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Early intervention in the hospital setting: experience from the WHO Collaborative Study
Author(s) -
Saunders John B.
Publication year - 1988
Publication title -
australian drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0819-5331
DOI - 10.1080/09595238880000631
Subject(s) - intervention (counseling) , brief intervention , test (biology) , medicine , schedule , harm , health care , session (web analytics) , family medicine , psychology , nursing , social psychology , paleontology , economic growth , computer science , economics , biology , operating system , world wide web
Early intervention is a new approach to the management of problem drinking. It consists of, firstly, a screening test to detect persons drinking harmfully or hazardously before dependence has become established. This is followed by a short diagnostic interview and a brief session of therapy. It is intended to be within the scope of non‐specialist health professionals working in a variety of health care settings. The W.H.O. Collaborative Study which forms the subject of this present paper, was established to develop a suitable screening procedure and to evaluate various forms of brief therapy. A ten item “core” questionnaire has been developed by selecting the most representative questions contained within a comprehensive assessment schedule which was administered to alcohol consumers (excluding those physically dependent) recruited in six centres in both the developed and developing worlds. The questions selected relate to the quantity and frequency of drinking, alcohol dependence and alcohol‐related problems including psychological reactions to drinking. The instrument has high sensitivity and specificity and is easy to administer and to score. A second “clinical screening procedure” has been devised which includes non‐alcohol specific questions, clinical examination findings and a blood test. Three different types of brief therapy are currently being evaluated in 11 centres in a controlled clinical trial. In our own centre 1,000 subjects attending various health care facilities, whose drinking places them at risk of harm, are randomised to receive brief advice, counselling in problem solving strategies, counselling together with diary monitoring and feedback of laboratory results, or no therapy. Approximately 230 have been recruited from the outpatient clinics of the hospital. The project has generally been well received by staff and patients alike. Recruitment is now complete and at the present time the progress of subjects is being assessed by independent interviewers up to 12 months from the time of enrolment. Preliminary findings will be discussed.