Brief Intervention in Addiction Treatment

There are many different forms of drug and alcohol intervention.

Not everyone who receives support for risky substance use goes to inpatient rehab or is moved on to having very formal care plans and treatment packages.

This is because, in some cases, it is possible for the relevant professionals to identify where there may be risky alcohol or problematic substance use and may be able to offer assistance before things start to worsen.

A brief intervention is a form of addiction treatment that focuses on helping individuals to get their substance use under control in short, structured forms of support.

Brief interventions are typically used by professionals in primary care settings – for example, social workers, psychologists, drug counsellors and doctors.

These primary care providers are in a unique position, as, by having regular contact with individuals, they are able to continually assess risk and identify any decline.

This level of care means that these professionals are well-positioned to notice the development of any unhealthy habits that could be putting you at risk, meaning that can be able to help you to put contingencies in place to prevent harmful alcohol consumption or use of drugs from developing into severe substance use.

What is a Brief Intervention Used For?

We know that an addiction to illicit drugs or alcohol use disorders does not develop overnight.

Rather, dependency develops over time.

It can be tricky to look backwards and identify exactly at what point risky alcohol use began.

That’s because, when we’re in the situation ourselves, it can be harder to make a subjective assessment.

This is part of what makes substance use disorders so difficult – how do we know when we should start to worry? How do we identify addiction in ourselves?

Usually with addiction, it is the people around us who notice before we do.

Brief Intervention can be a way of helping you identify when your drug and alcohol consumption might be becoming risky, and to provide you with a menu of options to take forward with you if an intervention for alcohol use (or for drug use) is needed.

Who Could Benefit from Brief Interventions?

A brief intervention can be as simple as ‘taking an opportunity to talk to people about healthy lifestyles.’

This means that all of us, at some point in our lives, might be involved in a brief intervention of some kind.

Whilst brief interventions are common in the context of harmful drinking or in situations of a drug use disorder, they can happen in lots of other different situations.

Some of these situations include:

Nutritional Difficulties
Physical activity
Mental health and wellbeing
Sexual health
Smoking

Having conversations on these kinds of topics with a healthcare provider may seem quite intimidating.

However, the role of a brief intervention isn’t to make you feel judged or singled out – the goal is to help you to assess risk and be able to have an open, honest conversation about your situation and how to move forward in a healthy, sustainable way.

The Five Components of Brief Interventions

Brief interventions are usually really quite short.

They can be quite speedy conversations, ranging from around 5 to 15 minutes.

During this time, the clinician will go through a 5-step process.

These 5 steps are known as the 5 As of Brief Intervention, and they help healthcare providers to understand your current situation quickly and clearly in the span of a single session.

The 5 As of Brief Intervention are:

Ask
Assess
Advise
Assist
Arrange

Ask

The ask stage is the first part of the brief intervention and is the way that the topic of discussion will be introduced.

So, you may be asked to discuss the quantity of drugs and alcohol you are currently using, how you are currently feeling in terms of your physical and mental health, etc.

In a way, this can work as a kind of screening for risky behaviour.

Assess

The assessment stage is how the primary care provider is able to tell if you are ready and willing to make a change in your current situation.

For some people, it may be difficult to acknowledge that there is something that needs to be changed.

This isn’t something to be ashamed or embarrassed about – it’s actually very common.

The role of this conversation isn’t to try and convince you that there is an issue, but to provide you with a space to communicate about your consumption of drugs and alcohol in order to be transparent and honest.

Advise

In the advising section of the conversation, your clinician will ask you some questions about how much you may know about drugs and alcohol.

They might ask you, for example:

If you are aware of what the recommended daily or weekly intake of alcohol in units may be.
If you are aware of what your usual daily or weekly intake of alcohol in units may be.
If you are aware of the signs of addiction, and know what the difference between casual and unhealthy alcohol use is.
If you are aware of various health effects that can be experienced by heavy alcohol or drug use.

Assist

The assists stage happens when the primary care provider has been able to distinguish if you feel ready and are willing to try and change your drug and/ or alcohol habits.

If you are, then your clinician will be able to speak with you about the different treatment options available to you in depth.

They will also be able to answer any questions you have and will signpost you to a wide range of appropriate and accessible resources to assist you on this recovery journey.

Arrange

The final part of this is arranging.

This means beginning the treatment process through a formal referral to treatment.

This could mean having a follow-up with the same professional to check in on how you are doing or can be a referral to treatment in a different clinical setting.

What Kinds of Things Are Clinicians Looking For?

During the ‘ask’ stage of your brief intervention, it is likely that your clinician may ask you some questions that are adapted from a screening tool.

There are different screening tools, including the CAGE (a tool for alcohol screening) and CAGE-AID (a kind of drug abuse screening test).

Both of these tests are made up of four different questions, and they are designed to help clinicians identify if people are dealing with habits that have (or could in the future) develop into a substance use disorder.

It’s a way of objectively determining the severity of substance abuse to assess if you need some structured support.

