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Minnesota Adult Basic Education Disability Specialists

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Crisis Intervention

Substance Abuse or Dependence

Common sense will dictate that if a student comes to class high or drunk, you should send him or her home via safe transportation. The problem arises when a student is experiencing withdrawal. If you suspect this is the reason for his or her inattention, consider the following:

  1. If you don’t know the student’s habits, ask him or her if they have recently consumed a drug or alcohol. If yes, ask if they are experiencing a hangover. Suggest they let it work itself out and come back the next day. If they answer no, describe the behavior you are seeing and ask them to explain. If they deny a problem, continue to work with them, if possible, or ask them to come back on another day when they feel more “together” or alert.
  2. If you know the student abuses drugs or alcohol, point out how you see it affecting their academic work and ask whether they want to continue. If they answer yes, ask if they can abstain while attending classes. If again they answer yes or describe good intentions, ask whether they know of a resource that will help them keep that pledge.
  3. Ask for a commitment to contact a support group or counselor if they don’t have one already, and provide a referral if necessary. Wish them well and ask them to return when they have been sober at least one week. Tell them you are looking forward to seeing them then. See the Resources section for referral information.

In any crisis, go slow, be patient, model calm behavior and be willing to wait. Help the person feel secure by establishing a relationship of respect and trust. Let the person know what is going to happen. Most importantly, work with what is familiar and be consistent.

If the individual has been using or drinking:

There is no hard and fast plan to dealing with an individual who has been drinking or using drugs.  However, there are some techniques that have been found to be effective in keeping the person safe, including:

  1. Use a calm, soft reassuring voice.
  2. Breathe slowly and calmly.
  3. Manage your anger and fear.
  4. Use short, simple sentences.
  5. Maintain eye contact.
  6. Use the person’s name.
  7. Do not yell or blame.
  8. Reassure them frequently that you are trying to help them.
  9. Be confident and direct, but not confrontational.
  10. Ask questions, do not make statements.
  11.  Drop to their level. If they are sitting, sit. If they are on the ground, crouch.
  12. Give the person some space, and try to get them to a quiet spot.
  13. Make sure your body language matches your tone and isn’t confrontational. Take your hands out of your pockets, uncross your arms.
  14. Agree with the 10 percent of what they are saying that is true.
  15. Allow the person to vent their feelings but should set limits to behavior permitted.

You will want to have the individual go someplace where they can safely detoxify. This may be the hospital, local detox or home. You will want to have a ready list of the local hospitals and detox centers in your community, and know the process to get them there. Check with your supervisor to see if the school has a policy and plan for using behavior.

Some police departments will transport, others will not.  Some hospitals will transport, others will not.  If these are not an option, you will want to contact a family member or friend to take the person there.

If the person is suffering a craving:

Cravings are easier to deal with in that the individual is sober and does not wish to use.  Help the individual remember why he or she does not wish to use.  Help them with “stop and think” strategies.

  1. Take the person out of the situation.
  2. Talk through the cravings. They only last for a few minutes.
  3. Acknowledge the feelings and frustrations around the situation and/or
    being sober.
  4. Summarize progress to date and build on successes.
  5. Use a balance sheet for benefits and consequences around use and non-use.
  6. Ask for a commitment from them to stay sober, and put it in writing. Give them a copy.

If the person is angry or aggressive:

Anger and aggression can accompany an individual who is craving or who has been using.  The techniques listed under “has been using or drinking” are very helpful in this situation as well.  If possible, identify the source or cause and eliminate it.

If an outburst does occur:

  1. Remain calm. Always model calm behavior.
  2. Do not try to argue or reason with the person
  3. Agree with the 10% of the person’s argument that is true.  It is very difficult to argue with someone who is agreeing with you.
  4. Redirect if possible, use the person’s name.
  5. Remove the person from the situation to a calm environment. If individual is unwilling to do that, remove the other people from the situation.
  6. Give eye contact, and talk to the person at their physical level.
  7. Ask for help from others including security and if needed, remove yourself for some regrouping time after the person is safe.
  8. When the person is sober, provide concrete, non-judgmental feedback about how their behavior affected them and others.
  9. Set up a concrete no-use contract with strategies. Write out, in detail, expectations and follow through with any consequences. Give a copy to the person and keep one for yourself.

