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Brief Interventions

Brief interventions are aimed at those drug-using clients with a low degree of dependence experiencing problems primarily relating to intoxication and regular use. It is a move away from a "specialist only" approach.

While this approach may also be used for non-dependent clients where child safety issues exist, other measures ensuring child safety and protection should be considered and implemented where appropriate.
Contents

Brief interventions usually involves one to five sessions which may include:

  1. Case finding and screening
  2. Assessment
  3. Personalised feedback and initial information
  4. Motivational interviewing
  5. Goal setting
  6. Relapse prevention
  7. Provide a self-help manual
  8. Harm reduction information
  9. Follow-up appointment

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bullet 1. Case finding and screening
bullet Routine questions about alcohol and other drug use consumption and problems
bullet Possibly additional use of screening instruments such as a modified Severity of Dependence Scale, AUDIT or CAGE
bullet Those who are not suitable for Brief Intervention:
bullet High degree of drug dependence
bullet Co-existing psychiatric disorder
bullet Aligned with Alcoholics Anonymous or Narcotics Anonymous
bullet Detoxification required
bullet Client choosing an alternative treatment option
bullet Those not suitable to be referred or seen on a more intensive basis

(more detail available at Referral Procedures & How to Raise the Issue)

bullet 2. Assessment
bullet A brief drug use assessment including the following:
bullet Drug use history including
bullet Present drug use
bullet Problems associated with drug use
bullet Any relationship to current issue
bullet Self-monitoring may also be used

(more detail available at Assessment Index)

bullet 3. Personalised feedback & initial information
bullet Feedback of information including the counsellor's overall assessment of specific problems and issues. Counsellor should identify those issues which the client is concerned about and those he/she is not. For example, while the client may understand about the long-term consequences, they may not be a problem for him/her.
bullet Information given on low-risk alcohol consumption levels and other relevant health-related issues as necessary such as Hepatitis C. (Note, client should first be asked if he/she already knows about this information).
bullet Provide alternative construction to 'alcoholic' or 'addict' and relate to problems of intoxication and regular use.

 

bullet 4. Motivational interviewing
bullet Weighing up of pros and cons of drug use against life goals.
bullet Primarily for those with ambivalence but can be used with anyone to help clarify benefits, problems and possible goals.

(more detail available at Motivational Interviewing)

bullet 5. Goal setting
bullet Discuss goals of cutting down, stopping or changing patterns of use (e.g. binging, needle use issues)
bullet Include goals for reducing drug-related problems and/or enhancing positive behaviours (particularly those which compete with drug use and/or drug-related problems - eg positive parenting behaviours which compete with negative parenting associated with drug use)
bullet For those wishing to change, set a SMART (Specific, Meaningful, Assessible, Realistic, Timed) goal.
bullet For those not wishing to make any changes (precontemplators) give harm reduction information and flag file for follow-up.

 

bullet 6. Relapse prevention
bullet Identify and discuss management of high risk situations
bullet Identify and develop management strategies to support the 'helps' and reduce the 'hinders' of achieving their goals
bullet Explain difference between a total relapse and a lapse
bullet Develop contingency plan if client relapses or lapses
bullet Identify and mobilise client human supports where possible

(more detailed information available at Relapse Prevention)

bullet 7. Provide a self-help manual
bullet This is the central part of brief interventions and often contains each of the former steps.
bullet Identify these steps in the self-help booklet (or web site) with the client.
bullet Not suitable if poor English or unmotivated.

(List of self-help manuals is available at Self-help Manuals)

bullet 8. Harm reduction information
bullet Ask about knowledge on harm reduction issues
bullet Provide verbal and written information on harm reduction issues
bullet Some examples of harms may include child safety, overdose, unsafe injecting practices, suicide, domestic violence, motor vehicle trauma, etc.

(More detail available at Harm Reduction)

bullet 9. Follow-up appointment

Follow-up is an important reinforcing aspect of brief interventions. At the very least a telephone follow-up arranged for all clients.

bullet Follow-up usually includes:
bullet Review of drinking/drug use or other goals
bullet Careful identification of positive and other changes for the client and others (eg child/ren)
bullet Possibly ongoing assessment review of self-monitoring or other issues
bullet Problem solving
bullet Relapse management
bullet Goal re-negotiation

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Related Internet Sites

Brief Intervention (ADF, Victoria)

 

Other DrugNet Pages in this Subject Heading

[ Introduction ] [ Treatment Steps ] [ Brief Intervention ] [ Raise the Issue ] [ Motivational Interviewing ] [ Intoxication ] [ Relapse ] [ Harm Reduction ] [ Referral ] [ Withdrawal ] [ Treatment Options ] [ Involuntary Clients ] [ Self-help ] [ 12 Steps AA/NA ] [ Overdose ] [ NIDA Publications ] [ Adolescents ]

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