Case History 2
(Identifying information has been changed in order to maintain confidentiality.)
Identified Client: Michael is a 27 year old male who is the younger of two children. He is a brother, son, co-worker, and in a relationship with his girlfriend of 7 months who is also using drugs.
Drug of Choice: Methamphetamine (uses Meth by smoking it) Pot and Alcohol.
Living situation: Lives in apartment with a male room-mate who is also a co-worker and a regular smoker of pot. Girlfriend lives in apartment complex a short walk from clients apartment. Girlfriend has a 4 year old son.
Initial Contact: The parents (Conrad and Patricia) of this 27 year old male (Michael) contacted me via phone to talk about the options of doing an Intervention with their son Michael. They were concerned he may be using drugs and was "going off the deep end". We scheduled an appointment for the next day.
The initial meeting was attended by parents, Conrad and Patricia, older brother, William (35) and his wife, Nancy.
The concern: Family members were informed by the room-mate that Michael could not make his end of the rent and room-mate believed this was a result of Michael's methamphetamine use. They family had their own information of Michaels drug use because of his work attendance and performance.
Michael worked in a family owned and operated construction business. It had been some time since Michael had done any real responsible work at the company, actually he was more often late or missed work altogether and the situation was getting worse. When Michael did show up he resented the fact that he had to do regular construction work and not be the boss. Although Michael had many opportunities to �take the ball and run� at work he continually failed to prove himself.
The brother, William was enraged by Michael's behavior. William was a hard worker and very focused on becoming the operating partner of the business when dad, Conrad retired. William had low tolerance for Michael's attitude and behavior regarding work. They had a falling out a year or two earlier related to a work performance issue and William had little use for his brother's behavior at work and preferred him to not be involved in the business. Conrad (dad) continued to pay Michael a full paycheck whether or not Michael was at work. Conrad feared that his son just wasn't going to make it but couldn't fathom him being destitute. Most of the time Michael used his paycheck to pay his girlfriends bills and rent and not pay his own. Then Dad and Mom would step in a pay Michael's bills. (The dysfunctional, enabling family system). William was so angry about parent's contuing to bail Michael out of his situation that he would yell at parents and tells them how unfair it was and that he wanted nothing to do with him.
By the end of this initial meeting a plan was developed to go forward with a Family Intervention. Homework assignments were given, a list of logistical concerns was created, we talked about the kind of treatment program that might be the best kind of help that we could offer Michael if he was willing to get help. An appointment was made for the role-play and Intervention.
Some of the logistical items that needed attention were to contact treatment programs and find out cost and availability of admission. Family members were asked to write letters to include their concerns, their feeling about their concerns, and what they wanted or hoped would happen as a result of the Intervention.
The Role-Play: We met in the role-play session. Parents, brother and sister-in-law, and room-mate. Everyone brought their rough-draft letters and we were ready to begin, almost. First came the anxious questions they had been thinking of since deciding we would do the Intervention. Mostly from Dad. �What if we're wrong and really don't really have a problem? What if he's just caught up with this girl and how's just not making good decisions?� �Come on Dad, we know he's using, I sent him home from work so many times because he's been up the entire night before and not slept, he's looked like crap, come on you know he's using too. Besides I'm tired of you trying to cover for him all the time, it's about time that Michael take responsibility for him�. Sister-in-law, Nancy had a perspective of the family dynamic that both was insightful and stirred up feelings and emotions from Mother, Patricia. Nancy said she felt it wasn't OK to have anything negative or event express a concern about Michael in front of the parents because mom had a way of raising her eyebrow and slightly rolling her eyes when Nancy spoke about Michael and work. I saw his actually happen during the role-play but we weren't there to do family therapy, we were there to focus on getting Michael the help he needed and that was or goal and our mission. And this behavior form mom toward Nancy became a focus of later work between the women and a part of their change and healing. As it turned out Mother had strong feeling of resentment and anger towards William for not enabling his brother Michael and just help him through this difficult time in his life and Mom believed that if everyone would just love Michael enough that eventually he would get turned around and straightened out and everything would be OK. (Did I mention that through the course of working together, it was disclosed that dad, Conrad had his own drinking problem?) Dad did finally disclose that he probably did drink a little too much, but then he'd always had a few beers or drinks at the end of the day to unwind and relax. Patricia had lived with this their entire marriage and as it turns out she had grown up in a family with a father that was probably and alcoholic as she later reported. When it came time for mom to read her letter, she began to cry. She started off slowly and softly and progressively got more and more focused. She had written several pages of what her concerns were. Many of which had to do with Michael's relationship with his girlfriend and his apparent need to take care of her when he couldn't take care of himself. She agonized over the possibility that Michael was lost to himself and so taken with his girlfriends struggle of being a single parent and the difficulties she was dealing with that he couldn't see what was going on in his own life. What if something happened to the parents? Would Michael be able to take care of himself? He hadn't been able to meet his simple needs of paying his bills and making it to work. AS far as the drugs were concerned (which again was hard for both parents to actually acknowledge the signs and symptoms of in their son) Mom did agree that Michael had lost a considerable amount of weight and did in fact have a terrible record at work. Mom agreed that Michael's face and skin seemed to be broken out much of the time and rarely would he return phone calls when before he always called her right back if she had a call into him. And, yes, they had been paying his bills for some time. Patricia was able to acknowledge that she did in fact believe her son Michael had a significant drug problem. She also stated that she felt the family, all of them had been enabling Michael and she wasn't willing to continue helping him live life that way. She wanted him to go to treatment and get the help he needed.
