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I. Brief Interventions
  • Brief interventions for patients with alcohol use disorder are effective in primary care.
    • The goal of brief interventions is to decrease or eliminate unhealthy alcohol use.
    • Effective brief interventions involve a combination of feedback/advice from the health provider and agreement and cooperation from the patient regarding drinking behaviors.
    • Patient resistance and ambivalence are the most common barriers to a successful brief intervention.
  • The CSAT and FRAMES approaches are two common, effective brief step-wise intervention strategies.
  • Patients begin the stages of change before they recognize that they have a problem and reach the final stage when they are able to maintain the changes they wish to make.
  • View relapse as a natural part of the recovery process rather than a treatment failure.
II. Alcohol Use Problems: Motivational Interviewing
  • Motivational Interviewing is a patient-centered approach to facilitating health behavior change that is effective in alcohol interventions.
  • Goals or procedures of Motivational Interviewing include drawing attention to discrepancies in what the patient says, showing empathy, finding something to agree with if they are resistant, and supporting self-efficacy.
  • The steps of Motivational Interviewing, which can be use as alcohol interventions, are engage the patient, focus the interview on a topic related to alcohol use, evoke feelings about the topic, and work with the patient to make a plan.
  • Other Motivational Interviewing skills to appy with patients having alcohol use problems include use of open-ended questions, facilitating talk about changing, affirming strengths of the patient, and use of reflective listening and summarizing.