Psychologist Dr. Jason Kilmer describes Brief Intervention Techniques. He’s an expert on how and why they work. David Hanson interviews Dr. Kilmer..

Brief Intervention Techniques

Interview with Dr. Jason Kilmer

Hanson–

I understand that Brief Intervention Techniques are very effective in reducing alcohol abuse.

Dr. Kilmer–

Yes. Particularly in our work with college students, they’re an important piece of the puzzle, David. Researchers in college student drinking know that general prevention efforts are important in reducing problems.

Of course, some students chooce to drink in ways that cause problems. We know that traditional education-based programs have not been successful in reducing drinking problems.  This is especially the case with those that emphasize abstinence.

We have studied the value of brief interventions for such students. Brief interventions work in two ways. First, they get people thinking differently about their use or misuse. This helps them think about making changes in their drinking.  Second, it  gives students who drink with skills that allow them to do so in a safer way. This minimizes potential harm from drinking.

Brief Intervention Techniques

Hanson–

Exactly what are these techniques?

Dr. Kilmer–

Largely, they are interactions that are based on Dr. Bill Miller’s Motivational Interviewing. Motivational Interviewing acknowledges that people are at different levels of readiness to change. Some have never thought of making any changes in their drinking. Others have thought about it but haven’t done anything to change. Some may be trying to cut down. And others have cut down and maintained their new pattern. Motivational Interviewing meets people where they are in terms of readiness to change.

How Does the Tecnique Work?

Hanson–

Specifically, what does the technique do?

Dr. Kilmer–

Motivational Interviewing is a non-judgmental, non-confrontational approach. It works in a range of ways. It’s largely through providing objective feedback based on information provided by an individual. It increases a person’s awareness of the risks faced as a result of the person’s  level of alcohol use.

This helps people identify discrepancies between how they see themselves and how may actually be. The strategy prompts people to think about their consumption and what might be gained through change.

When done with individuals, a person receives personalized feedback about his or her alcohol consumption and related behaviors. In groups, feedback can be given based on data collected from group members prior to a program. Some researchers have used mailed feedback after collecting data on a questionnaire such that no face-to-face interaction actually occurs.

Other Brief Intervention Techniques?

Hanson–

Is there another Brief Intervention Technique?

Dr. Kilmer–

Not so much another technique as much as the complement to this approach. Skills Training Programs are very valuable. They were first developed and evaluated by Dr. Alan Marlatt and his colleagues. These approaches attempt to develop skills for drinking in safer ways.

Information-only programs may raise knowledge and awareness. But they don’t generally lead to changes in behavior. Once a person is thinking about change, Skills Training Programs provide the skills to make  changes in drinking behavior.

Hanson–

How do they work?

Dr. Kilmer–

They acknowledge that the best way to avoid negative consequences is to abstain from drinking alcohol. However, they also provide harm reduction strategies for those who choose to drink.

Harm Reduction

Hanson–

Harm reduction strategies?

Dr. Kilmer–

Yes. These recognize that any steps toward reduced risk are steps in the right direction. Abstinence may be the optimal outcome. Yet skills for drinking in a way that will minimize harm is another option.

For example, we provide blood alcohol level estimation training. People can then set drinking limits based on their gender, weight, and time spent drinking. We teach practical strategies for maintaing these limits. That includes such things as spacing drinks, alternating alcoholic and non-alcoholic drinks, eating food before drinking, etc.

Hanson–

That makes good sense.

Dr. Kilmer–

We hope so! And, most importantly, these techniques are demonstrably effective in reducing alcohol consumption levels. And this reduces drinking problems.

Hanson–

That’s the best news of all. Thanks for your time, Jason.

Dr. Kilmer–

Thank you, David, it’s been my pleasure.

Dr. Jason Kilmer is Professor of Psychiatry and Behavioral Sciences at the University of Washington in Seattle.