Suggesting Treatment to a Loved One

You may have heard that your child “has to want help” in order to get better. Chances are they do want help getting better, but we may not be hearing them because we don’t know what to listen for.

If your loved one expresses even a little willingness to start getting help — whether it’s attending an AA or NA meeting, or getting a treatment consultation — it can be all the invitation you need to begin the conversation.

While the hope is that your child will readily and quickly agree to treatment, don’t despair if they first say no or need more time to think about it. There will be opportunities to raise the subject again. Managing your expectations around them engaging with, and staying in, treatment are a part of good self-care.

So, how does a willingness to get help sound? It usually comes in the form of “change talk.” Change talk is any time your child voices a concern over the way things are, or expresses a desire to improve their life in some way. Do any of these sound familiar?

• “I’m really feeling depressed that I don’t have a decent job.”
• “I think I really upset [a friend] last night when he thought I had one too many.”
• “I wonder if I should go back to school.”
• “I want to move out and have my own place.”

When a loved one expresses change talk, help them connect the dots. Gently explain how their substance use is related to their current worries and their hopes for a better future.

The following sample dialogue demonstrates what this might sound like.

Note how the parent or caregiver is working really hard to remain open-minded and invite dialogue rather than dismissing or criticizing. Some techniques to help you have similar success include:

• Use open-ended questions. The parent in this example likely knows that substance use is at the root of their child’s unemployment, but draws it out without judging them.
• Wait for the right time. Change talk can open the door to this type of conversation, but it won’t work if they’re under the influence, racing out the door, overly tired or might otherwise feel interrupted.
• Give them options. Note that the parent in this example didn’t say “You have to stop.” They provided some options. It’s helpful for your loved one to have input and a choice.

Some parents choose to use incentives or leverage to get their teen or young adult into treatment. An incentive ties treatment to something their child wants. For example, “If you complete treatment and remain sober, we’ll help you with a deposit for a space of your own.”

Leverage usually involves taking something of value away. For example, “If you don’t get help, we won’t cover any more of your expenses like tuition or rent.” Choose how to use leverage carefully. Depending on what is at stake, it could cause them to react defiantly, making the situation worse.

It helps to present any leverage in a loving way. Give your child a week or two to think about it before going through with whatever you’ve decided. For example:

Intervening — that is, stepping in and speaking up — is a vital first step in taking action to address your child’s substance use. But pop culture has popularized the notion of “an intervention.” This is a scenario in which family and friends confront a loved one with the impact of their substance use, usually followed by an ultimatum: go to treatment or else.

The success rate of this style of intervening is lower than using other evidence-based approaches like Community Reinforcement and Family Training (CRAFT). Claims to the contrary are generally limited to getting someone into treatment, with no measures related to the successful completion of treatment.

If there is a danger to self or others as defined by the courts, civil commitment laws can be invoked to mandate treatment. In the U.S., 38 states have laws that permit civil commitment to inpatient or outpatient substance-abuse treatment programs. An additional eight states have a form of involuntary treatment, such as emergency hospitalization due to substance-related concerns. The commitment process varies from state to state, so it’s important to look into what specifically is required for mandated treatment.