Evidence for Brief Interventions in Addiction Support

A challenge often faced by healthcare professionals when they identify a person with problematic substance use is how do they help that person to recognise and change their current behaviour. This can be achieved through a brief intervention (BI). A BI can be described as any form of activity involving a minimum of time in an attempt to change a person’s alcohol or drug use.

A brief intervention (BI) is a short, evidence-based, structured conversation usually delivered by a trained professional in an optimistic manner to support the person seeking help. It can be used to raise awareness and assess a person’s willingness to engage in a conversation about healthy lifestyle choices and/or their mental health, (13). The aim of a brief intervention (BI) is to engage the person seeking support with a view of changing some aspects of their life in order to reduce the risk of their substance use. .

The Wellness Recovery Action Plan®, is a comprehensive self-designed prevention and wellness process that anyone can use to modify their behaviour It was developed by a group of people trying to overcome their own mental health challenges and is currently used by individuals and health care systems throughout the world to address all kinds of physical, mental health and life issues (17).

Barbor and colleagues (2007) suggest a brief intervention employs a cooperative style of motivational interviewing which engages the person in a conversation to address their problematic substance consumption over a short timeframe (15). These interventions usually last between 5–30 minutes.

The intervention begins by asking the person for permission to talk about the possible drug or alcohol use. This helps the client to understand their level of substance use. The person is given individualised feedback in a manner that helps them understand their substance use in relation to what’s considered normal consumption. The structure of the BI can be split into different phases:

• Ask the person to talk about their needs
• Advise and encourage the person to talk about any identified problems or health concerns they may have
• Assess the person’s needs based on the evidence they have shared
• Assist the person to understand when they need to do to change their behaviours
• Arrange for a referral to treatment or counselling if agreed with the client Each phase will explore the benefits and harms of substance use while attempting to elicit a motivational change in the person.

The World Health Organisation and multiple research studies show that brief interventions are effective, particularly in primary care in supporting people to reduce alcohol consumption. They have proven to be particularly effective among people who are drinking at harmful levels, but who are not dependent on alcohol (14). For people who are alcohol or drug dependent, a referral to specialist treatment services may be necessary.

A brief intervention is usually a follow-up from the assessment and screening stage when the healthcare professional identifies a potential risk based on the evidence provided by the client. The intervention is usually a short motivational interview conducted with the full cooperation of the client within a structured framework. A successful BI would achieve one measurable behavioural change that enables the client to experience a small, incremental step towards recovery.

References

<sup>13. O’Shea J, Goff P, Armstrong R. SAOR Screening and Brief Intervention for Problem Alcohol and Substance Use. In: Executive HS, editor. 2 ed. Dublin: Health Service Executive; 2017.
14. Organization WH. Motivational Interviewing for Substance Use: A Manual for Use in Primary Care. Geneva: WHO; 2003.
15. Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahmed K, Bray J. Screening, Brief Intervention, and Referral to Treatment (SBIRT) toward a public health approach to the management of substance abuse. Substance abuse. 2007;28(3):7-30.
17. Cook JA, Copeland ME, Hamilton MM, Jonikas JA, Razzano LA, Floyd CB, et al. Initial Outcomes of a Mental Illness Self-Management Program Based on Wellness Recovery Action Planning. Psychiatric Services. 2009;60(2):246-9.</sup>