CIS London

Welcome To World Drug Day
London , 2018

About Dr. Louise Stanger
• Clinician-Educator
• Interventionist
• Author-Falling Up A Memoir of
Renewal- Amazon
• The Clinicians Guide to Addiction
Interventions-In press Routhledge
• Widow, Wife, Mother, Grandmother
• Soul Cycler adventurer
• Honored Participant World Drug
Day

Collective Intervention Strategies
The Definitive Guide to Addiction Interventions: Collective Strategies
(in press Routhledge)

Objectives
• Identify, Describe and
Demonstrate CIS
• Define & Describe & Identifyh
how shame, trauma, addiction,
mental & physical health effect
families
• Demonstrate the power of
family mapping & science of
portraiture in CIS
• Share invitational vocabulary

Demonstrate CIS -Case Studies
Clinical & Reverse Interventions
Change Agreements

Create Possibility
Aspiration that a better life is possible

Substance Abuse-
Addiction
Mental Health-
Depression/Anxiety
Chronic Pain-Physical
Maladies
Relationship failures -
Legal
But-how do our clients
arrive?

ASAM March, 2011
A Primary Chronic Disease
of the brain reward,
motivation, memory and
related circusy
Dysfunction leads to
Biological, psychological,
social and spiritual
manifestations
Individual pathologically
pursing reward or relief
thru substances

Problematic
Behaviors
Substance Abuse-
Mental Health
Chronic Pain
&
Codependency
&
Process Disorders -Sex, Gambling,Work,
Debiting, Spending, Shopping ,Religiosity,
Disordered Eating, Digital etc.

Chronic Pain
133 million People Experience
Chronic Pain
1 in 5 globally (more women then
men )
65% of all people experience
chronic pain once in their life
75 % of all heroin users started with
a prescription
Annual cost of $365 billion , $154
For young people
151 people die daily (CDC)

Mental Health Issues
Anxiety
Depression
Narcissism
PTSD
Bi-Polar
Personality
Psychosis
Phobias

Shame
Shame is that intensely
painful feeling of believing
we are flawed and
therefore unworthy of love
and belonging.
I am not good enough
Brene Brown

Definitions of
TraumaOverwhelming experiencing
that cannot be integrated
and elicit animal defensive
mechanisms and
dysregulated arousal
“A stress that causes
physical or emotional harm
that you cannot remove
yourself from”
Larke Huang , Director of
Health Care Equity at
SAMSHA

Trauma is objective
What happened ( I was
date raped , humiliated
, I fell of a ladder, had
a concussion, was in a
terrible accident etc

Trauma is subjective :
How do I perceive the situation ?
Relationship to early
childhood experiences -
and Alcoholism
Adverse Childhood
Experience- 17,000
patients -Kaiser- effects
of trauma are cumulative
and one of most
destructive forms is
recurrent calling and
humiliation

What do your Clients Say about
Trauma ????
Verbal abuse
Physical abuse
Witnessing a tragedy
Not being told about
something
Accidents
Divorce
Death

Addiction -Attachment Disorder
Values are lost as we attach to substances and other unhealthy behaviors

Dr. Louise A. Stanger
“An Intervention is an invitation to
seek
and accept care “

Professional Interventionists are
Called when
Families are Fearful
,Angry &Confused
Attached to the
Problem
Cognitively and
emotionally Dis-
regulated
Attempts have failed

Collective Intervention Strategies
Louise Stanger Ed.D, LCSW, CDWF, CIP

Why CIS?
• Collective - In that to be successful there must be a team
of Families, Friend, Collegues, Associates, business
partners , managers or co-workers assembled to bring
about change
• Intervention- In that we seek to move (i.e/ motivate a
person to a place of change)
• Strategy, in that nothing is set in stone ; we may adapt
the process as needed

• Strength Based
• Solution Focused
• People are Teachable
• Change is Possible
• The Present is Important
• We can rise to our best
possible self
Philosophical Underpinnings

