The main addiction intervention methods differ most in one way: whether the person is surprised or invited. The Johnson model is a planned surprise meeting. Invitational models such as ARISE tell the person from the start. CRAFT teaches family members skills over several weeks, and systemic approaches work with the whole family. No method fits every family.
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Not sure which approach fits your family? Talk with our intervention team. Your first call is free.
Key facts
- “Intervention” covers several different methods. They share a goal, helping someone accept treatment, but they get there in different ways.
- Research on these methods mostly measures one thing: whether the person entered treatment. It does not tell you how a particular family will do.
- Our intervention team does not use one branded method. We tailor the approach to each family and explain why we recommend it.
- A planned intervention is not an emergency response. If someone is in danger, call 911; for a suicidal or mental health crisis, call or text 988.
The methods side by side
| Method | Is the person told in advance? | Who takes part | How long it usually takes | Research base | May fit when |
|---|---|---|---|---|---|
| Johnson model | No. The meeting is a planned surprise | Family and close friends, usually with a professional | Days to weeks of preparation, then one meeting | Widely used; one well-known trial found many families did not go through with the meeting | The person refuses every conversation and there is no history of violence or serious mental illness |
| Invitational and ARISE | Yes. The person is invited from the first meeting | A wider circle of family and friends, often including the person | Often days to a few weeks, with steps added only if needed | Promising results from studies without a comparison group | The family wants honesty from the start and has several people willing to take part |
| CRAFT | Not applicable. There is no single meeting | One or more family members, working with a trained clinician | Several weekly sessions | The strongest randomized trial evidence of the family methods | The family has some time, safety is stable, and they want to improve home life either way |
| Systemic family | Yes. There are no hidden meetings | The whole family, including the person | Several meetings over weeks, then continued family work | Grounded in family therapy research; few trials of the named model | Family patterns, conflict or several struggling members are part of the picture |
The Johnson model
Developed from the work of Vernon Johnson in the 1960s and 1970s, this is the intervention most people picture from television. Family and friends meet in secret with a professional, write letters describing specific moments and their love, choose a treatment program in advance, and then gather with the person without warning. Each person reads their letter, and the group asks the person to go to treatment right away, often stating what will change if they refuse.
Its strength is clarity: everyone says the same thing at the same time, and treatment is ready. Its weakness is that many families find the surprise hard to carry out, and some people feel ambushed. Read more about the Johnson model.
Invitational interventions and ARISE
Invitational approaches start from the opposite assumption: the person should know what is happening. ARISE, short for A Relational Sequence for Engagement, is the best known. A family member calls, the professional coaches them to invite the person to a first meeting, and more formal steps follow only if earlier ones do not work. The final stage resembles a traditional intervention, but most families never reach it.
Supporters value the honesty and the lower risk of a blowup. A 2004 study of 110 cases reported that most people entered treatment or self-help, often within about a week, though the study had no comparison group. Read more about invitational and ARISE interventions.
CRAFT (Community Reinforcement and Family Training)
CRAFT is not a single meeting. Over several sessions, a family member learns how substance use fits into the person’s day, how to reward sober behavior, how to stop cushioning the consequences of use, how to stay safe, and how to suggest treatment at the moment the person is most open to it. It also focuses on the family member’s own wellbeing.
In a 1999 randomized trial with 130 family members of problem drinkers (Miller, Meyers and Tonigan, Journal of Consulting and Clinical Psychology), 64 percent of CRAFT families saw their loved one enter treatment, compared with 30 percent for Johnson-style preparation and 13 percent for Al-Anon facilitation. A 2002 trial with family members of people who used drugs found a similar pattern. Read more about CRAFT.
Systemic family intervention
Systemic approaches grow out of family systems theory, which sees a family as a connected unit in which each person’s behavior affects everyone else. The person is invited from the start, there are no secret meetings, and the work usually continues over several sessions and into treatment. The goal is to change the patterns around the addiction, such as rescuing, avoiding conflict or covering up, not only to get one person into a program.
SAMHSA’s treatment guide on family therapy, TIP 39, describes the systems view that underlies this work. Read more about systemic family intervention.
Letter-centered approaches
Several programs build an intervention around carefully written letters, read aloud in a calm and loving meeting. Letters appear in many methods, including the Johnson model and the later stages of invitational models. A good letter recalls specific, recent moments without blame, says how they affected the writer, and ends with a clear request. Our guide to doing an intervention includes advice on what to say.
What the research can and cannot tell you
The studies above are useful, but read them carefully. They measure whether a person entered treatment within a set period, not whether they stayed sober afterward. They were run by trained clinicians following manuals, often by the people who designed the method. The families who volunteer for research may differ from yours. Two findings hold up well across this work: families can learn skills that improve their own lives whether or not their loved one agrees to treatment, and a plan that the family will actually carry out matters more than a perfect plan that never happens.
How we choose an approach with your family
On a first call we ask about safety, the substance or behavior involved, mental health, past attempts at help, who in the family is ready to take part, and how much time there is. Those answers point toward an approach, and often toward a blend: an invitational first conversation, letters prepared in case they are needed, and CRAFT-style skills for the weeks before and after. We tailor the approach to your family, and we will explain why we recommend what we do.
Whatever the method, the work does not end at the meeting. Read what to do if they say no and what happens after an intervention, or return to our addiction intervention services.
Frequently asked questions
What is the most effective intervention method?
No method works for every family. In randomized trials, CRAFT engaged more loved ones in treatment than Johnson-style preparation or Al-Anon facilitation, but the best choice depends on safety, time and who is willing to take part.
Is a surprise intervention a good idea?
Sometimes, but not always. A surprise meeting can break through years of avoidance, yet many families find it hard to carry out, and it can be risky when there is violence, suicide risk or serious mental illness.
What is the difference between ARISE and CRAFT?
ARISE is an invitational intervention that brings family and friends together with the person, adding steps only if needed. CRAFT has no group meeting; it teaches one or more family members skills over several sessions.
Do we have to choose one method?
No. Many families blend approaches, for example an honest invitation, letters prepared in advance, and CRAFT-style skills for the weeks around the conversation. A good professional explains the tradeoffs.
Which method does your team use?
We tailor the approach to each family rather than using one branded method. We explain the options and why we recommend one for your situation.
Talk with our intervention team
Tell us about your family and we will walk you through the approaches that fit, wherever you live in the US.