Substance Abuse or Dependence

Common sense will dictate that if a student comes to class high or drunk, you should send him or her home via safe transportation. The problem arises when a student is experiencing withdrawal. If you suspect this is the reason for his or her inattention, consider the following:

  1. If you don’t know the student’s habits, ask him or her if they have recently consumed a drug or alcohol. If yes, ask if they are experiencing a hangover. Suggest they let it work itself out and come back the next day. If they answer no, describe the behavior you are seeing and ask them to explain. If they deny a problem, continue to work with them, if possible, or ask them to come back on another day when they feel more “together” or alert.
  2. If you know the student abuses drugs or alcohol, point out how you see it affecting their academic work and ask whether they want to continue. If they answer yes, ask if they can abstain while attending classes. If again they answer yes or describe good intentions, ask whether they know of a resource that will help them keep that pledge.
  3. Ask for a commitment to contact a support group or counselor if they don’t have one already, and provide a referral if necessary.  Wish them well and ask them to return when they have been sober at least one week. Tell them you are looking forward to seeing them then. See the Resources section for referral information.

In any crisis, go slow, be patient, model calm behavior and be willing to wait. Help the person feel secure by establishing a relationship of respect and trust. Let the person know what is going to happen. Most importantly, work with what is familiar and be consistent. 

If the individual has been using or drinking:

There is no hard and fast plan to dealing with an individual who has been drinking or using drugs.  However, there are some techniques that have been found to be effective in keeping the person safe, including:

  1. Use a calm, soft reassuring voice.
  2. Breathe slowly and calmly.
  3. Manage your anger and fear.
  4. Use short, simple sentences.
  5. Maintain eye contact.
  6. Use the person’s name.
  7. Do not yell or blame.
  8. Reassure them frequently that you are trying to help them.
  9. Be confident and direct, but not confrontational.
  10. Ask questions, do not make statements.
  11.  Drop to their level. If they are sitting, sit. If they are on the ground, crouch.
  12. Give the person some space, and try to get them to a quiet spot.
  13. Make sure your body language matches your tone and isn’t confrontational. Take your hands out of your pockets, uncross your arms.
  14. Agree with the 10 percent of what they are saying that is true.
  15. Allow the person to vent their feelings but should set limits to behavior permitted.

You will want to have the individual go someplace where they can safely detoxify. This may be the hospital, local detox or home. You will want to have a ready list of the local hospitals and detox centers in your community, and know the process to get them there. Check with your supervisor to see if the school has a policy and plan for using behavior.

Some police departments will transport, others will not.  Some hospitals will transport, others will not.  If these are not an option, you will want to contact a family member or friend to take the person there.

If the person is suffering a craving:

Cravings are easier to deal with in that the individual is sober and does not wish to use.  Help the individual remember why he or she does not wish to use.  Help them with “stop and think” strategies.

  1. Take the person out of the situation.
  2. Talk through the cravings. They only last for a few minutes.
  3. Acknowledge the feelings and frustrations around the situation and/or
    being sober.
  4. Summarize progress to date and build on successes.
  5. Use a balance sheet for benefits and consequences around use and non-use.
  6. Ask for a commitment from them to stay sober, and put it in writing. Give them a copy.

If the person is angry or aggressive:

Anger and aggression can accompany an individual who is craving or who has been using.  The techniques listed under “has been using or drinking” are very helpful in this situation as well.  If possible, identify the source or cause and eliminate it.

