Effectiveness Bank web site Matrix row
Supported by  Alcohol Research UK web site Society for the Study of Addiction web site Skills Consortium web site. Opens new window  Federation of Drug and Alcohol Professionals web site. Opens a new window
Matrix Row logo Alcohol Matrix row 1: Screening and brief intervention
Now complete are the first five instalments of the course exploring row 1 of the Alcohol Treatment Matrix, developing your understanding of research evaluating a key public health strategy – alcohol screening and brief intervention. Part prevention and part brief treatment, these programmes are intended to identify risky drinkers at locations such as GPs’ surgeries and emergency departments, and then to deliver brief advice to reduce risk. Do they work well enough – and can they be implemented widely enough – to reduce alcohol-related harm across a population?
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Cell A1: Effectiveness of screening and brief intervention
Explains that screening and brief interventions aim to reduce alcohol-related harm across a population rather than focusing on dependent individuals. Highlights the SIPS studies, the most significant to date in the UK. Develops evidence-informed understanding of three key questions: Does SIPS mean, ‘Just do the minimum’?; How ‘real world’ were real-world trials?; How strong is the evidence for the UK?

Cell B1: Influence of the practitioner on brief interventions
Highlights Swiss studies which uniquely dissected how brief interventions work. Develops evidence-informed understanding of four issues: In such a brief encounter, why does the practitioner matter?; Are some practitioners naturally effective?; Why does saying lots of the ‘right’ things have no impact?; What about interventions not based on motivational interviewing?

Cell C1: Management of screening and brief intervention
How implementation and impact are affected by the management functions of selecting, training and managing staff, and organising the programme. Highlights UK study which presaged a shift from universal to ‘targeted’ screening. Develops evidence-informed understanding of four issues: Are managers the key to quality?; Leave practitioners and patients to decide whether to address drinking?; Reserve intervention for non-dependent drinkers?; Where to focus implementation efforts?

Cell D1: Impact of organisational context
Highlights a striking illustration of the importance of organisational context emerging from what seems the world’s most determined implementation drive. Develops evidence-informed understanding of two key issues: Are there ‘good’ reasons for ‘bad’ implementation?; Do the same characteristics facilitate both screening and brief advice?

Cell E1: Generating system-wide programmes
Influence of commissioning and contracting decisions across an administrative area. Context is that NICE insists UK commissioners “must” generate a system which provides the training, resources and time needed for routine brief intervention. Find out what happened when that was tried in Scotland. Develops evidence-informed understanding of three key issues: What is ‘quality’?; Do incentives give the wrong message and risk perverse effects?; Commission for alcohol, alcohol plus drugs, or lifestyle issues?
Also see hot topic on whether brief alcohol interventions can improve public health.