Font Size: | Print

Brief Interventions

Unlike traditional alcoholism treatment, which focuses on helping people who are dependent on alcohol, brief interventions–or short, one-on-one counseling sessions–are ideally suited for people who drink in ways that are harmful or abusive. Unlike traditional alcoholism treatment, which lasts many weeks or months, brief interventions can be given in a matter of minutes, and they require minimal follow-up.

The goals of brief interventions differ from formal alcoholism treatment. Brief interventions generally aim to moderate a person's alcohol consumption to healthy levels and to eliminate harmful drinking practices (such as binge drinking¹), rather than to insist on complete abstinence from drinking–although abstinence may be encouraged, if appropriate.¹ Reducing levels of drinking or changing patterns of harmful alcohol use helps to reduce the negative outcomes of drinking, such as alcohol-related medical problems, injuries, domestic violence, motor vehicle crashes, arrests, or damage to a developing fetus.

Exactly what constitutes a "brief intervention" remains a source of debate.² Brief interventions typically consist of one to four short counseling sessions with a trained interventionist (e.g., physician, psychologist, social worker). Moyer and colleagues² looked at 34 different studies and found that people who received brief interventions when they were being treated for other conditions consistently showed greater reductions in alcohol use than comparable groups who did not receive an intervention. People seeking treatment specifically for alcohol abuse appeared to reduce their alcohol use about the same amount, whether they received brief interventions or extended treatments (five or more sessions). These findings show that brief interventions can be an effective way to reduce drinking, especially among people who do not have severe drinking problems requiring more intensive treatment.

The appropriate intervention depends on the patient–that is, on the severity of his or her problems with alcohol and whether he or she uses tobacco or other drugs, or has a co-occurring medical or psychiatric problem. The choice of intervention also is based on the clinical setting, the clinician's skills and interest, and time constraints. A brief intervention usually includes personalized feedback and counseling based on the patient's risk for harmful drinking. Often, simply providing this feedback is enough to encourage those at risk to reduce their alcohol intake.¹

Brief interventions may include approaches–such as motivational interviewing–that are designed to persuade people who are resistant to moderating their alcohol intake or who do not believe they are drinking in a harmful or hazardous way. Motivational interviewing³ encourages patients to decide to change for themselves by using empathy and warmth rather than confrontation. Clinicians also can assist patients by helping them establish specific goals and build skills for modifying their drinking behavior.

Brief interventions can be useful in a variety of settings and are potentially cost-effective in reducing hazardous or harmful alcohol consumption. Medical settings such as emergency departments or trauma centers also may provide opportunities, or "teachable moments," when people may be open to making changes in their alcohol consumption. New technology, such as computerized interventions, may offer an effective means for implementing brief interventions, especially in settings in which time constraints or lack of resources or training in intervention techniques are issues.

Research is yielding new information on the efficacy of various brief interventions at a rapid pace; practitioners, clinicians, college administrators, and others responsible for initiating screening and brief interventions should consider this new scientific evidence when deciding which strategies best fit their situations.