Interventions can help people who are engaging in self-destructive behaviour mitigate or discontinue their actions. Interventions fall into three main categories: individual-, group-, and family-based interventions. The following paper will examine cases from each of the three categories to see in which situations they successfully reduce risky behaviour, and in what way.
One intervention that worked with individuals was that studied by Toseland et al. (1990) In this study, family caregivers, who undergo a lot of stress as part of their long-term commitment to their care receivers’ health and well-being, were provided interventions to help them cope (p. 209). The intervention was based on an “ecological systems framework,” which asserts that “human beings use coping skills to adapt to the stresses they face” (p. 210).
Toseland’s study (1990) was also a part of an intervention that worked with groups as well. The group variant was also based on the ecological systems framework (p. 209). The groups had 2-hour weekly sessions, over the course of eight weeks, in which they discussed— whilst maintaining a positive, encouraging atmosphere-issues the caregivers were having (p. 211).
Another individual-based intervention was part of the Booth et al.’s study (2011) of 550 opiate injection drug users (p. 338). This intervention was based on the Indigenous Leader Outreach Model, in which outreach workers who were part of the users’ community asked users where they thought they fit on the hierarchy of risky behaviours and how they thought they could alter their own behavior to achieve a lower position (p. 337). Then, over the next five months, interventions continued in which the users were reassessed on the hierarchy and asked how they could further lower their risk position (p. 337).
Wharff et al. (2012) conducted a family-based intervention for suicidal adolescents. The goal of the study was “to sufficiently stabilize patients within a single ER visit so that they can return home safely with their families” (p. 133). The model they based the study on is FBCI (Family-based Crisis Intervention) (p. 133). Social workers first spoke with families and target adolescents separately, getting each side to tell their story—the narrative approach (p. 136). The social worker then got either side to talk about what they thought it would take for the adolescent to go home safely (p. 136). The social worker then brought everyone together to try to improve familial communication and create any changes necessary for the adolescent to return home safely (p. 136).
Another case of family-based intervention was that done for Gabriel and Shelly (Waisbrod, 2012), two immigrants from North Africa, and their child Omer. Omer was having trouble at school (p. 123). He was mean to other kids and didn’t listen to his teachers, to the point that the principal often requested that he go home (p. 123). So staff of the family’s daycare and the family themselves decided to implement an at-home solution, in which a social worker tried to reorient the family’s feelings of deprivation and discrimination to a more positive light—to see themselves as survivors instead.
The individual and group approaches in Toseland et al.’s intervention (1990) were both concluded to be “helpful for caregivers” (p. 215). The individual-oriented approach was found to better combat psychological symptoms and deep personal issues (p. 215). The group approach was better for improving social support, and apprising caregivers of the resources available to them (p. 215). Despite this, the group approach, and certainly the individual one, did not improve the frequency that caregivers looked to other people in their support network for help (p. 215).
The individual approach in Booth et al.’s study (2011) of injection drug users did result in decreased injection and sexual risks (p. 341). It was better than the network approach at reducing sexual risk (p. 341). However, it was much worse than the network approach at reducing frontloading, backloading,and the needle risk composite score (p. 341).
In Wharff et al.’s study (2012) of suicidal adolescents, clients who received FBCI were less likely to be subsequently hospitalized for suicidal action than those of the control group (p. 141). FBCI does seem to sufficiently calm suicide risk so that the adolescent can have a safe follow-up at home (p. 141).
The in-home family intervention of Omer (Waisbrod, 2012) does seem to have succeeded in transforming Omer and his family’s perceptions of themselves as “deprived victims❞ to “survivors of the system” (p. 124). Also, a “marked decline” in Omer’s belligerent behaviour was observed (p.124).
Professionals tending to a case like Omar’s should have experience with second- generation families, as these families can present some typical pitfalls for the inexperienced. If social workers are seen to be intervening “from an external position,” they can be met with anger and avoidance by parents (p. 124). This anger and avoidance can then be perceived as “unappreciative and disrespectful” by the social worker, which then causes a “recursive loop” of mutual disrespect that accumulates as it goes back and forth (p. 124).
As all the cases looked at show, there is value in intervention for all individuals engaged in risky behaviours, no matter whether it’s individual-, group-, or family-based. Sometimes one method garners better results, like the individual approach did overall in Waisbrod’s comparative study (2012). But other times, the benefits are merely different, like in Toseland’s (1990).
