The Stanger Process

AN ELEVEN-STEP PROCESS FOR A TWELVE-STEP SOLUTION

Dr. Louise Stanger works with families to understand their role in the intervention process, which is a systemic approach to healing the entire team. Her intervention approach is eleven steps divided into three-phases, all based on sound social work principles of starting at the beginning and working from the foundation of unconditional positive regard. She utilizes evidence-based approaches that include Cognitive Behavioral, Motivational Interviewing, Solution-Focused, 12-Step, and Mindfulness Modalities within an invitational Team-Systems framework. (That sounds like a mouthful, but what it means is that Dr. Stanger designs an intervention specifically for the family and the loved one’s situation, behavior, and treatment needs.)

PHASE ONE: INTERVENTION AGREEMENT AND INITIATIVE

Step 1: Establish The Intervention Agreement

Dr. Stanger explains to your family the necessary work to make an intervention possible and learns about your loved one. She completes a thorough family history, which includes a snapshot of generational issues, known as the ‘family map’ or ‘genogram’. Dr. Stanger stresses to the team the importance of taking responsibility for the intervention results. Terms of the intervention are agreed upon at this time, ensuring all team members are committed to the intervention.

Step 2: Determine Key Stakeholders

Dr. Stanger helps the intervention team members reach out to others who are significant in the life of your loved one. By inviting others to join the intervention team, she is expanding the sphere of influence the team has. She makes sure that everyone understands their roles and is supportive in the process. Key stakeholders can be immediate/extended family members, partners, clergy, best friends, human resource or co-workers, and others. Dr. Stanger interviews each one and gets to know their perspective.

Step 3: Define Client Guidelines and Confidentiality

It is critical that everyone agrees with the expectations, commitments, timelines, ground rules, goals, and objectives. This requires great clinical skill on Dr. Stanger’s part. Interested persons may have competing wants and needs. Occasionally, team members don’t even like each other. However, they must put aside their own issues and come together seeking the common good and health of their loved one.

All participants sign client information sheets and confidentiality agreements. Dr. Stanger is committed to fostering a trusting, purposeful, and confidential relationship. All participants receive copies of Privacy Practices and HIPPA Information.

PHASE TWO: INFORMATION GATHERING, OBJECTIVES AND ACTION PLAN

Step 4: Identify Background Information

Once the intervention agreement is finalized, the intervention team members review the overall process, ask questions, and begin to learn more about addiction. Through this practice, everyone learns more about what is going on, what the disease of addiction looks like, and how the team is going to get healthy together.

Step 5: Assess the Identified Patient and Key Stakeholders

Information gathering about your loved one comes from a variety of sources: family members, friends, partners, employers, treatment professionals, and others. Together everyone paints a portrait of your loved one’s behavior so Dr. Stanger can make a clinical assessment based on a retrospective analysis. By obtaining a good social history combined with the generational map from step one, Dr. Stanger can determine many complex factors, including if there is an underlying mental health disorder. For example, perhaps depression, bi-polar behavior, or ADHD came before the substance abuse. This assessment helps form the blueprint for action.

Step 6: Teach, and Survey Family Members’ Involvement.

Dr. Stanger works with the intervention team members as they address the pain that they’ve experienced from your loved one’s addiction or disorder. Intervention team members then may elect to participate or not. It’s not always an easy decision, as interventions are incredibly emotionally taxing. The team members are faced with the choice of progress and some hard work, or stagnation and further decline. This is often a turning point for loved ones. Participants often discover hope and optimism at this stage. They begin to see that it is possible to laugh again.

Step 7: Develop a Measurable Action Plan

After the above information is gathered and evaluated through careful investigation, the best treatment center is chosen and a date is set for the intervention. Participants anticipate objections to treatment that your loved one may bring up: childcare, employment, school, or other plans that they see as too important to miss. A plan is developed to address, minimize, and eliminate objections. Likewise, participants explore reasons that your loved one might accept and embrace treatment. Participants prepare to share their experiences, their fears and their hopes with their loved one.

The actual place and time of the intervention is set and transportation is arranged. Special consideration is given to the timing of intervention, to avoid intervening when your loved one could possibly be under the influence.

After your loved one agrees to go into a treatment program, in most instances a team member accompanies them and gets them registered and settled in. In certain circumstances, transportation can be arranged when necessary.

PHASE THREE: IMPLEMENTATION, REVIEW AND FOLLOW-UP

Step 8: Pre-Intervention

This is an emotional time for the intervention team. Together, you learn there are “no more secrets” as you share possible ways in which you may have enabled your loved one’s addiction. Often times the behavior was inadvertent, and done out of love such as excusing missed school, covering up work absences, or ignoring missing money. Next we revisit potential objections of your loved one and problem solve answers to their arguments. Dr. Stanger is consistently available to speak with individuals and assuage their anxieties. Participants may also attend support groups or continue seeing their own counselors during this period.

Step 9: Actual Intervention and Immediate Actions

Dr. Stanger’s role as interventionist varies with each intervention team. Most often, the intervention team is coached along as they address their loved one. When necessary, Dr. Stanger may accompany your loved one to a quiet place to calm him or her down so that he or she is more able to listen to their friends and family. The attention is always on being in the moment – making sure he or she is respected, valued, and cared for.

“I feel fortunate that all of my interventions have had a successful outcome – behaviors have been changed for the better as a result of the intervention,” says Dr. Stanger, “and many times I bring another seasoned professional with me. I have found this to be most helpful for all.”

From a safety standpoint, if an intervention has potential to be volatile or become violent, threatening harm to the loved one or someone on the team, it is critical to have two professionals present. This system also gives the loved one the opportunity to relate to more than one professionally unbiased person. It also allows someone to stay with the intervention team after your loved one is escorted to treatment to process the events of the intervention, providing closure, reassurance and answering questions and concerns that come up.

Step 10: Progress Review and Feedback

Following the intervention and its outcome, Dr. Stanger offers time together to review this life-altering process. Together, the team reflects on the event and looks at how each team member can take care of themselves – be it a support group, therapy, a fun activity, or simply having a good night’s sleep because their loved one is in a safe place.

Step 11: Post Intervention Follow up

Case management services are offered while your loved one is in treatment as well as Solution-Focused Coaching for intervention team members as they navigate new ways of caring for themselves. Together, the team talks once a week and receives advice on family programs from the treatment center, local self-help groups, and mental health groups. Dr. Stanger also works closely with treatment centers to recommend after care living options and licensed counselors for your loved one. Periodic check-ins are scheduled to build on the team’s success, and to create a healthy, positive change for the family and your loved one that lasts.