07.21.10 10:38 PM ET
The Rehab Show That Works
The A&E reality-TV show Intervention has a 71 percent success rate in rehabbing the most determined, hardened addicts. Natasha Vargas-Cooper digs into why the show's methods work.
Of the 161 addicts that have appeared on A&E’s show Intervention in the past five years, 130 are sober today. There is no standard metric for recovery, but you take into account the high recidivism of drug offenders going back to jail, the chronic relapsing of people who have passed through state-based rehab programs, and anyone who has dealt with an addict in his or her personal life, the 71 percent recovery rate is, by any standard, astonishingly high. It is a number the producers of the show tout, not only because it’s impressive, but because they believe it is accurate. After the participants go through the show and complete rehab, Intervention has a dedicated staff member to do check-ins with participants, put them in touch with other support groups, and send out sobriety birthday cards.
Interventionist Jeff VanVonderen asks of families: “When you’re paying the guy’s rent, would you agree with them living with free rent so they can use their rent money for dope?”
Lauren's family and friends beg her to go to rehab to avoid a downward spiral.
Intervention’s alumni range from hardened alcoholics to young women with virulent eating disorders, with meth-heads, huffers, and full-blown opiate addicts in between. The show casts from a pool of the most dogged drug addicts, whose pathologies have wrought enough carnage in their lives that their families willingly collude with reality-TV show producers to lock their loved one in a room and demand they check into treatment under threat of banishment, homelessness, or jail while the cameras roll. So here is the obvious question: How has a 45-minute reality show that airs during summer on basic cable succeeded where so many other treatment regimes have failed? Why does a camera crew filming a determined drug addict hitting bottom convince someone to go into recovery? Does it merely take a united family leveling threats all at once to exorcise some of the demonic powers of addiction? In other words, what the hell is this show doing right?
Before we get into any discussion about the inner workings of the show, the quality of Intervention (A&E, Mondays at 9 p.m.) should be addressed. It is riveting. There is no need to qualify this assessment with a pejorative “for a reality-TV show.” The only thing Intervention has in common with shows like Real Housewives of New York City or Survivor is that it’s unscripted. Intervention offers real drama—drama in the Greek sense of the word: It’s all fear and pity and pathos. Instead of just documenting the annals of addiction and the humiliation people put themselves through in order to maintain it, the show instead focuses on the complicated ecosystems that sustain addiction: families. This focus is perhaps the key reason for the show’s success as both documentary series and an outreach program.
“The truth is that most addicts, if it was up to them, do not have the resources to even be an addict,” Jeff VanVonderen—one of the show’s trained interventionists—tells me over the phone from his home in Orange County, California. “Somebody’s gotta be paying something or putting up with something or ignoring something.”
VanVonderen is a Level II (specialized in treating drugs, alcohol, gambling, and eating disorders) certified interventionist who also holds a degree from seminary school. VanVonderen is a Midwesterner, built like a line backer, and a lapsed alcoholic himself. His counterpart on the show is Candy Finnigan, also a trained interventionist; Finnigan, a recovered addict, has big, soulful eyes and a social worker’s disposition. VanVonderen, on the other hand, deals with addicts and their families as though he were coaching a football team getting whooped on its own turf.
Concern turns to intervention for the student alcoholic whose parents "will not stand by and watch him die."
When you are selected to be on Intervention you are tricked out of necessity. Participants are told they are subjects of a documentary series about addiction, which is essentially true, but what they are not told is that while they are holed up in their living rooms with a camera crew getting loaded, their family is preparing with producers for a filmed showdown. Once a subject is selected, Intervention researchers spend an average of two weeks compiling a psychological profile of the addict that’s then reviewed by Finnigan and VanVonderen. The show also has a dedicated facility liaison, Jennifer Sneider, who chooses what kind of rehab the participant is sent to. She selects from a pool of about a hundred facilities ranging in price from $50,000 to $120,000 for a 90-day stay, which is the minimum mandated by the show. The facilities give Intervention participants free stays in return for the free advertising. Sneider tries to line up the specialties of the treatment facilities to the patient profile.
