Understanding the aim of an intervention will help both the counsellor and all parties to convince a patient that they will need professional help to deal with their addiction. The primary goal is to ensure that the addict makes the motivational shift to start seeking and accepting professional treatment.

To achieve this we have outlined a series of conversational scenarios that typically transpire in interventions with patients in various stages of denial.

Setting up an intervention:

Prepare yourself: Interventions are emotional events that require time, effort, courage and commitment from you. If you feel daunted, get a trusted friend to share the journey with you.

Do research: Your background knowledge and other sources can help, but the best option is to get personal advice for your situation by talking to a therapist. Some cases need extra preparation.

Get help: Sometimes a therapist can attend an intervention. You can also ask a trusted friend or group of people, including family members, to join you and together, you can be part of the intervention.

Vet the helpers: If you want others to attend and assist with intervention, choose people both you and the patient will trust. Authoritative strangers are acceptable, but limit them to two – do not aim to generate fear as it can close communication channels.

Draw in employers: Fear of losing a job is one of the big reasons for denial. If a sympathetic employer’s support can be enlisted, it will be much easier to break down denial.

Choose the time: Estimate a time when the patient will be available. Set the event for that time. Avoid a rushed talk.

Choose the place: In most cases, the patient’s home is chosen as the venue for the intervention, but it can be any private and quiet place, depending on circumstances. A therapeutic environment which inspires respect, calmness and trust is ideal.

Prepare the helpers: Arrange a meeting with the group members before the planned intervention. Inform everybody of all the details and what their roles will be.

Be ready: If the intervention succeeds, you should take the patient to the rehab centre immediately. Make prior arrangements with the centre and pack a small suitcase for the person in advance.

Implement the intervention: The intervention should be convened without the patient’s prior knowledge of the planned event. Wait until everybody is present before starting.

Introduction: Emphasise that the event was arranged because you care about the patient; that it is not an ambush by enemies, but a show of support. Tell the person in a caring, honest manner, how their behaviour and the negative consequences affect you. Let others in the group present their observations in turn.

Show acceptance. Tell the patient that mistakes are normal and acceptable, but that living with a mistake is not. You do not want perfection, you just want them to have a normal, happy life.

Do not be intimidated: Some patients use intimidation as the next best defence after denial. Calmly tell the person that you are aware of this and that it will not work.

Do not intimidate: The patient dislikes it as much as you do and will retaliate if you try to overpower them in an unreasonable manner.

Do not take charge: Avoid the impression that you are taking over. The person’s participation is crucial. If you act imperiously, the patient may withdraw or retaliate.

Do not humiliate: People need acceptance, reassurance and motivation. Empathy and trust is essential to get anyone to open up. Insults or harsh accusations will not work.

Do not dictate: It must be a give-and-take discussion between equals, with mutual understanding and consensus. If you act superior, patronising or overly-demanding, it will alienate the person.

Do not blame: There are reasons why this happened. Refrain from blaming the person and instilling guilt in them. Once again, this will only close up communication channels and for progress to take place, a sense of open-mindedness is necessary.

Respect the person’s rights: Above all; do not forcibly remove the substance – it will cause instant anxiety.

Do not teach: Avoid lecturing. You can use your research knowledge to sensibly support your views and to challenge denials.

Be patient: Allow the person to talk. Try not to interrupt. You will not be able to reach consensus if you do not know what the person’s views are.

Show understanding: People affected by addictions are often criticised, but their representations are swept aside, so they develop a feeling that nobody wants to understand them. Give them opportunity to tell their story.

Learn: Open your mind and accept that the person may see things that you do not. Make a note of these items and tell them it will be addressed during treatment.

Resist self-pity: Do not take what the patient says personally. They are simply using every means of defence at their disposal. It is not their true perception of you.

Reassure: Assure the patient that the withdrawal effects will be minimised and that you will continue to support them during treatment – This is important and must never be skipped.

Do not give up: If an intervention is rejected, try again. Denial may be temporary. People often just need time to reconsider. Keep in mind that they are unable to help themselves – deserting them may not be the best moral option.

Act: When an intervention succeeds, immediately take the person to the treatment centre. Do not allow time for a change of heart.