Judith Landau

Outcomes with the ARISE approach to engaging reluctant drug- and alcohol-dependent individuals in treatment.

Our goal was to explore, through a Stage I NIH clinical study, the effectiveness of a manual‐driven, timely response method for helping the “concerned other” get resistant substance abusers into treatment/self‐help with minimum professional time/effort. A manual‐driven protocol, “A Relational Sequence for Engagement (ARISE),” was applied with 110 consecutive, initial calls/contacts from concerned others; no cases excluded for research, refusal, or other reasons. The research was conducted at two upstate New York outpatient drug/alcohol clinics. Participants were concerned others who called regarding a cocaine, alcohol, or “other drug” abuser (N = 110); participating family/friends: 11 ARISE clinicians; and 110 substance abusers. ARISE is a graduated continuum starting with the least demanding option/stage, increasing effort as needed to engage substance abusers in treatment/self‐help. Stage I: Coaching the concerned other to arrange a meeting of significant others, inviting the substance abuser; Stage II: 1 to 5 additional meetings (median = 2); Stage III: A modified Johnson “Intervention.” Primary outcome variables were substance abuser engagement (or not) in treatment/self‐help; days between first call and engagement; clinician time/effort. Predictors were concerned other, substance abuser, and clinician demographics; number of participants per case; and Collateral Addiction Severity Index. ARISE resulted in an 83% success rate (55% at Stage I). Median days to engagement was 7 (IQR = 2 to 14). Average total time (telephone, sessions) per case was 1.5 hours. Treatment/self‐help chosen was 95% treatment and 5% self‐help. Number of family/friends involved correlated 0.69 with a success/efficiency index. Conclusions. A call from a family member or concerned other for help in getting a loved one into treatment is a rich opportunity for treatment professionals and agencies to engage substance abusers in treatment. These initial calls are similar to referral calls from EAPs or probation officers looking to get an individual started in treatment. ARISE provides an effective, swift, and cost‐efficient option for engaging substance abusers in treatment or self‐help. The more significant others involved, the greater the success of treatment engagement.

Strength in numbers : The ARISE method for mobilizing family and network to engage substance abusers in treatment

The model described in this paper takes into consideration two key findings: (a) In a given year, the vast majority (90–95%) of active substance abusers do not enter treatment or self-help groups, and (b) substance abusers have frequent contact with their families (60–80% either live with a parent or are in daily contact). This paper presents a method for mobilizing and collaborating with families and extended the support system toward working with resistance and getting the substance abuser into treatment. Principles and techniques are provided for convening and structuring intervention network meetings toward that end. This intervention network approach can be used either alone or as part of an overall model, ARISE (A Relational Intervention Sequence for Engagement). The ARISE model addresses both clinical and programmatic issues in treatment engagement for substance abusers.

Intergenerational family relations and sexual risk behavior in young women.

PurposeTo more fully understand the associations between family variables and sexual behavior of young women. Study Design and MethodsForty-two female clients of an urban youth agency (16 to 25 years of age) were interviewed about intergenerational stories and contact with extended families. Individuation was measured by self-report using the intergenerational individuation subscale of the Personal Authority in the Family System Questionnaire. Self-report questions were used to gain information about the young women’s sexual risk behavior. Data were analyzed using Pearson correlation, independent t-tests, and multiple regression. Family stories were analyzed for themes of resilience or vulnerability. ResultsYoung women who perceived their connection with previous generations in a resilient light tended to be more individuated and report less risky sexual behaviors. Clinical implicationsThese results may give direction in the design of family interventions for reducing sexual risk taking and enhancing positive health behavior. Interventions would include promoting a healthy degree of attachment between adolescents and their families, exploration of family of origin issues, and referral for more intensive services when needed.

ASSISTING A CONCERNED PERSON TO MOTIVATE SOMEONE EXPERIENCING CYBERSEX INTO TREATMENT APPLICATION OF INVITATIONAL INTERVENTION: THE ARISE MODEL TO CYBERSEX

Cybersex and Internet pornography addiction are new problem areas confronting couples and families. A most significant experience inducing family members to reach out to a therapist or an Interventionist for help with their addicted member is the realization that the individual they are living with has become a stranger. This article focuses on the changes in the attitude, emotions, and behaviors of the addicted individual from compulsive Internet pornography use and cybersex. Identifying these changes for the family members validates their experience of now living with a stranger. This article then presents the three-level empirically based, manual-driven method of Invitational Intervention, A Relational Intervention Sequence for Engagement (ARISE) as an effective tool for helping families to get their loved ones into treatment.

Invitational Intervention: The ARISE Model for Engaging Reluctant Alcohol and Other Drug Abusers in Treatment

SUMMARY Families are an untapped resource in motivating resistant alcohol dependent and other drug addicted individuals to enter treatment. Contrary to popular belief, families maintain a disproportionately close connectedness with their addicted loved ones. In this article, the authors present the underlying functional components of this connectedness, and describe the process called Family Motivation to Change for mobilizing family and friends to form an Intervention Network for the express purpose of getting a resistant addicted loved one into treatment. This is the core of ARISE as A Relational Intervention Sequence for Engagement. ARISE uses an Invitational Intervention method, with the family conducting most of the Intervention, thus minimizing the clinicians expenditure of time and cost.

Neurobiology and Addiction: Assisting the Family and Support System to Get Resistant Loved Ones into Treatment

A conceptually based, practice-oriented therapy approach provides practicing clinicians an understanding of the powerful impact of active drug addiction on brain function and its effect on individual behavioral change and on family interaction. Engagement of the reluctant abusing family member is specifically addressed, informed by neurobiology and grounded in a family-oriented approach. Psychoeducational interventions from the first call to seek professional help validate family members’ experience and respond to their desperation. An overview of the various phases of the ARISE model (A Relational Intervention Sequence for Engagement) is integrated into the chapter. Examples from treatment, supportive outcome data and selected psycho-educational resources are included.