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 wtih use should be in place. The clinician and patient will come to this agreement by using the negotiating processes of the brief intervention. The following are the four main steps of a brief negotiated intervention:

 

 

Raise the Subject

 

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

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

Enhance Motivation

 

  • Assess Readiness to Change-use readiness ruler
  • Explore patient's reasons for change and ability to change

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:

 

  • AUDITFor females (18-65) and all persons 66 and older-greater than or equal to 7
  • AUDITFor males (18-65)-greater than or equal to 8
  • DASTFor 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. Brief interventions can also be used in a variety of ways and in a variety of settings, including general populations, primary care, emergency departments, and in-patient trauma centers. They could also be used to talk with patients about medication adherence, diabetes prevention planning, weight loss or exercise plans, and more. To learn more about brief interventions, click on the links below.

 

Resources

Brief Negotiated Interview: Boston University School of Public Health BNI ART Institute

The Yale Brief Negotiated Interview Manual:  Yale University School of Medicine

Brief Intervention Training Videos:  Oregon Health and Science University SBIRT Training Videos

SAMHSA-HRSA: SBIRT-Brief Interventions: Many resources on brief interventions, brief treatment, and motivational interviewing.

Brief Interventions for Hazardous and Harmful Drinking: A manual for use in Primary Care: Thomas Babor, World Health Organization, 2001