How to help a loved one accept treatment
What research supports, what tends to backfire, and how to look after yourself while you wait for a yes.
Calls are answered by a partner at-home treatment provider, not by this guide.
- Approach CRAFT
- Described by SAMHSA TIP 39
- Avoid Shame and surprise confrontation
- For you Al-Anon and Nar-Anon
The short answer
Calm, steady encouragement works better than a surprise confrontation. SAMHSA’s guide to family therapy (TIP 39) describes CRAFT, short for Community Reinforcement and Family Training, a structured approach of about 4 to 6 sessions that teaches families to reward sober time and encourage treatment. SAMHSA notes that people pressed into treatment by confrontation are more likely to return to use than people encouraged through positive reinforcement.
What CRAFT looks like at home
CRAFT works through you, the family member, rather than through the person who is using. A counselor teaches you to change how you respond so that sober time feels better than using time. SAMHSA’s example is simple: telling your loved one how much you enjoy time together when they have not been drinking, or going to a movie after a sober day (SAMHSA, based on TIP 39).
In practice, families working this way tend to:
- Learn the pattern. Notice when, where and with whom use happens, and what comes before it.
- Reward sober time. Make the good moments warmer and more frequent.
- Step back from rescuing. Let natural consequences happen when it is safe, rather than covering for a missed day or a bill.
- Talk without blame. SAMHSA’s guidance is to avoid blaming and shaming, say clearly that you are worried, say that you hope they get help, and praise any step in the right direction.
- Have a plan ready. When your loved one says “maybe”, you want two or three checked options and a phone number, not a week of research.
About surprise interventions
The televised kind of intervention, where family members gather and confront someone without warning, is often called the Johnson Intervention. SAMHSA removed it from the 2020 update of TIP 39. It said many families find the method too confrontational and blaming, that most families never go through with the confrontation itself, and that the Surgeon General’s report on addiction singled it out as ineffective.
That does not mean an intervention professional cannot help. Some use invitational approaches, where the person is told about the meeting and invited to take part. If you hire one, ask which method they use, what training they have, and whether any treatment center pays them. In Florida, paying or receiving anything for patient referrals is illegal under s. 817.505.
Have the destination settled before any conversation. Our clinical-first checklist and cost guide will help you get there.
When it cannot wait
If your loved one has overdosed, is unconscious, or is in danger, call 911. If they talk about suicide, call or text 988. The free SAMHSA National Helpline, 1-800-662-4357, is open 24 hours a day for treatment referrals and information.
If your loved one has lost control of their use and refuses help despite real risk, Florida’s Marchman Act lets a family ask a court for an assessment and treatment order. NIDA’s research guide notes that treatment does not need to be voluntary to be effective, and that pressure from family or work can increase treatment entry and retention (NIDA).
Look after yourself, too
SAMHSA encourages family members to attend support groups such as Al-Anon and Nar-Anon, and links Al-Anon with better well-being for families. Once your loved one is in care, a good family program continues that work.
Questions about helping a loved one
What if my loved one keeps saying no?
Keep the door open and keep using the same calm approach. A “no” today often becomes a “maybe” after a hard morning or a consequence. Make sure your plan is ready for that moment.
Should I give an ultimatum?
Only if you are ready to follow through, and only about your own choices, such as what you will no longer pay for. Threats you do not keep teach the opposite lesson. A counselor trained in CRAFT can help you decide.
Is paying their rent or bills enabling?
It depends on what it protects. Keeping a roof over someone’s head is different from paying off debts that came from using. CRAFT asks you to stop shielding your loved one from the natural results of use while keeping them safe.
What if they will not leave home for treatment?
Some people accept care that comes to them. Read about treatment at home. It is not safe for everyone: severe alcohol or benzodiazepine withdrawal can need a hospital, and in an emergency, call 911.
For treatment centers
Licensed Florida centers can apply for the one featured spot on this guide.