Intervention


Introduction Background    Background Definition    The EAP Concept Goal    The EAP Concept Types    The EAP Concept Do’s and Don’ts   The EAP Concept Web Links


Background

Piloting an aircraft requires the highest levels of alertness and technical skill. Individuals who become successful airline pilots are generally intelligent and have strong ego structures. These characteristics are beneficial when operating an aircraft, but they can hinder the ability to break through a chemically dependent pilot’s denial. Denial, of course, is a hallmark of the disease of addiction. It is explained in some detail in the Disease Model section of this website. Simply said, though, denial is the inability of the alcoholic or addict to make the connection between their alcohol or drug use and the negative consequences associated with that use.

Due to the need for an uncompromising level of safety in aviation, it would be natural for someone to be concerned if they observed heavy or inappropriate use of alcohol or another drug by a pilot. We know that addiction, by its very nature, involves loss of control. And, the idea that a pilot with an active addiction is operating an aircraft is a scary one. We know, however, the presence of denial in an alcoholic or addict means they will often be unable to recognize they have a problem. A typical pilot’s personality makes the task of getting them to see a different reality than their own a very tough assignment. An intervention is one method that has been shown to be effective in breaking through denial.

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Definition

An intervention is an event that presents reality (specific information) in a receivable form (with concern) to a person unable to see that reality (in denial).

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Goal

The goal of the intervention is to have the pilot in question agree to a professional substance abuse evaluation; it is not to try and get the subject to admit that they are chemically dependent. The diagnosis will be made, or not made, as a result of the evaluation following the intervention.

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Types

Interventions are intended to interrupt the progression of chemical dependency disease. There are several types of intervention that can be conducted. The type that is used is largely dependent on the people involved in the intervention and the amount of information available. A useful way to examine the different types is to look at each as it relates to the participants involved. In all cases, it is imperative the intervention be led by someone who is trained in interventions. Usually, this means using a health care professional trained in substance abuse to lead, coordinate, and facilitate the event.

Classic

The “classic” intervention consists of family members and is conducted by an “interventionist,” i.e. a trained therapist. Family members often have the greatest amount of information indicating a possible problem with chemical misuse. They are also emotionally significant to the person being intervened upon. Some of the difficulties with this type of intervention, however, are overcoming the existing family roles and dynamics. The family has probably enabled the pilot’s drinking or using over time, and the pilot will use that fact as a rationalization to discount their current concern. Also, the pilot will have developed some strong defense mechanisms in relationship to any specific family member. It is also often difficult for the family members to provide credible negative consequences to the pilot in that they love him and are often financially dependent upon him. All of these obstacles and problems can be overcome and, in many cases, a family intervention is the most effective of all types in breaking through an addicted pilot’s denial. However, it should be clear that an intervention of this type needs professional assistance and that family members should not attempt to conduct an intervention without help.

Company Led

A company led intervention has both disadvantages and advantages when compared to a classic intervention. The company probably has less information specifically associated with alcohol or drug misuse. The company also has limitations on its authority to compel a pilot to undertake an assessment. These limitations may be statutory or contained in the company/union working agreement. The company may, however, be able to provide a highly significant negative consequence for the pilot’s refusal to be evaluated: removal from flight status. The emotional significance of retaining his job is often a key in getting the pilot to agree to the assessment. However, one should realize that agreeing to the evaluation is not the same as breaking through the pilot’s denial. A pilot may well agree to go to the assessment, and even participate in extended treatment, while maintaining internally that he “really doesn’t have a problem.” Of course, in this case, the long-term maintenance of denial creates a significant risk of relapse.

Peer

A third type of intervention is one that is led by the pilot’s peers. This type of intervention is somewhat unique in that people who may be emotionally significant to the pilot lead it, but they are not in a position to provide a credible negative consequence. Peers may have much of the same information as the company, and sometimes more information, but the pilot will rarely agree to an assessment unless a credible negative consequence can be created. Most effective peer interventions are orchestrated to involve the company in some respect. They are often held in the Chief Pilot’s offices without a company supervisor being present. The location allows the peers to present a circumstance to the pilot that demonstrates cooperation between the company and the peers. This setting causes the pilot to realize that lack of cooperation may result in further company actions.

Combination

The most effective intervention is probably one that includes all the people mentioned above: family members, company supervisors, and peers. However, such an intervention is extremely difficult and time consuming to coordinate and execute. This is not to say it shouldn’t be done. If all the elements are present (a willing family, concerned supervisors, and willing peers) this type of intervention provides the pilot with the greatest opportunity for long-term recovery. But, delaying an intervention because one or more of these elements is missing can lead to a missed opportunity to disrupt the progression of the disease. “Striking while the iron is hot” is a phrase that can be well applied to interventions. The longer the time period that transpires between the precipitating event and the intervention, the stronger the pilot’s rationalizations about the event and the more impenetrable his denial.

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Do’s and Don’ts

There are many things to do, and not do, when conducting an intervention. The most important thing to do is to control the event. Addicts and alcoholics are masters at deception and persuasion. From their perspective, an intervention threatens the very source of their comfort and wellbeing. They will take whatever steps are available to protect their freedom to imbibe in their drug of choice. A trained interventionist will take steps to control many aspects of the intervention. These aspects include choosing a location that is not comfortable for the pilot, maintaining tight control of the discussion to avoid arguments and cross-talking, and keeping the discussion factual and not blaming or criticizing. A properly prepared intervention will also include arranging for immediate transportation to an assessment/treatment facility and making sure the pilot has a bag packed. It is crucial for intervention data and workplace concerns to be transferred to the assessing professional.

There are dozens of other details to plan for and consider when conducting an intervention. It is not possible to cover every circumstance here, which is one of the reasons professional, experienced help is so critical. It should be clear, though, that an effective intervention may be a crucial step in getting a chemically dependent pilot the help they need. Without the intervention of loving, caring people, the future of the alcoholic or addict is very dim. The progression of this disease will often lead to incarceration, illness, or death. Over the past 40 years the HIMS program has played a critical role in preventing these negative outcomes for thousands of professional pilots, and enabled them to safely continue the career they love.

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Web Links

National Council on Alcoholism and Drug Dependence

www.ncadd.org

National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov

Organizations Dedicated to Fighting Abuse
www.datehookup.com/content-organizations-dedicated-to-fighting-abuse.htm

Intervention Center
www.intervention.com

Reference

Johnson, Vernon E. “I’ll Quit Tomorrow: A Practical Guide to Alcoholism Treatment” – Revised edition (September 1990)