Which kind of crisis is this?
If something dangerous is happening now — they can't be roused, breathing is slow or stopped, they've had a seizure, they're threatening to harm themselves, or you're frightened for anyone's safety — call 911. Give naloxone if it's available; it does no harm if no opioid is involved. For suicidal thoughts, call or text 988. For violence in the home, the National Domestic Violence Hotline is 800-799-7233.
If you've reached breaking point and want to get them into treatment — that's a planned intervention, and the rest of this page is about doing it well. It is not an emergency response, and treating it like one is how these go wrong.
Both of those get called "a crisis," and families arrive here in either state. They need almost opposite things, so it's worth being clear which one you're in before reading further.
It Doesn't Look Like Television
Most people picture the same scene: everyone assembled in a living room, the person walks in unaware, letters are read aloud, and a bag is packed by the door. That image comes from television, where it exists because it produces a filmable emotional climax in forty minutes.
It is a production convention, not a clinical protocol — and it's worth knowing that before you organise your family around it. Surprise and confrontation can put someone straight into defence, and a person who feels ambushed by the people closest to them may agree in the room and disengage within days. Where there's a history of violence or serious mental illness, an unplanned confrontation can also be genuinely unsafe.
None of which means family involvement doesn't work. It does. It just doesn't have to look like that, and often shouldn't.
The Approaches
The Johnson Model is the confrontational format described above — a prepared, often surprise meeting where people present the impact of the person's use and ask them to go to treatment immediately. It's the one everyone pictures, and it remains in use.
CRAFT — Community Reinforcement and Family Training — takes a different route entirely. Rather than confronting the person, it works with the family: changing how they respond, improving how conversations go, reducing what inadvertently supports continued use, and looking after the family's own wellbeing. It's described in the research literature as an evidence-based approach [1], and it doesn't hinge on one decisive conversation.
Invitational approaches involve the person from the start rather than springing a meeting on them, and include the wider family in the process.
Which suits a particular family depends on the relationships, the history, and the risks involved — which is a clinical judgement rather than something to pick from a webpage. What's worth taking from this section is simply that there is more than one option, and that the default most families assume is the default isn't the only one.
Why a Professional Changes the Odds
You can do this without one. It's worth understanding what you're taking on if you do.
Families are not neutral parties. Everyone in the room has history, and old arguments surface under pressure — one person gets angry, another apologises, someone raises something from years ago, and the conversation stops being about treatment. A professional isn't emotionally entangled and can hold the thread when that happens.
The less obvious contribution is logistical, and it's often what decides the outcome: making sure there is an actual treatment place, that admission can happen today, and that transport exists. A great many family-run interventions produce a yes and then collapse into "we'll sort it out next week."
It's especially worth involving someone where there's been violence, a serious mental health condition, or a previous attempt that went badly.
What to Sort Out Beforehand
Whatever approach you take, the preparation is the same, and it matters more than the wording of anything anyone says.
Have treatment actually arranged. Verify their insurance beforehand — you can do this on their behalf — and know what admission would involve. Willingness is often narrow and short-lived, and the gap between "yes" and "we can take you now" is where it closes.
Know the clinical starting point. For alcohol or benzodiazepines, supervised detox usually comes first, because that withdrawal can be dangerous. "Just stop tonight" is not a safe ask in those cases.
Agree what each person will do if the answer is no, and only commit to things you'll actually hold. And pick a moment when they're sober — a conversation with someone intoxicated is not a conversation.
If They Say No
Plan for this, because it's the common first outcome and families treat it as a verdict when it's usually just timing.
A refusal generally means the moment or the framing was wrong, not that the answer is permanent. What helps afterwards: keep the offer visibly open, hold whatever boundaries you named without turning them into punishment, and stay ready. Willingness tends to arrive abruptly — after a frightening night, a health scare, a consequence that finally landed — and it doesn't wait around.
It's also worth saying: an unsuccessful conversation isn't wasted. People frequently describe being reached by something said months before they acted on it.
Getting help planning it
You don't have to design this alone, and you don't need to have decided on an approach before calling. Our Families & Loved Ones team helps plan these conversations — what to say, when, who should be there, and what to do with each possible answer.
We can also handle the part that most often fails: having a place ready, benefits verified on their behalf, and admission able to happen quickly rather than next week. Where use sits alongside depression, anxiety, or trauma, that gets treated too — which matters, because it's often the reason previous attempts didn't hold.
If someone is in immediate danger, call 911. For suicidal thoughts, call or text 988. For violence in the home, the National Domestic Violence Hotline is 800-799-7233. Do not attempt an intervention where you believe it may provoke violence — get professional guidance first.
FAQs
- What is a crisis intervention for addiction?
- The phrase covers two different things. One is the immediate response to a dangerous situation — an overdose, a psychiatric emergency, someone at risk of harming themselves — which needs emergency services, not a family meeting. The other is a planned conversation in which people close to someone ask them to accept treatment. This page is mostly about the second; if it is the first, call 911.
- Do interventions actually work?
- Family involvement genuinely can move someone toward treatment, and approaches such as CRAFT — Community Reinforcement and Family Training — are described in the research literature as evidence-based. What is less supported is the specific format popularised by television: a surprise confrontation with an ultimatum. That is a production convention, not a clinical protocol.
- What is the Johnson Model intervention?
- The classic confrontational approach: family and friends gather, often as a surprise, present prepared statements about the impact of the person’s use, and ask them to enter treatment immediately. It is the format most people picture. It is one approach among several, and whether it fits a particular family is a clinical judgement rather than a default.
- What is CRAFT?
- Community Reinforcement and Family Training — an approach that works through the family rather than confronting the person. It focuses on changing how those around them respond, improving communication, and reducing the reinforcement around use, while also supporting the family’s own wellbeing. It is described in the literature as evidence-based, and it does not depend on a single dramatic conversation.
- Should we hire a professional interventionist?
- It is worth considering, particularly where there is a history of violence, serious mental illness, or previous attempts that went badly. A professional keeps the conversation on track when emotion takes over, and — more practically — makes sure a treatment place, transport, and admission are actually ready, which is where most family-run attempts fall apart.
- What if they refuse?
- That is a common first outcome and it is not the end. It usually means the timing or framing was wrong rather than that the answer is fixed. What helps is keeping the door open, holding whatever boundaries you set, and being ready when willingness appears — it tends to arrive suddenly and not last long.
- Can we get treatment arranged before we talk to them?
- Yes, and you should. You can verify their insurance on their behalf and have admission ready before the conversation happens. Asking someone to accept help and then telling them it will be several days is how a yes turns back into a no.
Sources
- National Institute on Drug Abuse (NIDA), NIH/PMC. Community Reinforcement and Family Training (CRAFT) with concerned significant others.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Substance Use Disorder Treatment and Family Therapy.
- National Institute on Drug Abuse (NIDA). Principles of Effective Treatment.
- National Institute of Mental Health (NIMH). Suicide Prevention.
This article is for informational purposes only and is not a substitute for professional clinical guidance. It does not provide scripts or instructions for conducting an intervention.
Written by
Clinical Director
Gigi Price holds licenses as a Licensed Master Social Worker (LMSW) and Licensed Chemical Dependency Counselor (LCDC), and completed her Master’s degree in Social Work at Texas State University. As Clinical Director of Virtue Recovery Houston, Gigi has conducted research to identify the most effective approaches for treating patients with acute mental health diagnoses, PTSD, and substance use disorder, assembling a team of clinicians offering CBT, DBT, ACT, Somatic Exposure, EMDR, and CPT.
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