Theoretical
Underpinnings
Salvador Minuchin
Virginia Satir. TFT
Bowen , Family
Systems
Bowlby, Attachment
Monica McGoldrick-
Family Systems
Therapy

Theoretical Strategies
• Motivational Interviewing
• Cognitive Behavioral
• Acceptance & Commitment
• Values Clarification
• Solution Focused
• 12 Step or other Self help
• Mindfulness
• Breathing

Counseling Skills Used
• Listening- Empathy
• Genuine
• Unconditional Positive Regard
• Concreteness
• Reflecting- Echoing Key words
• Body Language
• Open Ended Questions
• Paraphrasing- Summarizing
• Counselor Self Disclosure
• To Do Not Harm

Collaborator
I am the mirror who reflects back their pain, their fears
their voices. I am the inquirer who asks difficult
questions, who searches for evidence and patterns. I am
the companion on the journey bringing my own story to
the encounter, making possible an interpretive
collaboration, I am the audience who listens , laughs ,
weeps an applauds. I am the spider women spinning
their tales.. I am the therapist who offers cathaersis
support and challenge… I am also the stage manager
coordinating the intersection of three plays-the story
teller, the narrator and the readers inviting your voice to
the drama” Sara Lawrence Lightfoot

Interventions Include a Village of
Potential Change Agents
Participants are experts
Value Driven
Solution Focused
Evidenced Based
Interventionists job is to
bring people together for
the common good and to
identify SA, MH and other
issues

Families are taught
• The nature of substance abuse
process and mental health
disorders. If appropriate about
chronic pain syndrome or other
medical legal problems
• The way an intervention is
conducted
• The active and instrumental
part they have in moving
someone to change

Clinician Interventionsist
Must Be able to :
• Develop a Team
• Do a Family Map that engages everyone
• Do a Retrospective -bio-psycho-social
• Develop case strategy
• Create Treatment Plan & Placement
• Case Management
• Follow with Aftercare
• Facilitate Family Engagement in the healing
process
• Have Concierge Capabilities
• ETHICS are Paramount

Ethics?
Beliefs an individual or
group makes about
what constitutes proper
behavior
Standard of Conduct
Make sure you know

Dr. Louise Stanger
“An Intervention requires Crucial Conversations”

Collective
Perspectives
Bringing Folks
Together
For The
Common Good

Clinical & Reverse
Interventions

Basic Anatomy
• Intervention Agreement &
Initiative
• Education, Information
Gathering & Assessment
• Implement , Review, Followup

Family Mapping
A Way into Story

Folks have unconsciously
colluded with the problem

Dr. Louise Stanger
“A Successful Intervention has the Potential To
Transform not just the Identified Client but the
Entire Family”

Families Learn
• Their History
• Their Ways of Communicating
• To take Care of Themselves
• To Discover Curiosity
• To Discover Joy
• To try Out New Ways of
Relating

Families Learn
• Chronic Pain , Addiction , Mental
Health are all Diseases
• Boundary Setting-Responding
Not Reacting
• Caretaking is not always helpful
• Chronic Pain is 80% Emotion
• Attachment Disorders
• Join in the Solution

Meet Jack and his
family
54 yo old retired executive
lives with 29 yo son
Two previous treatment
episodes
3 children 19, 22, 29
Wife in process of divorce-
Being asked to leave
treatment center as wrong
placement
Had to get him from A -B

Families Readiness to
Change
In 2 months 3 out of 5 family members were
ready to change
In 7 months 4 out of 5 family members had
engaged in treatment which lasted more then 60
days. 1 family member went for a 2 week
intensive,
2 Private therapists
1 family member refused treatment

Meet Sam
Family hx of SA
SA- MH -Body Dysmorphia
In and Out of Programs
Since 7 th grade
Failed to Launch
Attachment to women

Meet Christine
32 yo music executive
Opioids and disorder
eating
Depression, Anxiety
Mother and Father
Brother Cooper