If an outburst does occur:

  1. Remain calm. Always model calm behavior.
  2. Do not try to argue or reason with the person
  3. Agree with the 10% of the person’s argument that is true.  It is very difficult to argue with someone who is agreeing with you.
  4. Redirect if possible, use the person’s name.
  5. Remove the person from the situation to a calm environment. If individual is unwilling to do that, remove the other people from the situation.
  6. Give eye contact, and talk to the person at their physical level.
  7. Ask for help from others including security and if needed, remove yourself for some regrouping time after the person is safe.
  8. When the person is sober, provide concrete, non-judgmental feedback about how their behavior affected them and others.
  9. Set up a concrete no-use contract with strategies. Write out, in detail, expectations and follow through with any consequences. Give a copy to the person and keep one for yourself.

Helping Without Enabling

Enabling individuals with alcohol and drug issues is often an unconscious behavior. Professionals want to believe the individuals are being truthful about their behavior. Individuals often feel uncomfortable discussing these issues with someone, as it can be viewed in many households and cultures as a private matter.

However, we know that without help, individuals who are using alcohol and/or drugs will develop worsening problems in terms of family, work, school, community, and health, and they are at an increased risk for disability.

Limiting enabling behaviors can open the door to discussing the problem, and may lead to the individual getting help sooner.

There are common ways that individuals enable problematic behavior—without even knowing that they are doing it.

These include:

  • Avoiding and ignoring problem behaviors
  • Shielding the individual from situations and consequences
  • Attempting to control use
  • Attempting to control access to chemicals
  • Taking over the user’s responsibilities
  • Rationalizing use
  • Accepting manipulations and dishonesty
  • Compromising and cooperating with situations that are a problem
  • Not following through, or rescuing the user from, consequences
  • Limiting access to situations that will create consequences

Remember, you do play a role. Make sure you aren’t unwittingly supporting your loved one or student’s chemical use or abuse.

Behavior Modification Intervention

An intervention is a pre-planned attempt where concerned individuals (family, friends, co-workers, neighbors, etc.) attempt to convince the individual to seek professional treatment for their issues with alcohol and/or other drugs. Often interventions are held by family members and close friends and take place when other, more subtle approaches of getting help have been unsuccessful. There are two ways to do this: formal and informal.

Informal Intervention

An informal intervention is simply a conversation. It involves sharing observations, asking questions and suggesting treatment. An informal intervention is often successful if it is well planned and takes place in a comfortable place. The individual must be sober and calm.

Other helpful hints to make an informal intervention successful:

  1. Get the facts about alcoholism and addiction.
  2. Talk to someone BEFORE the intervention to get your feelings under control.
  3. Pick a time and place that fosters calmness and sobriety.
  4. Plan what you are going to say.
  5. Mentally prepare yourself by getting enough rest and being calm.
  6. Convey respect and concern.
  7. Use SPECIFIC examples of how the person’s chemical use has affected your life or the person’s life.
  8. Sometimes, videotape of behavior is helpful when prior interventions have not.
  9. Offer help. Know the treatment options available and what is required to go there. Check into insurance for options that are covered and how to get authorized to go to treatment.
  10. Set limits and consequences—and stick to them.
  11. Don’t expect miracles but remember that each intervention will chip away at the defenses.

Formal Intervention

A formal intervention involves a trained professional who acts as a facilitator and mediator. This person structures the pre-planned conversation between the supportive people and the individual. The formal intervention tends to be used when informal interventions and other forms of persuasion have failed to motivate the person towards treatment.

The goal is for the person to take concrete steps to address their addiction issues and get an agreement to enter a treatment program immediately. Just promising to stop or do so is not acceptable.  The group’s message is that they are unwilling to continue to overlook the damage that the use is having on the person and on each individual in the group.

Helpful hints for a successful formal intervention:

  1. Have a professional help you.
  2. Have concrete consequences for not agreeing to get help.
  3. Be prepared to FOLLOW THROUGH with these consequences if the individual refuses.
  4. Bring together a group of individuals who are concerned and have influence.
  5. DO NOT include children.
  6. Have a plan of who is going to say what and in what order.
  7. Rehearse what you are going to say in a concerned and caring way.
  8. Use “I …” statements instead of confrontation statements that start with
    “You …”
  9. Use examples. Video or audio tape may be helpful if the person is highly resistant.
  10. Have all the arrangements made for the person to start treatment. For example, have a chemical health assessment set up, a doctor’s appointment for a physical, and get the person on the waiting list at the treatment center.
  11. Get a WRITTEN commitment from the person, make copies for all individuals at the intervention including the facilitator.

