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Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized trial
Maureen A. Walton, Stephen T. Chermack, Jean T. Shope, Raymond Bingham, Marc A. Zimmerman, Frederic C. Blow, Rebecca M. Cunningham
JAMA 2010, Volume 304, pages 527–535
A leading cause of mortality and morbidity in adolescents is violence, and adolescents seeking care in the emergency department are an important population for injury prevention based on increased risk for problems related to alcohol and violence. The objective of this US study was to assess the efficacy of single-session brief interventions addressing violence and alcohol among adolescents with self-reported alcohol use and aggression who sought acute general emergency department care. Data were collected for interventions delivered by a therapist or by stand-alone interactive animated program delivered by a computer. The authors found that brief interventions delivered by a therapist in this setting were associated with a clinically meaningful reduction in the occurrence of violence. To prevent severe peer aggression in 1 adolescent, only 8 at-risk adolescents (with past year alcohol use and aggression) would need to receive the brief intervention delivered by a therapist. At 6 months, participants in the therapist and computer conditions were less likely to report alcohol-related consequences than controls. Especially if designed to be easily incorporated into emergency department practice, these approaches can result in substantial public health benefits.
Patient-provider concordance with behavioral change goals drives measures of motivational interviewing consistency07/22/2015 - 09:23
Laws MB et al. Patient Educ Couns 2015
There is an extensive evidence base for the effectiveness of motivational interviewing (MI) in behavioral counseling by trained practitioners. However, evaluation of MI techniques in regular medical practice has been more limited. The authors present data addressing the relationship between patient concordance with provider behavioral change goals and measured MI consistency from two studies of primary care, study participants were people with HIV. Studies of behavioral change counseling by trained MI practitioners have supported the effect of clinician talk in evoking client change talk. However, this may not be as feasible in the context of medical encounters with lightly trained providers. The study findings suggest that medical providers should be mindful that it is more difficult to maintain MI consistency with resistant patients, while this is precisely the situation in which MI technique is posited to be most useful. Training in MI for medical providers should emphasize this point. However, it may be that MI as such is not really applicable to very brief conversations with resistant patients, and that medical encounters require a modified approach.
- 07/22/2015 - 09:22
Tanner-Smith EE et al.
J Subst Abuse Treat 2015
The authors performed a meta-analysis synthesizing findings from 185 experimental and quasi-experimental independent study samples that examined the effects of brief alcohol interventions on alcohol-related outcomes for adolescents and young adults who were not seeking treatment. The study results indicate that participants who received brief alcohol interventions reduced their alcohol consumption between 1.0 and 1.3 drinking days per month, relative to control participants, who reported an average of 6.2 drinking days per month at baseline. The effects of brief alcohol interventions persisted for up to 1 year after the end of the interventions. Although the magnitude of the effects is generally modest, the brevity and low cost of these interventions allow them to be applied on a relatively large scale where they may add incrementally to the influences that deter risky drinking among youth. Even modest reductions in alcohol consumption may have lasting benefits for youth during these critical developmental periods where progression to alcohol use disorders begins.
- 07/22/2015 - 09:22
Satre DD et al. J Subst Abuse Treat 2013
The authors examined the efficacy of a motivational interviewing (MI) intervention to reduce hazardous drinking and drug use among depression patients as an adjunct to usual care in an outpatient psychiatry clinic setting. The intervention consisted of one 45-minute in-person motivational interviewing session followed by two 15-minute telephone “booster” sessions. At three months, patients who had received MI intervention were significantly less likely than controls to report any hazardous drinking in the prior 30 days: 60.0% vs. 81.8%. No impact was found for the intervention on cannabis use or depression symptoms. The study findings have implications for the development of appropriate alcohol interventions, which are integral to the delivery of effective psychiatric services, in which patients frequently present with alcohol and drug use in addition to major depression.
Part 1 of lecture series Alcohol dependence and sleep disruption
Part 2 of lecture series Alcohol dependence and sleep disruption
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