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UK-focused review for Britain's National Institute for Health and Clinical Excellence of what impedes or promotes the implementation of brief alcohol interventions at the level of the organisation, the staff doing the work, and the patients targeted by the programme.
Addressing the substance use promoting tendencies of the personality traits of London secondary school pupils at particular risk of substance misuse led to less intensive drinking six months later, and there was some support for the psychological mechanisms thought to underpin the intervention.
Offering valuable clues to how best to do motivational interviewing, this London study of cannabis-using students found they were most likely to stop using after brief interventions which embodied the spirit of the approach and featured responses from the counsellor reflecting back and elaborating on the student's comments.
From the Netherlands, the first randomised controlled trial to evaluate internet-based therapy for problem drinking via text-chat conversations with a real therapist found this improved on an automated self-help option; on average alcohol intake was cut by nearly two-thirds.
Computer simulation suggests that health would improve and/or costs be reduced if on-line brief interventions and therapy were added to or replaced conventional alcohol-related health care; these results for the Netherlands are based on a simulation model applicable as an aid to national policymaking in other countries.
This synthesis of nine relevant studies of non-student adult samples confirmed that computer-delivered self-help interventions offer a low-cost way to extend the public health impact of interventions for risky drinkers. Yet to be shown is that they can replace therapists for severely dependent individuals seeking treatment.
Spending just ten minutes each on a drinking feedback and advice web site is leading over 2000 heavy drinking Dutch men a year to reduce to safer levels was the implication of this randomised trial from the Netherlands.
Though drinking problems were widespread, Scottish probation and community service staff were unconvinced of the appropriateness of screening their offender clients for risky drinking and (if indicated) offering brief advice. Not a priority, was the common feeling.
DOCUMENT 2011 HTM file
European drug prevention quality standards: a manual for prevention professionals
These first European standards on delivering high quality drug prevention may be assumed to be dry and technical, but could transform prevention practice if implemented, leading to fewer ineffective activities and an increased focus on approaches and interventions with realistic and achievable objectives.
Applying a systematic and comprehensive framework to map the strategies trialled in attempts to implement screening and counselling for risky drinking primary care patients gives some clues to what it has taken to achieve a high screening rate, the essential first step in the process.
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