Helping Without Enabling

Enabling individuals with alcohol and drug issues is often an unconscious behavior.  Professionals want to believe the individuals are being truthful about their behavior.  Individuals often feel uncomfortable discussing these issues with someone, as it can be viewed in many households and cultures as a private matter.

However, we know that without help, individuals who are using alcohol and/or drugs will develop worsening problems in terms of family, work, school, community, and health, and they are at an increased risk for disability. 

Limiting enabling behaviors can open the door to discussing the problem, and may lead to the individual getting help sooner.

There are common ways that individuals enable problematic behavior—without even knowing that they are doing it. These include:

  • Avoiding and ignoring problem behaviors
  • Shielding the individual from situations and consequences
  • Attempting to control use
  • Attempting to control access to chemicals
  • Taking over the user’s responsibilities
  • Rationalizing use
  • Accepting manipulations and dishonesty
  • Compromising and cooperating with situations that are a problem
  • Not following through, or rescuing the user from, consequences
  • Limiting access to situations that will create consequences

Remember, you do play a role. Make sure you aren’t unwittingly supporting your loved one or student’s chemical use or abuse.

Behavior Modification Intervention

An intervention is a pre-planned attempt where concerned individuals (family, friends, co-workers, neighbors, etc.) attempt to convince the individual to seek professional treatment for their issues with alcohol and/or other drugs. Often interventions are held by family members and close friends and take place when other, more subtle approaches of getting help have been unsuccessful. There are two ways to do this: formal and informal.

Informal Intervention
An informal intervention is simply a conversation. It involves sharing observations, asking questions and suggesting treatment. An informal intervention is often successful if it is well planned and takes place in a comfortable place. The individual must be sober and calm.

Other helpful hints to make an informal intervention successful:

  1. Get the facts about alcoholism and addiction.
  2. Talk to someone BEFORE the intervention to get your feelings under control.
  3. Pick a time and place that fosters calmness and sobriety.
  4. Plan what you are going to say.
  5. Mentally prepare yourself by getting enough rest and being calm.
  6. Convey respect and concern.
  7. Use SPECIFIC examples of how the person’s chemical use has affected your life or the person’s life.
  8. Sometimes, videotape of behavior is helpful when prior interventions have not.
  9. Offer help. Know the treatment options available and what is required to go there. Check into insurance for options that are covered and how to get authorized to go to treatment.
  10. Set limits and consequences—and stick to them.
  11. Don’t expect miracles but remember that each intervention will chip away at the defenses.

Formal Intervention
A formal intervention involves a trained professional who acts as a facilitator and mediator. This person structures the pre-planned conversation between the supportive people and the individual. The formal intervention tends to be used when informal interventions and other forms of persuasion have failed to motivate the person towards treatment.

The goal is for the person to take concrete steps to address their addiction issues and get an agreement to enter a treatment program immediately. Just promising to stop or do so is not acceptable.  The group’s message is that they are unwilling to continue to overlook the damage that the use is having on the person and on each individual in the group.

Helpful hints for a successful formal intervention:

  1. Have a professional help you.
  2. Have concrete consequences for not agreeing to get help.
  3. Be prepared to FOLLOW THROUGH with these consequences if the individual refuses.
  4. Bring together a group of individuals who are concerned and have influence.
  5. DO NOT include children.
  6. Have a plan of who is going to say what and in what order.
  7. Rehearse what you are going to say in a concerned and caring way.
  8. Use “I …” statements instead of confrontation statements that start with
    “You …”
  9. Use examples. Video or audio tape may be helpful if the person is highly resistant.
  10. Have all the arrangements made for the person to start treatment. For example, have a chemical health assessment set up, a doctor’s appointment for a physical, and get the person on the waiting list at the treatment center. 
  11. Get a WRITTEN commitment from the person, make copies for all individuals at the intervention including the facilitator.
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