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- Brief interventions consist of a few minutes’ informal advice and information. The method can be used as a health promotion tool to educate heavy drinkers.
- The interventions are targeted at those who are not yet experiencing major problems. They are not designed for the treatment of alcohol-dependent drinkers.
- The aim is to persuade the client that drinking at harmful levels could damage their health and to encourage them to consider reducing their alcohol intake.
- Brief interventions involve advice on reducing consumption in a persuasive but non-judgemental and non-confrontational manner.
- The health professional’s approach should be personalised via an assessment of the client’s consumption and how this compares with recommended limits. The health risks associated with excess alcohol intake should be discussed and advice should be reinforced by the use of health promotion literature. Goals should be agreed upon for lowered consumption.
- Information regarding specialist alcohol services can also be given.
HOW DO THEY WORK?
- Brief interventions encourage and focus the client’s motivation to change. Advice on the health risks linked to excessive alcohol can help clients to recognise the risk to themselves and encourage them to realise that change is necessary.
- The client may have already contemplated that they drink too much, but they may need confirmation of this to take action.
- The brief intervention also aims to encourage the client that change is possible as well as required.
- The FRAMES model describes the basics of effective brief interventions.
F - Feedback to the client of assessment information;
R - Responsibility for change in alcohol consumption is the client’s;
A - Advice, written or verbal, should be of a clear nature;
M - Menu of change options for the client to choose from;
E - Empathy and understanding;
S - Self-sufficiency for change in drinking patterns to be encouraged.
WHEN CAN THEY BE USED?
- Brief interventions are usually opportunistic - the client is not seeking help for alcohol problems and has come into contact with health services because of other health issues. These interventions can be given effectively by non-specialists with short training.
- Primary care, general hospitals and A&E departments have all been identified as ideal settings to implement brief interventions and research has shown positive results.
- In 1992 the World Health Organization investigated brief interventions in primary care. At nine months follow-up there was found to be an average 25 per cent reduction in daily alcohol consumption.
- In 1993 Freemantle et al examined six random control trials and found a 24 per cent reduction in alcohol consumption overall as a result of brief interventions.
- Wilk et al (1997) calculated that heavy drinkers who received a brief intervention were twice as likely to moderate their consumption at six to 12 months as those who had not received one.
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