Motivational Enhancement Team

BRIEF INTERVENTION

This is an innovative service which is offered in general hospitals and general practitioner surgeries. It targets those who have drink related medical problems.

Just twenty minutes with a trained motivational worker can have a significant impact on people's drinking behaviour according to results published by CAIS following the successful introduction of a Brief Intervention scheme at Glan Clwyd Hospital in North Wales

Patients are referred from the short stay ward, medical and orthapaedic wards and the accident and emergency department.

They are at first assessed by medical or nursing staff to determin their suitability using a brief screening questionnaire "FAST". They are then referred to the motivational worker who sees the patient in a quiet private room.

The patient and the worker work through a visual motivational intervention and then engage in a motivational interview using a laptop computer programme and the patient is given an immediate feedback from summarising their goals for change.

After giving consent, the patient is contacted within three months from the interview. The impact of the intervention is evaluated. The patient is also contacted a year after the intervention, and this is also evaluated.

Patients are also asked if they have returned to hospital and whether the intervention has had any impact on their drinking levels.

They are also given information about local services on the reverse of their feedback form and a self-help manual to help reduce their drinking.

The results show that there was a significant reduction in drinking levels, that the service has helped to motivate patients to change their drinking behaviour and that the services had been helpful and that the service has helped prevent some patients from being re-admitted to hospital for drink-related causes.

Dr David Cartlidge, Consultant and Clinical Director in Accident and Emergency Medicine of Glan Clwyd Hospital states: "It is my view and that of the senior nurses in the hospital, that the presence of this service has allowed a more organised input, with more clear directed referral of this group of clients.

It is also my belief that the service should be allowed to continue to grow and we should now use some sort of screening tool for identification of high risk individuals, so we can increase the numbers who are seen by the Brief Intervention Service".

The approach of the present project has drawn upon the structure and principles of Motivational Interviewing (Miller et al., 1988) and condenses them into a highly economical brief intervention. Its purpose is to motivate drinkers for change by making the adverse consequences of excessive drinking more prominent than the positive consequences. The brief intervention is delivered in one session, and like Motivational Interviewing (Miller et al., 1988) includes a comprehensive assessment of the drinkers pattern of drinking, and the current and future negative consequences. The results of the assessment are presented to the problem drinker in a non-confrontational manner, which provides the right environment for the client to make the final decision about change (Miller & Rollnick, 1991; Miller et al., 1992).

Brief alcohol interventions as short as five minutes have been shown to be effective in reducing alcohol consumption within primary care settings (Poikolainen, 1999).

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