Meet Josh- Age 52
Money Manager
• A=Age 14 Played Pocker-
family trips to Vegas
• B Divorce pending 2 14 year
old boys
• C-Highstrugh -anxiety-poss-
Mania - Cocaine- Alcohol-Pills
• Dx-Hx of religiosity, Trauma
workaholism, MH , holocaust
survivors 3 generations

Meet Sylvia-62
Hoarder- Depression- Substance Misuse
• A-Valium from Mom
• B= Suicide adopted son, two
daughters, Husband had
affairs
• Stole money from dying
mother, collects, collects,
collects little trinkets
• C-Cognition Problems,
MH/SA/RO Early Dementia

Meet Ed
Two Families
Celebrity
Personal
Cervical Pain
Opioids
Alcohol
Marijuana

Celebrity Management
Business, Personal, PR, Hairdresser, Stylist, Lawyer, Entourage, Security Etc Etc

Meet Jake
• International Soccer Player
• Back and knee
• Family- Mother- Father,
brother, subsequent child of
infant death
• Family Hx of Depression,
Trauma, Codepedency
• Religious orientations different
• Secrets

Meet Rock
Refered by Producer
37 foster homes
legal problems
sexually assaulted
Gang leader
Chronic Relapser
Multiple marriages and children
Poet

Sometimes the First Story is
SFD
Great Treatment
center
CorrectFamily Map
Wrong Placement
How did I react ?

Rock is one of the Most
Courageous Gentleman
Walked Into His Story
Got Curious
Felt Safe to End the SFD -
Confabulations
And asked for Help
And After I got Over being
Uncomfortable, I was of
service

100 Million- One in Ten
Americans - 1.5 Billion
Globally

Concussions
Facial pain
Neck Pain
Accidents -Driving, Texting
Exercising, Weekend
Warrior Tasks
Hips, Knees , Shoulders

Low back pain
Osteoarthritis
Rheumatoid Arthritis
Migraines
Fibromyalgia
Pelvic Pain
Carpel Tunnel Syndrome

Common Types of Chronic
Pain
• 28% Low Back Pain
• 15% Migrane or Headache
• 15 % Neck Pain
• 4 % Facial Pain
• #1 Cause of long term
disability

Impact of Chronic Pain on
Families
• Person with Pain
• - Pain that does not show
• -Fluctuating Activity Levels
• -Isolation in home and income
• -Unpredictable Mood Swing
• Doubt about reality of Pain
• Loss of friends, job, productivity
• Loss of plans , hope for the future
• Family Members
• -Inability to see or feel pain
• Increased responsibility for
maintaining home and income
• Loss of personal support
system
• Emotional Outbursts of person
with pain’Added Daily stress
• Loss of plans and hope for the
future

Meet Maddi
10 operations - 6 treatment centers

First major accident age 14
Family History of SA , MH and
Molestation
Pain Body, Sexual Assault Trainer
For past 9 years has been in and out of
treatment centers
Walking on crutches or not walking at all

Maddi gains trust with primary clinician
Maddi gains trust with exercises
Maddi Starts to talk to therapist
Family is confronted with their substance
abuse and their need to detach
Maddi experiences a difference in family
Maddi experiences a Community Integration
Approach
Maddi could be your next client

Meet Helen - 62 y.o
FemaleHip replacement
Knee replacement’
Shoulder
Constant pain-anxiety
Cancer survivor
Tried to commit suicide
Angry Husband & Family
Addicted

IN THE
BEGINNING
Not able to take breaths -
use of Heart Math
Self Esteem was missing
Smile was gone
Only memories of what
once was

I Have Lost
Relationships
Money
Self Esteem
Ability to Walk
Smile

Strategies
15 day detox- Pain still 20% due to
Hyperalgesia
Education
Cognitive Behavioral Therapy
Mindfulness
Mediation
Yoga etc - Canoeing- walking
Peer Support

