from aggressive confrontation, and that clinical studies have linked worse outcomes to more confrontational approaches. The Johnson Institute itself now emphasizes a supportive, compassionate style.

Does a confrontation work better than positive support?

The best-known study compared three approaches and found CRAFT engaged 64 percent of initially unmotivated problem drinkers in treatment, compared with 30 percent for the Johnson intervention and 13 percent for Al-Anon facilitation. In the Johnson group, 70 percent of families decided not to go through with the confrontation.

When should a family get professional help for an intervention?

SAMHSA advises considering factors such as a person's withdrawal status, co-occurring mental health conditions, legal involvement, or a history of violence in the family before using a family-based approach. If there is any risk of violence or a medical emergency, call 911 and prioritize safety over the conversation.