Brief Intervention Techniques

Interview with Dr. Jason Kilmer

Brief Intervention Techniques, as well as why they are effective, are explained by program evaluation expert, Dr. Jason Kilmer.

Dr. Hanson--

I understand that Brief Intervention Techniques are very effective in reducing alcohol abuse.

Dr. Kilmer--

Particularly in our work with college students, they're an important piece of the puzzle, David. Researchers in college student drinking acknowledge that general prevention efforts are important in delaying the onset of use as well as in attempting to keep problems from developing. However, some students may make the choice to use alcohol, and do so in a way in which negative consequences might accompany their use. We know that "traditional," education based programs, particularly those that emphasize abstinence, have not demonstrated success in reducing the harm associated with substance use by college students. For these students, we have researched the value of brief interventions. Brief interventions work in two ways: (1) to get people thinking differently about their use so that they make begin to think about or actually make changes in their alcohol consumption, and (2) to provide students who make the choice to drink with skills that allow them to do so in a less dangerous and less risky way to minimize the potential harm associated with their use.

Dr. Hanson--

Exactly what are these techniques?

Dr. Kilmer--

Largely, they are interactions that are based on Dr. Bill Miller's Motivational Interviewing. Motivational Interviewing acknowledges that people may come to a counseling session, an assessment, or a prevention program at different levels of readiness to change their drinking behavior. Some people have never thought of making changes in their drinking, others have thought about it but not taken steps to change it, some may be actively trying to cut down, and others have cut down and maintained their new pattern. Motivational Interviewing meets people where they are in terms of readiness to change.

Dr. Hanson--

Specifically, what does the technique do?

Dr. Kilmer--

Motivational Interviewing is a non-judgmental, non-confrontational approach that works in a range of ways. Largely, through the presentation of objective feedback based on information provided by an individual, the strategy attempts to increase a person's awareness of the potential problems caused, consequences experienced, and risks faced as a result of his or her alcohol use. As feedback is presented, the clinician or program provider may foster the development of discrepancies between where a person sees him or herself and where he or she may actually be. In short, the strategy seeks to find the proverbial "hook" that will prompt a person to think differently about his or her use and ultimately consider what might be gained through change.

When done with individuals, a person receives personalized feedback about his or her alcohol consumption and related behaviors. In groups (e.g., an entire fraternity or sorority), feedback can be given based on data collected from group members prior to a program. Some researchers have used mailed feedback after collecting data on a questionnaire such that no face-to-face interaction actually occurs.

Dr. Hanson--

Is there another Brief Intervention Technique?

Dr. Kilmer--

Not so much another technique as much as the complement to this approach. We see Skills Training Programs to be so valuable in our work with college students. First developed, implemented, and evaluated by Dr. Alan Marlatt and his colleagues at the University of Washington in Seattle, these approaches attempt to develop skills for drinking in a less dangerous and less risky way. One of the limitations of information-only programs is that they may raise awareness and information about the effects of a substance, but they don't seem to translate to changes in behavior. As a logical adjunct to a Motivational Interviewing session, once a person is thinking about or talking about change, Skills Training Programs work to provide the individual with the skills to make these changes in their drinking behavior.

Dr. Hanson--

How do they work?

Dr. Kilmer--

They acknowledge that the best way to avoid negative consequences is to abstain from drinking alcohol. However, they also provide harm reduction strategies for those who choose to drink such that moderate drinking goals can also be considered.

Dr. Hanson--

Harm reduction strategies?

Dr. Kilmer--

Yes. These recognize that any steps toward reduced risk are steps in the right direction. Consequently, while abstinence may be the optimal outcome, skills for drinking in a way that will minimize harm can be considered if this is not viewed as realistic, attainable, or attractive. For example, we provide blood alcohol level estimation training so that people can set limits for moderate goals that are unique to their gender, weight, and time spent drinking. We teach practical strategies for reaching these limits, such as spacing one's drinks, pacing oneself, alternating alcoholic and non-alcoholic drinks, consuming food before drinking, drinking for quality instead of quantity, not leaving one's drinking unattended, and so on.

Dr. Hanson--

That makes good sense.

Dr. Kilmer--

We hope so! And, most importantly, these techniques are demonstrably effective in reducing alcohol use and its associated problems.

Dr. Hanson--

That's the best news of all. Thanks for your time, Jason.

Dr. Kilmer--

Thank you, David, it's been my pleasure.

 

Dr. Jason Kilmer is an addictive behaviors specialist and adjunct member of the faculty at The Evergreen State College in Olympia, WA. He is also a co-Principal Investigator on an NIAAA-funded grant and works as a research scientist and the University of Washington in Seattle, WA.

References and Readings

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