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Motivational Interviewing in the ER Highly Effective in Reducing Teen Drinking

A brief alcohol intervention called motivational interviewing can help teenagers and young adults receiving emergency room treatment for alcohol use or unrelated issues, a team of German researchers report in a new study.Teenagers and underage young adults are exposed to a wide range of serious, severe or potentially fatal risks when they consume alcohol. In a study review published in March 2015 in the journal Alcohol and Alcoholism, researchers from two German institutions assessed the usefulness of an alcohol intervention technique called motivational interviewing in helping teens and young adults who end up in emergency rooms for alcohol-related problems or problems not directly related to alcohol use.

Teenagers and Drinking Consequences

Alcohol use is currently declining among American teenagers. Figures from the year 2014 (compiled by the University of Michigan on behalf of the National Institute on Drug Abuse) indicate that 41 percent of all U.S. teens in the eighth, 10th and 12th grades consume alcohol at least once yearly. This level of intake represents a 2 percent drop from the combined annual drinking rate in these three grades in 2013 and also reflects a longer-term decrease in alcohol consumption that extends throughout the 21st century. American adolescents are also reducing their participation in binge drinking, a pattern of consumption defined by rapid and highly risky alcohol intoxication.

Unfortunately, binge drinking is still relatively common among teenagers who consume alcohol. Known consequences of drinking in general (and alcohol binging in particular) in teen populations include increased chances of dying from alcohol-related causes, increased exposure to physical assaults and physical assault perpetration, increased exposure to sexual assaults and sexual assault perpetration, increased exposure to accidental or intentional injury and increased risks for potentially damaging changes in the normal process of brain growth and development. Compared to their older counterparts, younger adolescents have a relatively low rate of involvement in alcohol use and an accompanying low rate of exposure to alcohol-related harm. By the time they reach the threshold of adulthood at age 18, more than two-thirds of all U.S. teens have consumed alcohol on at least one occasion.

Motivational Interviewing

Motivational interviewing (also known as motivation enhancement therapy or brief motivational interviewing) is an intervention technique designed to provide assessments of potentially problematic drinking behaviors, review the dangers of risky alcohol use in affected individuals and (when appropriate) promote participation in a substance treatment program. The approach emphasizes collaboration between doctor/therapist and client/patient, while simultaneously de-emphasizing potentially off-putting authoritarian interactions. When conducted in a doctor’s office or a similar setting, a multi-session course of motivational interviewing has proven effectiveness as an intervention for adults and teenagers dealing with alcohol-related issues. In an emergency room, where time is limited and interventions are typically conducted by health professionals who don’t specialize in alcohol-related issues, motivational interviewing commonly occurs in a single session that lasts roughly 15 to 20 minutes.

Usefulness in an Emergency Room

In the study review published in Alcohol and Alcoholism, researchers from Germany’s Institute for Social Medicine and IB Medical Academy used data from six previous studies to explore the usefulness of motivational interviewing when conducted on teenagers and young adults in emergency rooms. The studies under consideration included a total of 1,433 individuals between the ages of 13 and 25. Some of the studies compared the outcomes of motivational interviewing to the outcomes of other alcohol intervention techniques used to help adolescents and young adults with alcohol problems. In these studies, points of comparison included the frequency of alcohol use after receiving an intervention and the amount of alcohol consumed after receiving an intervention.

After completing their review, the researchers concluded that motivational interviewing conducted in an emergency room setting is at least as effective for teenagers and young adults as other forms of alcohol intervention conducted in this setting, and often considerably more effective. For example, findings from two of the studies indicate that young people who receive motivational interviewing reduce their alcohol intake by a substantially larger amount than young people who receive other alcohol interventions. The authors of one of the studies under consideration determined than this alcohol reduction effect is highest in teenagers who consume alcohol in unusually large amounts. All told, the researchers concluded that, compared to other approaches to intervention, motivational interviewing in an ER setting commonly results in a lower level of drinking participation for teens and young adults, as well as a lower general level of alcohol intake.

Posted on October 10th, 2015

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