Identification and Brief Advice for Alcohol – Putting theory into practice

© Alcohol Concern 2013

Identification and Brief Advice for Alcohol –

Putting theory into practice

What is Identification and Brief Advice?

“IBA involves giving simple advice to people drinking at increasing or higher risk levels who may not be consulting for an alcohol

related problem.”

British Medical Journal (2010) 340:c1595

Why do we use IBA?

• Proven effectiveness in reducing consumption• Opportunity to inform the nation• 1 in 8 will make changes• Service users 2x more likely to moderate drinking

in following year• Quick and easy • Training for non-specialists in as little as half a day• Transferable skill

What are the benefits?

Public Health reduction in:

• hospital admissions• alcohol related mortality• violent crime• cost to industry• family breakdown• units consumed by 13-34%

Benefits to individual

• lower blood pressure• better sleep patterns• increased wellbeing• increased effectiveness of medication• increased productivity• improved relationships

Benefits to staff

• extra tool to help clients• transferable skills• supports DANOS• effective intervention

Appropriate settings/services for the delivery of brief advice

• GP surgeries• Health Centres• A & E• General wards• Physiotherapy• Occupational Health• Paramedics• Health visitors• Community nursing• Social work• Job centres

• Police and PCSOs• Counselling services• Advice and advocacy• Tenancy support• Community Centres• (Further) education• Places of worship• Drop-in centres• Pharmacies• And more…

What barriers are there to delivering IBA?

• Time• Don’t know how to start the conversation• Client may get annoyed• Don’t know who to work with• Privacy/confidentiality• What do I do if I find out they have a problem?• Don’t know enough about alcohol• Not my job

Conversation starters

• As part of a national campaign we’re screening everyone of drinking age

• This is just part of the service to make sure we’re meeting all your needs

• A good way to lose weight is to reduce your alcohol calories

• Have you heard about the Dry January campaign?

Elements of brief advice:FRAMES

Feedback about risks of substance use

Responsibility placed on client to change

Advice to cut down / abstain etc.

Menu of options and choices

Empathic approach

Self-efficacy: encourage & reinforce client’s strengths

Exercise

• Read through your scenario

• Write 6 sentences, one for each element of FRAMES that would be appropriate for this person

• Use full sentences not bullet points

How do we make it happen?

• Confidence

• Management support

• Policies and protocols for delivery

• Availability of leaflets/information

• Relationship with local alcohol services

Examples of brief advice

• Introduce and explain screening outcome score• Provide advice and information on safe drinking levels• Give information on the health risks associated with excessive

drinking.• Build motivation – suggest the use of drink diaries, “pros and

cons” to change lists.• Support to identify triggers and manage cravings• Promote a change in drinking patterns – alternating alcoholic

and soft drinks, not drinking in large rounds/groups• Identify ongoing support – make onward referrals if/when

required

Alcohol Resources• www.alcoholconcern.org.uk• Resources, advice, information about alcohol. IBA training courses,

Workplace Programme for Alcohol• www.alcohollearningcentre.org.uk• Online resource including brief intervention e-learning section,

information about legislation and policy and video of simulated delivery of screening and brief intervention

• www.nhs.uk/change4life• Website containing information on units in drinks, information and

advice on cutting down• www.drinkaware.co.uk• Tips, information and resources, including the “drink wheel”• www.dryjanuary.org.uk