CAGE

If your clinician is assessing your use of alcohol, they will more than likely use the CAGE questionnaire.

The questions on this assessment will be something like this:

Do you feel, or have you felt in the past, that you should reduce the amount that you drink?
Do you feel, or have you felt in the past, annoyed or upset by people making comments on your drinking?
Do you feel, or have you felt in the past, guilty about your drinking?
Do you, or have you in the past, drink early in the morning to help you deal with hangover symptoms of feel more ready to tackle the day?

CAGE-AID

If your clinician is assessing your use of drugs, there is chance that they will make use of the CAGE-AID questionnaire.

The questions on this assessment will be something like this:

Do you feel, or have you felt in the past, that you should reduce the number of drugs you use?
Do you feel, or have you felt in the past, annoyed or upset by people making comments on your drug use?
Do you feel, or have you felt in the past, guilty about your drug use?
Do you, or have you in the past, used drugs early in the morning to help you deal with symptoms of ‘coming down’ or feel more ready to tackle the day?

Typically, if you say yes to one or more of these questions, a clinician is likely to suggest that reductions in drug use (or drinking behaviour) could positively benefit you and your health.

The stages of change model

For lots of people, being told that our behaviours equate to risky drinking or potential substance abuse patterns can be difficult to hear.

This is often because one of the ways that addiction can take hold is by convincing us that our drinking behaviour, use of illicit substances or abuse of prescription drugs is helping us.

This is often because, unfortunately, drug and alcohol use disorders can develop as a method of self-medicating, of dealing with difficult feelings and situations from other things.

This is called the self-medication hypothesis, and it can make it particularly difficult for people to acknowledge that something that they feel is helping them may actually be causing them further harm.

Because of this reason, it can often take some time to recognise when we are dealing with addiction.

This is where the stages of change model comes in.

There are several stages to this model, including:

Pre-contemplation
Contemplation
Preparation
Action
Maintenance

These five stages refer to a different state of readiness to address the problem of addiction.

Pre-Contemplation Stage

The pre-contemplation stage is often the first stage and happens when individuals do not have any plans to change their behaviours at the moment.

This might be because they are unaware that it could be problematic or risky.

Contemplation Stage

The contemplation stage is when people may be getting ready to change their behaviour.

This is usually characterised by people starting to notice for themselves that their use of substances is perhaps at a more severe level than they previously thought.

This doesn’t always mean that the individual is ready to change or knows how to go about doing this.

Usually in this stage, people will be weighing up the benefits of change vs the costs of staying the same, as often, change is a tricky process that does require productive effort.

It is not usually until the reasons to change feel more pressing and important that people will begin to make the shifts needed.

Preparation Stage

Preparation is the middle stage and happens when the individual feels ready to make changes and starts to think about what steps can be taken to begin to achieve this.

This often involves casual research into treatment options.

Action Stage

The action stage refers to the actual doing – the action of beginning to take the steps that will lead to a shift or change in behaviour.

It is often helpful here to draw up a risk assessment – this can be helpful in identifying what situations, contexts or people may put the individual at risk of using substances again, in order to help them find ways to either avoid or overcome these situations without the use of drugs or alcohol.

This can also include beginning to engage with other forms of structured support or therapy.

Some of the other types of therapeutic support that you may begin to access at this stage include:

Maintenance Stage

The final stage is maintenance.

Recovery from anything takes some time, and addiction recovery is no exception.

Even by working with some of the top addiction and mental health specialists in the world, recovery from substance abuse will not happen overnight.

This means that both parties – the individual working to overcome addiction, and the professionals helping them – need to continue to make a concerted effort.

Some people say that recovery is a choice that you make every day.

Whilst this isn’t true in all situations, and there are certain things that can take the element of control out of our hands, the maintenance stage shows that commitment to recovery is essential to finding our way out of addiction.

How Effective Are Brief Interventions?

Brief interventions are most successful when they are delivered in a manner that shows empathy and understanding between the client and clinician.

This happens when the client is given solid, accessible advice and the individual working to overcome addiction feels that they have both the tools and confidence to do so.

One study that looked at a range of different results on brief intervention suggests that in a follow up meeting held three months after engaging in brief intervention, drug and alcohol use decreases drastically.

It also found that engaging with brief intervention is associated with a reduced risk of drug or alcohol-related death.

This suggests that brief interventions can offer a solid foundation for recovery.

By helping to identify an issue and providing the tools for making change, brief interventions can be a very helpful method of starting you on the track to living a sober life.

Get Help Today

At Rehab 4 Alcoholism we know that addiction is not a choice and that everyone struggling with substances deserves a helping hand to get back on the right track to improved well-being.

If you are ready to access support for addiction or believe that a loved one would benefit from beginning formal support, we are more than happy to speak with you and learn more about how we can help you with your current situation.

We are a confidential service, and all our contact with you is designed to help give you practical support and peace of mind.

You can contact our team to seek advice and to learn more about the kinds of services we offer.

Whatever help you need to beat addiction, we are here for you.