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[psychiatry-research] ER counseling on alcohol helps teens stop drinking/reckless behavior

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  • Ian Pitchford
    FOR RELEASE: 1 DECEMBER 1999 AT 00:00 ET US Brown University http://www.brown.edu/Administration/News_Bureau ER counseling on alcohol helps teens stop
    Message 1 of 1 , Dec 1, 1999
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      FOR RELEASE: 1 DECEMBER 1999 AT 00:00 ET US
      Brown University

      ER counseling on alcohol helps teens stop drinking/reckless behavior

      Teens do much less harm to themselves and others after receiving brief
      counseling in the emergency room, says a new study of 94 young people, ages

      "The message is that we can effectively intervene in a 45-minute session and
      show a reduction in harm," said study leader Peter Monti, associate director of
      the Brown University Center for Alcohol and Addiction Studies and professor in
      the Brown University School of Medicine. "After all, reducing harm is
      ultimately what counts."

      After six months, counseled teens had 32 percent fewer drinking and driving
      incidents, 50 percent fewer alcohol-related injuries, and many fewer
      alcohol-related problems, such as scrapes with friends, compared to those who
      had received standard treatment.

      Motor vehicle records showed that counseled patients were much less likely to
      have a moving violation in the six months after treatment compared to
      standard-care patients. Overall, the researchers found that teens in both
      groups drank less.

      "Alcohol-related reductions in both groups are due somewhat to the fact that
      the emergency room is a setting that maximizes a teachable moment in these
      kids' lives," Monti said. "This is a captive audience facing consequences.
      Attention from the counselors was important to the kids. Frequently, adults
      sweep the fact of teen drinking under the rug."

      Teens in the study were approached in the emergency room after being treated
      for mild to extreme intoxication or for injuries from an alcohol-related
      incident such as a car accident. The teens received standard emergency room
      treatment or 45 minutes of counseling. Standard treatment included an
      assessment of drinking behavior, list of alcohol treatment centers, and a
      handout on drinking and driving.

      The counseling session was designed to be motivational, focusing on the harmful
      and risky effects of drinking. Counseling consisted of a review of the
      circumstances, open-ended discussion of the pros and cons of alcohol use, and
      the weighing of these advantages and disadvantages. Teens also received input
      on how they compared to peers in terms of drinking behavior, including teens
      entering treatment for alcohol addiction.

      "We don't tell teens what to do, but ask them how they would like things to be
      different," said Suzanne Colby, study author and assistant professor of
      psychiatry and human behavior. "They generate ideas on how to change behavior.
      Together we strategize on how that might be accomplished. If people come up
      with their goals, they?re more likely to follow through."

      Teens who received the motivational intervention were given the same handouts
      as those in standard care, as well as information about the effects of alcohol
      on driving, and a personalized feedback sheet. All teens in the study received
      follow-up interviews at three and six months.

      Two study authors, Robert Woolard, M.D., associate professor of medicine, and
      William Lewander, M.D., associate professor of pediatrics, run emergency rooms
      at Hasbro Children's Hospital and Rhode Island Hospital, where the study took
      place. The physicians drove the message home to their own staffs that emergency
      rooms are perfect settings for reaching young people who need help.

      "On average, these are teens at a much higher risk for alcohol-related
      problems," Colby said. "It's hard to do such an intervention in a high school
      where young people you target may be stigmatized for being labeled at risk. If
      you go into the emergency room and a teen comes in via an alcohol-related
      event, you can be confident that you are reaching a population at risk.

      "If you speak with college students or young people in the workplace about
      alcohol abuse, the message will likely fall on deaf ears, because few are
      cognizant of the negative effects of their drinking," Colby continued. "But if
      you catch young people in the middle of a negative experience caused by alcohol
      use, you can have an impact."

      The counseling is easy to learn and something social workers can be trained to
      do in hospitals, or counselors at colleges and school nurses at elementary and
      junior high, Colby said.

      "Our intent is to be able to train other people to do this intervention," Monti
      said. "We would like to see these types of protocols in emergency rooms across
      the country."

      The study has some limitations. For example, many potential patients approached
      to participate refused, as they'd already received medical care and wanted to
      leave the hospital. The research appears in the December issue of the Journal
      of Consulting and Clinical Psychology. The National Institute on Alcohol Abuse
      and Alcoholism funded it.
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