22 Sep Dr. Louise Stanger Interview – Part One
Dr. Louise Stanger radiates passion for her purpose: moving families to change through her “Invitational Intervention” approach to addiction treatment. Her solution-based paradigm gently leads families to bring their loved ones to a place where they can say, “Yes,” in seeking treatment for drug and alcohol addiction, mental health disorders, process addictions such as eating disorders, gambling, or sex addiction. I sat down with Dr. Stanger and discovered that not only is she an expert clinician with over 35 years experience working with families and conducting interventions, but she is much more: Dr. Stanger is a compassionate, accomplished woman who is by all accounts, fabulous.
Why did you start doing interventions?
I was a professor at San Diego State School of Social Work and I was given the task of developing the first substance abuse course for the graduate school. This was the time when social workers and other mental heath professionals were required to have training in substance abuse – the historical context of the time was the Betty Ford Center was just starting in Palm Desert, in terms of treatment centers Hazelden in Minnesota was considered the leader in the field. And in San Diego substance abuse treatment centers were developing.
One night a very tall, stately man was brought to my class as a guest lecturer. His name was Frank Pickard and he had written the book, “Family Intervention.” When he spoke, my whole body shook because I had grown up in a family beset with substance abuse and mental health disorders. I have always been really good with crisis intervention and when he spoke about Family interventions I said to myself, “This work is for me.”
From that day forward I began to do supervised interventions. I believe a successful interventionist is a good social worker or a professional that has a solid family systems theory background. At that time we did what was called a “surprise intervention,” but today I use and love the invitational approach. For me it is so much more respectful and compassionate. Today I will not do an intervention alone, I believe that’s fool hearty. (Louise has a large blog with Jeffrey Merrick on the issue of teamwork – she’s very clear that is the best approach with today’s complicated cases.)
So that’s how I got involved with doing interventions. As a university professor I would do only 5 to 10 per year, I had many other responsibilities and worked by word-of-mouth.
In terms of my academic career – I left San Diego State at one time to become an administrator at the University of San Diego (USD) as the director of alcohol and drug services. I wanted to secure a large grant: A parent-based intervention to reduce high problematic drinking. The venue was perfect at USD, so after retiring from San Diego State, becoming an administrator at USD, getting the grant, I decided that may not be the best place for me. I was at a crossroads. I said to myself, “I really have a passion, clinically, for only two things, performing interventions – helping families move to change, and sudden death, grief and loss work.” I have as an aside also had the opportunity to work for the New York Fire Department, the widows of 9/11 and some of the firemen.
I began exploring the vast world of substance abuse and substance abuse treatment. Even though I had been doing interventions I did not realize that: a) there was an interventionist on every street corner, and b) how robust treatment was becoming. I made it my business to really begin to interact in that world. I had been pretty famous in the academic world, and also the grant world, that’s how I clinically transitioned to, “this is what I love to do, let me see what impact I can have.” All in all it really was family of origin issues that prompted my desire to become an interventionist.
What is the benefit of an invitational intervention?
The benefit of extending an invitation is you’re not ambushing the “identified loved one;” you’re inviting them to change. Every day people are invited to change, in every treatment center, in every clinical venue, by police when you get a DUI, but in terms of meeting a family where they are without force, it’s more respectful to offer an invitation. Just imagine, you’re the identified loved one struggling with a substance abuse or mental health disorder and this whole cadre of people descends upon you. Well, we know that substance abuse and mental health disorders are beset with shame and feeling awful. If I’m setting up an ambush or an adversarial relationship by surprising you at the very start, I’ve got to work through that first.
If I can say to you (and I always tell our families the same thing), “Martha, we’ve been having this problem for a really long time, and I started to see a professional and the professional’s name is Dr. Louise.” We continue, ”This problem has gotten too big for all of us, it’s bigger than our family (or if I am working with a celebrity, “It’s been bigger than I as a business manager can handle, it’s bigger than your stylist can handle”) and tomorrow morning we’re having a meeting and Dr. Louise and Jeffrey will be coming. And so will Aunt, Uncle, Grandmother and sister, etc.”
You used the word “meeting?”
Yes, meeting, because that’s what it is. It’s a family meeting, the family clearly states that they don’t know how to solve this problem, it’s bigger than us and so we need some professional help. Because I’ve tried everything and it’s not working and I hope that you’ll come.”
Captive Interventions – Hospital – Adolescent – Failure to Launch Interventions
A hospital intervention is always a little different because the identified loved one is for the moment captive inside the hospital setting. This can be a great place to invite a loved one to change with or without a professional present
For example, I worked with a wonderful family who was very concerned about a loved one who was in her 60s and was hospitalized. She had a staph infection as she had been shooting up Dilantin, and she was also using Budder (a concentrated form of THC, the main psychoactive more potent than the buds of a marijuana plant that are usually consumed). She was captive in a hospital and she couldn’t go anywhere except to a skilled nursing home, so I helped the family by coaching a change agreement. The only place this woman could go was a hospital-based treatment center because she had been doing this for over half her life. Her father was 88 and had been supporting her; the only way he would continue to support her was if she went to treatment. So in this case the person was captive; they’re not going anywhere, they can’t go anywhere. This was in respect an invitational intervention, although I wasn’t even present because I was able to coach that family. Not always does the interventionist have to be physically present to aid a family. Clinical assessment of the situation is crucial in making that decision.
Under aged loved ones living at home can also been seen as captive individuals. They are after all legally under age. In these cases it is mandatory that strong boundaries be established. One must be respectful and firm with that 15-year-old because they’re oppositional and they’re defiant. The truth is, I don’t know that a surprise intervention or as they are sometimes referred to in the industry as a “grab and go,” is necessary with 14 or 15 year-olds. I still believe that an invitational intervention, not a surprise, works well with that population. I don’t specialize in that population for that reason. Under aged youth have theoretically fewer places to flee. Where are they going to go? Eventually they’re going to come home because they’ll run out of money, unless they go live on the street. I believe parents have tremendous power dealing with adolescents, power that they are afraid they don’t have. It’s a parent’s fright that holds them hostage, not the reality of their child. All they have to do is say, “It’s my way or the highway.” But because parents are so afraid of the highway, they have this imaginary “held hostage” visual.
Today we find many 18 – 30 year-olds living at home holding the parents hostage with their substance abuse and or mental health disorders. Parents are afraid to let them experience the consequences of their behavior. The family is held captive by their fears. In this instance as in all the other examples, working ahead of time with the family system involved and empowering them to take care of themselves and understand that healthy boundaries are possible in a compassionate, respectful way, makes the invitations to change (i.e. intervention) all the more possible and all the more respectful.
***Stay tuned for Part Two of my interview with Dr. Stanger posting next week, September 30th.
Dr. Louise Stanger will be speaking at the Moments of Change 2014 conference for innovations in integrated treatment
September 29 – October 2, 2013 at The Breakers hotel in Palm Beach.
To find out more about Dr. Stanger and her work, please visit her website: