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Alcohol Treatment Matrix row 1: Screening and brief intervention
|Row 1 develops your understanding of research evaluating a key public health strategy – alcohol screening and brief intervention. Part prevention and part 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?
Cell A1 Effectiveness of screening and brief interventions
|Asks if results of the most significant studies in the UK mean we should discard scientifically developed brief interventions and just do the minimum. Explores whether research results can be relied on as a guide to ‘real world’ impacts, whether brief interventions have passed their peak and are no longer effective, and focuses on evidence from the UK.
Cell B1 The influence of the practitioner
|Starts with the study which helped validate a move away from confrontation to client-centred counselling, then highlights Swiss studies which uniquely dissected how brief interventions work. Develops evidence-informed understanding of why practitioners matter, whether some are naturally effective, and whether it is they do not say which really matters. Finally explores the impacts of simple, unsophisticated advice – the under-researched elephant in the room.
Cell C1 Management is key to quality
|Explores why management may be the key to ensuring quality, asks if their support for screening and brief intervention should stretch to mandating these regardless of the priorities of clinicians and patients, where best to focus implementation efforts, and whether reserving brief interventions for non-dependent drinkers would be a big mistake.
Cell D1 Organisational context sets the scene
|Highlights a striking illustration of the importance of organisational context emerging from an unprecedented US implementation drive. Asks if there are ‘good’ reasons for ‘bad’ implementation and whether influences which affect screening rates differ from those which affect brief intervention. Explores the implications of the need to adapt research-validated interventions to different working contexts.
Cell E1 Generating system-wide programmes
|Context is that Britain’s health intervention authority insists we “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. Asks whether we should abandon the ambition to achieve population-wide health gains, what ‘quality’ consists of, whether implementation incentives give the wrong message, and whether to address alcohol, alcohol plus drugs, or lifestyle issues in general.