Who would of ever thought
Canoeing

Back Pain Severe-Not able to lift young children- possible candidate spine surgery
Mother Dying -house full of edibles and pills
Previous treatment for substance abuse
Unemployed
Stealing from wife and mother
Isolating
Lying
Family History- Alcohol and Pills
Anxiety , Depression
About Doug

Mental Health , Substance Abuse
&
Young Adults

Meet Sally
Mental Health- Sucicidality- Disordered Eating -Substance Abuse

About Sally
• Mother -Father South American, Jewish
descent
• Father Hx of Depression
• Family has 4 children- Sally is the
Subsequent child of an infant death -
Brother died of brain tumor at 9 months,
older brother age 5 dx with autism- PTS
• Bullying, Isolation , No Friends
• Trauma Riding , at School Sexual Assault
• 4 Suicide Attempts-Disorded Eating-
• Pills & Marijuana
• No Formal Inpatient Treatment

Meet Erik
20 years old
Only son of high wealth
family 92 sisters)
Legal issues
Substance Abuse
Anxiety & Depression
ADHD

Eriks Family
Sisters-Bullying and
Depression
Mom -Family History of
SA
Mom in Recovery
Dad Family History of
SA
and then Mom said I
have something to share
……

ABOUT DR. LOUISE
▸Clinician-Interventionist- Award Winner
▸Educator- Speaker- Trainer
▸Author, Falling Up!A Memoir of Renewal, Amazon Press
▸Author- The Definitive Guide to Addiction Intervention-Routledge in Press
▸Widow-Wife-Mother-Grandmother
▸SoulCycler-Adventurer
▸email -DrStanger@allaboutinterventions.com
▸www.allaboutinterventions.com-
▸619-507-1699

Resources
Stanger, L & Weber, L. 2018. The Definitive Guide to Addiction Interventions-
Collective Strategies . NY . Routhledge.
Stanger, L. 2016. Falling Up-A memoir of Renewal. Ca. WZY Press. available
on Amazon
Stanger, L 2016. Learn to Thrive : An Intervention Guidebook (available at
www.allaboutinterventions.com)
Stanger, L & Roger P. 2016-present Huffington Post, Thrive Global, The Sober
World, Renew, Recovery View, DB Resources, Counselor Magazine etc.
Stanger, L .& Flowers, J. 2016-present. Huffington Post, Thrive Global,The
Sober World.
Stanger, L & Holsomback, J. 2016-present. Huffington Post, Thrive Global, The
Sober World.
Stanger, L. WWW.AllaboutInterventions.com

Resources
Brown, Brene- Rising Strong . Speiegel & Grau International
2015 NYC NY
Brown, Brene, DaringGreatly. Gothom Books 2012
Lawrence Lightfoot,Sarah & Hoffman Jessica .The Art and
Science of Portraiture. Joey Bass. 1997
LawrenceLightfoot, S. Respect , 1998. Press Books, Mass.
Lawrence, Lightfoot,S. I’ve Known Rivers , Penguin Publishing.
Ny 1995
Lawrence, Lightfoot, S Growing Each Other Up, University of
Chicago Press. 2016

Resources
Kopp, Sheldon- If You Meet The Buddah on the Road , Kill
Him, 1982. Penguin House Random House, NY, NY
Stanger, Louise. Falling Up- A Memoir of Renewal 2015,
WZY Press
Stanger,http://www.huffingtonpost.com/entry/tricksters-
addiction-you_us_592f0f7ee4b0d80e3a8a329e
Stanger http://www.huffingtonpost.com/entry/what-are-the-
differences-between-trauma-
addiction_us_58f4e7aee4b048372700da27
www.allaboutinterventions.com

Resources
Stanger articles https://www.allaboutinterventions.com/pain-
management-and-opioid-
addiction/http://www.huffingtonpost.com/entry/
Stanger, Porter, Flowers Huffington Post-Trauma and
Addiction http://www.huffingtonpost.com/entry/trauma-
addiction-whats-the-
difference_us_58d14912e4b0e0d348b347f3
Flowers Articles,https://www.thriveglobal.com/authors/3611-
james-s-flowers-phd-lpc-s-and-angela-harris-msw-candidate
Stanger,https://www.allaboutinterventions.com/current-
news/

