Brief interventions

What is a brief intervention?

A brief intervention is a short — generally no more than 10 minutes — counseling session that offers brief feedback and advice using motivational interviewing techniques. The goal is to assist the patient or client in modifying their substance use patterns in ways that are less risky. The plan that is developed during the brief intervention should be patient-centered and based on the level of commitment that the patient is willing and comfortable to make.

By the time the patient leaves the session an agreement to reduce use or the risks associated with use should be in place. The clinician and patient will come to this agreement by using the negotiating processes of the brief intervention.

How does it work?

The following are the four main steps of a brief negotiated intervention:

Step one: raise the subject

Establish rapport:

• Ask permission to discuss patient's alcohol/drug use.
• Explain your role and set the agenda.

Step two: provide feedback

Review patient's alcohol/drug use patterns:

• Share patient's AUDIT/DAST score and review NIAAA low risk guidelines.
• Explore possible connections between health problems and alcohol/drug use.

Step three: enhance motivation

Assess readiness to change (use readiness ruler):

• Explore patient's reasons for change and ability to change.

Step four: negotiate plan

• Provide a summary/ask key question, "What do you think you will do?"
• Offer a menu of choices for change, provide recommendation, secure agreement.

Who should get a brief intervention?

A positive full screen on the AUDIT and/or DAST should be followed by a brief intervention.

Positive scores on the AUDIT differ based on gender and age. A positive full screen score on the AUDIT and DAST are as follows:

• AUDIT: For females (18-65) and all persons 66 and older-greater than or equal to 7.
• AUDIT: For males (18-65)-greater than or equal to 8.
• DAST: For all patients-greater than or equal to 1.

When brief interventions are done effectively, and with fidelity, they can reduce alcohol consumption and related consequences.

How else can they be used?

Brief interventions can also be used in a variety of ways and in a variety of settings, including:

• General populations
• Primary care
• Emergency departments
• Inpatient trauma centers

They could also be used to talk with patients about medication adherence, diabetes prevention planning, weight loss or exercise plans, and more.