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Nick Heather PhD, Northumbria University Presentation at INEBRIA2009, Newcastle/Gateshead, UK

INTRODUCTION TO THE CONFERENCE: BREAKING NEW GROUND IN THE STUDY AND PRACTICE OF ALCOHOL BRIEF INTERVENTIONS. Nick Heather PhD, Northumbria University Presentation at INEBRIA2009, Newcastle/Gateshead, UK 8/10/09. CURRENT SITUATION: The upside.

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Nick Heather PhD, Northumbria University Presentation at INEBRIA2009, Newcastle/Gateshead, UK

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  1. INTRODUCTION TO THE CONFERENCE:BREAKING NEW GROUND IN THE STUDY AND PRACTICE OF ALCOHOL BRIEF INTERVENTIONS Nick Heather PhD, Northumbria University Presentation at INEBRIA2009, Newcastle/Gateshead, UK 8/10/09

  2. CURRENT SITUATION:The upside • Good evidence for the effectiveness of alcohol SBI, especially in primary health care • Increasing acceptance of the major contribution SBI can make to reducing alcohol-related harm • Growing interest by governments around the world in the potential of SBI as an effective and cost-effective policy against alcohol-related harm

  3. CURRENT SITUATION:The downside • A necessary focus on testing the effectiveness of SBI has led to neglect of other important questions • Too much emphasis on meta-analysis? • Risk of complacency?

  4. SPECIAL TOPICS (1) • the theory of brief interventions; • development and applications of SBI in the criminal justice setting: • brief interventions and the Internet; • development, evaluation and implementation of SBI among young people; • application of SBI to black and minority ethnic groups;

  5. SPECIAL TOPICS (2) • optimal forms of screening in various medical and nonmedical settings; • innovative ways of encouraging health professionals to incorporate SBI in their routine work; • effective strategies for achieving integration of SBI in government policies; • applications of SBI in parts of the world where it has yet to make much impact.

  6. HOW MANY FORMS OF BI ARE THERE? • Brief advice (+FRAMES) vs. motivational interviewing • But do they have different effects? • If so, does motivational interviewing add to the effects of brief advice? • If so, with whom and under what circumstances?

  7. WHAT ARE THE LIMITS OF BI • Dichotomy of “dependent” vs. “non-dependent” unhelpful • At what point along the continuum of dependence and/or problem severity does BI become practically ineffective? • Is the dependence the only, or even the main factor determining the limit of BI effectiveness?

  8. HOW FAR CAN EVIDENCE OF BI EFFECTIVENESS BE GENERALISED? • Good evidence for effectiveness in primary health care (brief advice) and in higher educational settings (motivational interviewing) • But can this evidence be used to justify implementation on other settings? • NB. The extended precautionary principle

  9. HOW DO BRIEF INTERVENTIONS WORK? • By increasing the number who try to cut down (without necessarily increasing the effectiveness of change attempts)? • Or by increasing the success rate among those who do try? • Theoretical bases: • Stages of change (Prochaska & DiClemente); • Outcome and/or efficacy expectancies (Bandura); • Cognitive dissonance (Festinger); • Self-affirmation (Harris). • More research needed!!!

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