Is An Intervention Ever Too Early?

Let’s talk about interventions

The word intervention is often used when speaking of political, financial, commerce, legal and medical situations. Basically it means to come between disputing people or groups to intercede or mediate in an effort to change the course of events.

When it comes to health, particularly mental and behavioral health we define an intervention as:

An orchestrated attempt by one or many people – usually family and friends – to get someone to seek professional help with an addiction or some kind of traumatic event or crisis, or other serious problem. The term intervention is most often used when the traumatic event involves addiction to drugs or other items.

The process of this type of intervention was introduced in the 1960s by Dr.Vernon Johnson who was a recovering alcoholic and an Episcopal priest. He promoted what he referred to as “early intervention” to interrupt the disease of alcoholism before the process of the disease destroyed one’s life.

Johnson’s concept is key to what many family members ask themselves everyday…”should we have noticed earlier what was coming, could we have prevented the escalation of the disease of addiction…should we have intervened earlier?”

Research results examines the outcome of early intervention in children

It was 1991 when the Fast-Track Project study began. This was a collaborative study including researchers from Duke University, Pennsylvania State, Vanderbilt and the University of Washington. They screened nearly 10,000 five year-old children who lived in Durham, Nashville, Seattle and rural sections of Pennsylvania. Of these 10,000 the researchers identified 891 who were at high risk. Half of these were selected as a control group and the other half were assigned to participate in the Fast Track intervention. Here is an overview of the Fast Track Project as provided on the website:

Fast Track is a comprehensive intervention project designed to look at how children develop across their lives by providing academic tutoring and lessons in developing social skills and regulating their behaviors. Selection began when the participants entered kindergarten and children were placed either in the intervention group or the control group. The intervention was guided by a developmental theory stating the interaction of multiple influences on the development of behavior. There can be multiple stressors and influences on children and families that increase their risk levels. In such contexts, some families that experience marital conflict and instability can cause inconsistent and ineffective parenting. These children can sometimes enter school poorly prepared for the social, emotional, and cognitive demands of this setting. Often the child will then attend a school with a high number of other children who are similarly unprepared and are negatively influenced by disruptive classroom situations and punitive teacher practices. Over time, children in these circumstances tend to demonstrate particular behaviors, are rejected by families and peers, and tend to receive less support from teachers, further increasing aggressive exchanges and academic difficulties.

As youth get older, their risk for these behaviors increase due to peer influences, academic difficulties, and their personal identity development. The Fast Track project is thus based on the hypothesis that improving child competencies, parenting effectiveness, school context and school-home communications will, over time, contribute to preventing certain behaviors across the period from early childhood through adolescence.

The study was sponsored by the National Institute of Mental Health (NIMH)

The study’s findings…

The study was to cover 10 years and over those years the researchers published numerous progress reports. Most recently Kenneth A. Dodge, Ph.D. at Duke University (who headed the original project and secured the original sponsorship of the NIMH) worked with researchers from Pennsylvania State University, the University of Alabama, Tufts University and Simon Fraser University. The goal was to reach out to the original subjects and determine how they were doing some eight years after the program had ended. The full results are published on-line in the American Journal of Psychiatry: Impact of Early Intervention on Psychopathology, Crime, and Well-Being at Age 25.

This study showed modest improvements in psychological markers that predict long-term antisocial behavior and criminality and according to a Los Angeles Times article.  

Program graduates had fewer legal problems, substance abuse issues and risky sexual behaviors. The data suggest that intervention can work, and effects can persist over many years. Overall, the likelihood of psychological, criminal, sexual and behavioral problems dropped by about 9 percentage points from those of nonparticipants, the study found.

Dr. Dodge is quick to point out: “It’s not miracles; it’s not huge impacts. We weren’t successful with every child, but on average we have been able to prevent some of those [negative] outcomes.”

Some closing thoughts…

Being a member of a family is a journey that we all take. We travel through good times and difficult times that include financial hardships, illness, and emotional trials that if not recognized early can impact many members of the core family group and beyond. Often parents will notice signs, but are reluctant to ask questions and seek answers. Even spouses will look the other way and hope for a positive outcome. It is always best not to look away, but to reach out for help when you realize that your loved one is experiencing mental health issues and/or addiction.

Correctly guiding ourselves through life is challenging enough and trying to help a loved one who is suffering from alcoholism and drug addiction can seem impossible.

Often, the person in active addiction has difficulty managing their own lives and as time goes by it seems to get worse. The impact of their addiction on their lives are evident through loss of things like jobs, relationships and self-care. Perhaps several attempts and conversations have been initiated to help them without success. This is because the person trying to help is often too close and doesn’t have the professional background to be both emotionally neutral and aware of resources that match the needs of the addict. Such addiction professionals can help via home interventions or through recommending applicable treatment for the addict who is suffering.

Bottom line: It is never too early to consider an intervention!

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