CHAMPAIGN, Ill. – Reality television series such as “Intervention” that claim to provide unflinching portraits of addiction and treatment don’t accurately depict either one, and, at worst, the shows’ focus on the most extreme cases may deter some viewers from seeking help, according to a new study by researchers at the University of Illinois.
The study, which appeared recently in the journal Substance Use and Misuse, examined the narrative structure of the first six seasons of the A&E network series. As each episode unfolds, addicts and their family members reminisce about the addict’s childhood and a once-promising future derailed by troubled relationships, traumatic events and substance abuse or, less frequently, behavioral disorders such as compulsive shopping or overeating. With the help of a treatment professional, the desperate family stages an intervention, where they confront the addict about their harmful behavior and pressure the person to enter a 90-day residential treatment program.
“Part of the appeal of reality shows is they offer a kind of familiarity – the people look and sound like people we know,” said Jason R. Kosovski, a scholar at the U. of I. who researches cultural issues in media. “We feel some kind of connection – but the people are also sufficiently different that we can say: ‘I can relate to them, but I’m not that person. I don’t drink that much or do those things.’ “
“Clearly, the people on the show have the most extreme problems, and that’s by design”- to maximize entertainment value, said Douglas C. Smith, Kosovski’s co-author and a faculty member in the School of Social Work who researches addiction and treatment. “They select the most sensational cases.”
While the addiction genre – which includes TV series such as “Hoarders,” “Celebrity Rehab,” “Relapse” and “Obsessed” – strives to humanize psychological problems, it also reinforces the misconception that addiction and other disorders are the inevitable result of parental divorce or of experiencing trauma such as sexual abuse during childhood.
“There’s always a causality, and the causality is never genetic – it’s always environmental,” Kosovski said. “There’s this rather overt, unenhanced message that people from broken homes become addicts. Even though the relationship between trauma and addiction is rather high, it’s not nearly 100 percent as the show seems to indicate.”
On a recent reunion show, “Intervention” claimed that all of the 98 families approached to do an intervention completed one, and 98 percent of the addicts who received interventions entered treatment, statistics that Kosovski and Smith find questionable.
“Most families that are asked to do an intervention never follow through with it,” because members are uncomfortable with delivering ultimatums to the addicted person, Smith said. “Interventions can work, but just for that small percentage of families that actually do them and then when the outcome is getting the person into treatment. As a researcher who studies addictions and treatment outcomes, the most troubling thing about the show is these flagrant statements about how successful it is.”
For the addicts on “Intervention,” treatment is always a 90-day stay at a private, for-profit facility, an option beyond the financial means of most families. The show’s emphasis on inpatient treatment lends the misimpression that it has a higher success rate, although recent studies by Smith and other researchers indicate that community-based, outpatient treatment programs usually are as effective as inpatient programs at helping addicts achieve sobriety.
“A lot of times we have people that come into our clinics and think they’re going to get one thing, and they’re very surprised if we use a different approach that doesn’t involve a 12-step program such as Alcoholics Anonymous or a 90-day residential treatment program, which are getting increasingly more scarce,” Smith said. “About 80 percent of people that go to substance abuse treatment are treated in outpatient settings, and those who do go to residential settings – the settings look nothing like these posh, tropical treatment centers that they have on the show. It’s really an inaccurate picture of what the treatment system looks like.”
And, surprisingly perhaps, many people recover from substance abuse problems on their own, without any outside help whatsoever, Smith said.
“These are people that by all objective data have really serious addictions or drug problems, and it’s like a switch goes off and they just stop – without any family confrontation, police intervention, a residential facility or attending AA meetings for life,” Smith said. “It’s known as natural recovery and actually more common than you would think.”
The production methods of reality shows, where camera crews are silent bystanders as addicts flirt with danger – scoring drugs in crime-ridden neighborhoods, driving while drunk, and drinking or using drugs to the point of unconsciousness – raise numerous ethical concerns, as does the deceptive central premise of “Intervention,” the researchers said.
“In every show, there’s this screen shot saying that these people agreed to be in a documentary about addiction, but they don’t know they’re going to go through an intervention,” said Kosovski, who worked during college as a production assistant for a national TV talk show, for which he recruited guests and shepherded them through signing consent forms prior to taping.
“Presumably, they’ve been lied to persistently – by the producers, family members, their friends – about what’s been going on. And presumably, they signed consent forms. They may or may not have known what they were signing.”
Another concern for the researchers is whether the hard-core addicts and alcoholics featured have the capacity to comprehend the potential ramifications of having their drinking, drug use and related activities made public.
“We don’t really know what’s happened to these people afterward but we could imagine there may be some harm from being on the show,” Smith said. “Is this person truly able to provide an informed consent or not, if they were chemically altered? It’s something I have to deal with in my research studies on drug addiction.”
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