Resources
Stanger www.allaboutinterventions.com
Systemic Model www.systemicintervention.com
Arise www.linkingsystems.com
Jays www.lovefirst.net
Lamm www.bradlamm.com
Seeley www.intervention911.com

Resources
storti-www.stortimodel.com
Mintz www.reallifeis
Tap 35
www.motivational interviewing.org

Resources- Chronic Pain
R, L. Nahim, Estimates of pain prevalence and severity in adults,
2012, “j Pain, vol.16, no 8 pp789-80
A. May, “Structural Brain Imaging. A Window into Chronic Pain", The
Neuroscientist,vol17,No 2,pp.2019-220, 2011
Napadow& R.E. Harris ,”what has functional connectivity and
chemical neuroimaging in fibromyalgia taught us about the
mechanisms and management of centralized pain ? Arthritis Research
and Therapy .vol 16
Ingemanson, Morgan PHD , “Chronic Pain Lives in the Brin, April 17,
2017 Vox Brain Map http://evoxbrainmap.com/chronic-pain-lives-
brain/

Resources-Chronic Pain
Nahin, R. ,Boineau, R, Partap. S. K.,
Stussman, Weber, N.D. Evidence -Based
Evaluation of Complementary Health
Approaches for Pain Management in the
Inited States , Sept. 2016
Why Goldilocks is my Rehab Heroine
https://meduim.com/cheryllee-98816/why-
goldilocks-is-my-rehab-heroine

Resources-Chronic Pain
Driftwood Recovery https://www.driftwoodrecovery.com
http://www.nbcnews.com/nightly-news/video/louisville-kentucky-
sees-spike-in-heroin-overdoses-876423747884
Achenbach, Joel.The Washington Post, Dec.23, 2016. An opioid
epidemic is what happens when only treated with pills.
Gebelhoff, R. The opioid epidemic can turn into a pandemic if we
are not careful. The Washington Post .Feb. 9, 2017
https://www.washingtonpost.com/news/in-
theory/wp/2017/02/09/the-opioid-epidemic-could-turn-into-a-
pandemic-if-were-not-careful/?utm_term=.d7f5c8218e3c

ResourcesTrauma-
Addiction-Chronic PainStanger articles https://www.allaboutinterventions.com/pain-
management-and-opioid-
addiction/http://www.huffingtonpost.com/entry/
Stanger, Porter, Flowers Huffington Post-Trauma and
Addiction http://www.huffingtonpost.com/entry/trauma-
addiction-whats-the-
difference_us_58d14912e4b0e0d348b347f3
Flowers Articles,https://www.thriveglobal.com/authors/3611-
james-s-flowers-phd-lpc-s-and-angela-harris-msw-candidate
Stanger,https://www.allaboutinterventions.com/current-
news/

Brief History Lesson
• Surprise
• Invitational
• Action
Intervention “Models”

Traditional Surprise
Vern Johnson-I’ll Quit
Tomorrow
Frank Pickard- Family
Intervention
Ken Seeley-Face It Fix
It John Southworth-
Intervention Show

Traditional Made
Modern
The Storti Model Est.
1973
Heart to Heart: The
Honorable Approach to
Motivational
Intervention, 1995

Jeff and Debra Jay
Love First , A Families
Guide to Intervention
2000
Aging & Addiction ,
Colleran and Jay 2010
It Takes A Family,
2014

Action Intervention Model
Jean Campell LCSW,
Dr. Jim Tracey and Bill
Maher
Psychodrama ,
sociometry and other
action oriented
strategies for families

Thought Leaders in Invitational
Models
Spaere & Raitner -
Systemic
Arise -Garret and
Landau
Breakfree- Lamm

Interventions are
an Invitational
Process
An 11 step process for a 12 step
solution
Stanger
2016
on line
www.allaboutinterventions.com

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