Conrad was concerned about his son, both of them. He wanted them to get along. He had worked his whole life to make their life better. When he read his letter in the role-play he cried for several minutes, several times. He felt that he had let his son down. He was angry with his son and afraid that if he confronted him that Michael wouldn't talk with him again (which by the way happened in his own life between Conrad and his father over a disagreement they once had). He was terribly conflicted with wanting to confront Michael and scared that it wouldn't go well.
We spend the better part of several hours rehearsing and role-play the upcoming Intervention. As much as possible, anxieties were soothed, emotions tended too, and feelings shared. By the end of the role-play we were ready to meet with Michael the next day to do the actual Intervention. Confirmed the time. We would meet and gather at the parent's house the next morning. Dad was going over to pick up Michael in the morning and tell him he needed his help with something (which was absolutely the truth, the something he needed help with was getting his son help). The treatment program was on board and ready to admit Michael to their residential program.
The Intervention: The family and I were already at the parents home when Michael and Conrad arrived. They walked in through the garage door entry and into the kitchen/dining room. Michael said "Well what's going on here" I introduced myself to Michael, "Hello Michael, my name is Jerry Wittman and I'm a counselor. I've been consulted by your family to help facilitate a family meeting. Please come in and join us, everyone has some things to talk with you about, just here them out before you respond thanks". We're going to begin with your mother. Everyone in turn as we decided in the role-play read their letters to Michael. All shared their their concerns, their feelings, and what they hoped would happen from this meeting. Peopled cried.
At first Michael couldn't accept the help being offered. He said we didn't understand. He had a lot of things going on and he needed to be here, in town so that he could help his girlfriend and her son. Michael again was putting others before himself. Parents explained how if he didn't take care of himself he wasn't going to be able to care for anyone. They were in fact not goi9ng to continue to enable him by paying his bills. The brother added that the family had agreed there would be no more paychecks extended for work not done and in fact he was not going to even have his job if he wasn't' willing to go to treatment. After all they had drug-free policies at work after all they had drug-free workplace policies that had to follow at work. "Michael you must get treatment and you must go today" said mom. "Son, this is the plan and I want you to agree to this and get help" said Dad.
"What about my girlfriend?" Continued Michael.
It became known that the girlfriend too had been using. Michael was scared that if he went off to treatment the girlfriend would not be able to make it financially or logistically. The family made it clear that if Michael did not get treatment they were pulling all enabling help from him. That meant he would loose his truck (company truck) there would be no money, he would not be able to care for her or him. After some time Michael agreed to go to treatment and wanted parents agree that they would help the girlfriend. Parents said the kind of help they would offer her would be in the form of counseling. The parents wanted girlfriend to get help also because they knew that if girlfriend didn't get help and Michael returned from treatment program and continued the relationship with her and she was using it would only be downfall for Michael.
Michael said he needed to spend some time with girlfriend before he was willing to leave. A plan was developed. Within two hours Michael was in the car with his parents on his way to treatment.
Summary/Conclusion: Michael went to treatment and completed the 30 day program. His parents attended family program and counseling. Girlfriend became close to Mom during Michael's absence and began attending AA/NA meetings, she also attended family program at the treatment program. She was scheduled to be admitted to a local IOP (Intensive Outpatient Program) but continued to make excuses why she couldn't attend the scheduled sessions. Brother and sister-in-law also attended the family program.
It has been about three months since Michael returned from treatment. He says he has remained sober and clean. Family says he sees less and less of girlfriend these days. He is attending self-help meetings several times each week and has returned to work in the family business. Brother reports that Michael is much better about work, both attitude and attendance but is not perfectly compliant.