Motivational Interviews in Emergency Rooms can Prevent Alcohol Problems, Violence in Teens

A new study has found that a one-on-one talk with a therapist can help reduce violence and drinking problems among teenagers. For three years, researchers from the University of Michigan Health System offered to talk to adolescents at the Hurley Medical Center Emergency Department in Flint, Michigan, who reported aggressive behavior or having consumed alcohol at least two or three times in the past year. Of the 726 adolescents (ages 14-18), there was a 34 percent decrease in aggression among those who talked to a therapist. Those who only received a brochure had a 16 percent reduction in aggression. The study, published in an issue of the Journal of the American Medical Association that deals with violence and human rights, found that these brief motivational talks in the emergency room reduced the changes of a teenager experiencing peer violence or drinking problems by half. Senior author Rebecca Cunningham, M.D., an emergency room physician and director of the University of Michigan Injury Research Center, said that the emergency room can be an important area for talking to teens who are at a high risk of experiencing violence and alcohol use, which are leading causes of death among American adolescents. The one-on-one talks used motivational interviewing, which increases awareness of the risks and consequences of an individual’s behavior, urging them to become motivated to change the behavior and achieve a better future. The strategy helps patients think differently about their behavior and consider what might be gained through change. The talks also incorporated role-play exercises to help them learn how to cope with risky situations involving drinking and violence. Lead author Maureen Walton, M.P.H., Ph.D., research associate professor in the University of Michigan Department of Psychiatry, Addiction Research Center, said that most of the adolescents wanted to go to college and be good role models for their siblings, so the therapists talked to them about the differences between their behaviors and their goals. The patients were asked questions about alcohol use and violence using a computer program and were placed randomly into three groups where they received a brochure or had a brief motivational interview either via computer or with a therapist in the emergency room. The computer program worked well because of the teens’ familiarity with technology, and incorporated animated role-playing. Cunningham, who also works in the Hurley Medical Center Emergency Department, said that the emergency room can not only treat the immediate consequences of violence, but the motivational interviews can also help prevent future problems with alcohol and violence. Source: University of Michigan Health System, U-M study: Pep talk to teens in the ER reduced violence, alcohol misuse, August 3, 2010

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