This methodology seems to be one the vital elements to the show’s impressive sobriety rate: an accurate diagnosis. The 12-step method, the thinking goes, wouldn’t be very effective for a middle-aged mother with a busted back who subsists on a diet of prescription opiates to stave off crippling pain. Addiction, through her prism, is a small price to pay for relief from a twisted spinal column. The show would likely place her in a facility that specializes in chronic pain treatment and addiction, like Bay Recovery in San Diego. An adult male, on the other hand, who endured sexual molestation as child and now shoots heroin to ward off depression may be less likely to relapse if he were to be sent to a rehab facility that specializes in post-traumatic stress disorder. This latter case would be classified by Intervention and the treatment community as a “dual diagnosis.”
A dual diagnosis is a person who is mentally ill and has a substance-abuse problem. “Those two things wrap around each other like a vine on a trellis,” VanVonderen explains, “and if you tear one down and not the other, the other one comes back.”
In the recovery community, controversy still swirls around treating addicts as though they have a disease. The disease model of addiction treatment advances the idea that, in an addict, there are genetic as well as environmental issues that create a chronic, sometimes life-long reliance on addictive substances if not addressed. But others have argued that addiction is just as simple as a faulty character or the power of the drug itself; meaning, if you could convince the person to just quit their preferred poison, many of their problems would solve themselves.
Dan Partland, Intervention’s executive producer, says that the show adopts the disease model philosophy of treatment. “I don’t know if addiction is an actual disease or not, that’s not my field,” Partland says, “But treating addiction like it is a disease seems to work the best. So that’s what we do.”
A key factor in the show’s high recovery rate only gets about two minutes of air-time: the intervention training with the addict’s loved ones. The trainings are six- to eight-hours long and are conducted by Finnigan or VanVonderen the day before the actual intervention. One part of the training is spent unearthing the various ways the family has been hurt by the addict’s behavior, with the interventionist providing insight into the physiological science of addiction. But the majority of the time is spent dissembling the system that has enabled the addict to finance and feed their affliction. The family is forced to confront the great paradox of addiction: Enabling is the emotional infrastructure created to protect addicts from total self-destruction but ultimately empowers them to continue killing themselves. VanVonderen describes the training as an intervention on the family itself. The heart of the questions he often poses are: “Are you supporting something that you don’t agree with? When you’re paying the guy’s rent, would you agree with them living with free rent so they can use their rent money for dope?”
According to VanVonderen, it’s not hard to get an addict to agree to go to rehab during an intervention. When a family levels threats all at once, an addict will relent, but what they are actually trying to do is just get the threats to stop in the moment. Without some intensive pre-planning and commitment, the family has not changed the way it operates and, VanVonderen says, “That’s a formula for relapse.”
After the intervention is filmed and the participant goes directly to rehab, their treatment will last a minimum of 90 days. That is a relatively new precedent in the treatment industry, where the standard has generally been 28 days. When people qualify for state-funded recovery programs or are ordered to go to rehab by the courts, the state will only pay for 28 days. However, now more rehab programs are instituting 90-day treatment regimes because they are thought to yield better results. The idea is that “drying out,” or not using, for 28 days could get you clean, but it won’t keep you sober; simply weaning the body off substances is not enough. Treatment under the 90-day model is considered to be cumulative; the eighth week has a bigger impact than the fourth week. The production team, including the interventionists, say that it’s the show that has influenced the wide adoption of the 90-day program. (Lindsay Lohan will be the most recent and high-profile beneficiary of this evolving philosophy in treatment.)
So what role do the cameras play in this road to recovery? Is that another element in the show’s successful treatment rate? According to VanVonderen, no. "It's not because of the show that people have broken through their addiction —I think it's because of the intervention. People are more likely to go to treatment if there’s an intervention, they’re more likely to stay in treatment, they’re more likely to do better afterward, because everything’s changed. Not just, they went to treatment. The family’s gonna get well without you, and that comes through in the intervention.”
In other words, VanVonderen says the real power of the intervention comes through when addicts learn, “Now the jig is up, it’s not gonna work like it did before. That strikes fear into their hearts.”
Natasha Vargas-Cooper is the Los Angeles correspondent for The Awl. Her book Mad Men: Unbuttoned has been released by Harper's studio.