Strength in Numbers: The ARISE Method for Mobilizing Family and Network to Engage Substance Abusers in Treatment

Abstract

The model described in this paper takes into consideration two key findings: (a) In a given year, the vast majority (90-95%) of active substance abusers do not enter treatment or self-help groups, and (b) substance abusers have frequent contact with their families (60-80% either live with a parent or are in daily contact). This paper presents a method for mobilizing and collaborating with families and extended the support system toward working with resistance and getting the substance abuser into treatment. Principles and techniques are provided for convening and structuring intervention network meetings toward that end. This intervention network approach can be used either alone or as part of an overall model, ARISE (A Relational Intervention Sequence for Engagement). The ARISE model addresses both clinical and programmatic issues in treatment engagement for substance abusers.

The Community Assessment Inventory—Client views of supports to drug abuse treatment

“…Findings regarding the significance of friends for treatment engagement are consistent with earlier research De Civita, Dobkin, & Robertson, 2000;Garrett, Landau-Stanton, Stanton, Stellato-Kabat, & Stellato-Kabat, 1997;Landau et al, 2000). Similarly, the negative influence of drug using friends on treatment outcomes has been suggested in earlier work (Goehl et al, 1993;Havassy et al, 1991Havassy et al, , 1995Hawkins and Fraser, 1987).…”

A conceptual framework for drug treatment process and outcomes

“…To reduce early dropout from therapeutic communities, De Leon and colleagues (2000) employed bsenior professor induction seminarsQ as a motivational strategy, while Foote, DeLuca, Magura, et al (1999) mounted a Group Motivational Intervention approach to enhance and internalize the need for treatment. Other social strategies include using bsignificant othersQ (family or friends) as part of the induction plan for support of treatment engagement (De Civita, Dobkin, & Robertson, 2000;Garrett, Landau-Stanton, Stanton, Stellato-Kabat, & Stellato-Kabat, 1997;Landau et al, 2000). Another important approach focuses on reducing organizational barriers to treatment, as illustrated by recent initiatives for bPaths to RecoveryQ being funded collaboratively by Robert Woods Johnson Foundation and Center for Substance Abuse Treatment.…”

“…Twelvestep programs are examples (Apodaca & Miller, 2003), but other more structured and proactive interventions also are available. The Community Reinforcement and Family Training approach (Meyers, Miller, Smith, & Tonigan, 2002;Miller, Meyers, & Tonigan, 1999) and A Relational Intervention Sequence for Engagement intervention (Landau et al, 2000) follow manualized guides for recruiting and engaging patients in treatment. Similarly, Brief Strategic Family Therapy (Robbins, Bachrach, & Szapocznik, 2002;Szapocznik & Kurtines, 1993), Multidimensional Family Therapy (Liddle et al, , 2002, and Multisystemic Therapy (Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998) address special developmental needs of adolescents.…”

Getting Reluctant Substance Abusers to Engage in Treatment/Self‐help: A Review of Outcomes Andclinical Options

“…The SA is also invited to that first meeting-the process is kept aboveboard as much as possible and secrecy is discouraged. Staff move to the second level of intervention (Stage II) if the SA does not immediately enter treatment-either after the first call or following that first meeting (Landau et al, 2000). If, after two-to-five additional network sessions, the SA is still not engaged in treatment/self-help, the network members are offered the option of doing a modified (truncated, less confrontational) Johnson Intervention (Stage III), including specific consequences for the SA if he/she chooses not to enter treatment/self-help (Garrett et al, 1998).…”