Introducing the Subject of Counseling

If you are worried about a friend, your child, or another family member and have made the decision to get help, you may want to begin by pointing out what concerns you. For example:

 

  • I've noticed that you're hanging out alone a lot more often. What's going on? I'm worried.

  • I'm sorry that you've experienced such a tremendous loss. I know that I would feel lost if that happened to me.

  • Dealing with a bully is really hard. I'm worried about you and I want to take you to see a counselor.

 

Sometimes defining what counseling is can help ease the person's anxiety about counseling. It's okay to tell the person: 

 

You don't need to get your head shrunk, nor do you have to talk about family history for the past 100 years unless you want to.

 

You might say something like:

 

If I were to give you an airplane and tell you to fly, you wouldn't just jump in, start pushing buttons, and expect it to fly; right? First, you would take flying lessons so that you knew how to handle the plane.
 

Sometimes, we need help learning how to deal with an addiction or with our feelings, which can feel like an airplane spinning out of control. And just like learning to fly a plane, a counselor can help us learn to deal with things in life that make us feel like everything is spinning out of control. Let's talk about making an appointment for you to see a counselor, and together, your counselor and I will help you.

 

If the person isn't ready for help and if you don't believe the person is at risk for suicide, it's okay to keep an eye on things and bring the subject up again later. The person may even snap at you; don't take it personally. Assure the person that you care, and let the person know "I'll check back with you on this after you've had some time to think things through." Keep your promise to follow up!

 

The Active Minds website has more information on how to support a person, Be a Friend.

 

 

Introducing the Subject of Treatment

 

The Partnership for Drug-Free Kids provides some ideas for talking to a loved one or an adult about getting help. Tips include:

 

A little willingness goes a long way, and it's a good sign! Whether it’s a consultation, attending an AA or NA meeting, or seeking a higher level of care, it can be all the invitation you need to start the conversation. While it's not uncommon for a person to say no or want to think about it at first, there will inevitably be other opportunities to raise the subject. And remember, managing your expectations around engaging and staying in treatment are a part of good self-care.

 

Note: It’s important to do your homework before suggesting treatment so that you know what programs are suitable, have openings and what types of payment will be accepted. 

 

Listen for “Change Talk”

 

  • “I’m really feeling depressed that I don’t have a decent job.”
  • “I think I really upset a friend last night when I had one too many.”
  • “I want to move out and have my own place.”
  • “I wonder if I should go back to school.”

 

When the person expresses change talk, take notice and help him or her connect the dots. Caringly and compassionately explain how substance use is related to concerns in the present and hopes for a better future.

 

Interventions

Stepping in and speaking up is a vital first step in taking action to address a loved one’s substance use. However, media and pop culture have popularized the notion of an intervention as a scenario in which family and friends gather around a loved one to share the impact of the loved one’s substance misuse, usually followed by an ultimatum: go to treatment or else. The “or else” can include cutting the loved one off financially, asking him or her to leave the home and cutting off all communication unless the loved one agrees to treatment. The success rate of this style of intervention is lower than using other evidence-based approaches like Community Reinforcement and Family Training (CRAFT), and claims to the contrary are generally limited to getting someone into treatment, with no measures related to the successful completion of treatment.

 

Mandated Treatment

Oregon has civil commitment laws that establish criteria for determining when involuntary treatment is appropriate for individuals with  If there is a danger to self or others as defined by the courts, civil commitment laws can be invoked to mandate treatmentknown as assisted outpatient treatment (AOT).

For both inpatient and outpatient treatment, a person must meet the following criteria:

  • be a danger to self/others; 

  • be unable to provide for basic personal needs and is not receiving care necessary for health/safety; or 

    • have chronic mental illness;

    • have had two hospitalizations in previous three years;

    • have symptoms/behavior substantially similar to those that led to the previous hospitalizations, and 

    • will continue to physically or mentally deteriorate to either standard (1) or (2) if untreated.

 

Help for Youth

If the person who needs help is a youth in your care, the Partnership for Drug-Free Kids  provides information about:

 

  • Setting the Stage

  • Establishing a Connection

  • Having a Conversation, Not a Confrontation

  • Breaking Through Barriers, and

  • Keeping the Conversation Going