One form of drug counseling to help young people with drinking problems makes people in a 'we must do something' culture feel better may be of limited benefit, a new systematic review suggests.
Each year, around 320,000 people worldwide between the ages of 15 and 29 die as a result of alcohol misuse. Most of those deaths are due to car accidents, murders, suicides or drowning. Motivational interviewing is a counseling technique developed in the 1980s that is sometimes offered to people with alcohol problems. It aims to help them overcome ambivalence and change behavior. Counselors listen, adopt a non-judgmental, non-confrontational stance and then highlight the negative consequences of drinking.
The authors found that motivational interviewing did not substantially reduce drinking or alter alcohol-related behavior.
The researchers reviewed evidence from 66 trials involving a total of 17,901 young people aged 25 and under. Many of the studies recruited young people who were at high risk of alcohol related problems. In 49 trials, those involved attended one individual session. In the others, they attended group sessions or a mixture of group and individual sessions.
Four months later, participants who underwent counseling had only slightly reduced the amount they drank and how often they drank compared with people who were untreated. On average participants who had counseling had about 1 and a half fewer drinks per week compared to those who had no counseling (12.2 drinks compared with 13.7). The effect of counseling on the number of drinking days was also very small: 2.57 days per week compared to 2.74 in untreated people).
Participants also slightly reduced their maximum blood alcohol levels from 0.144% to 0.129%, but their average blood alcohol levels did not change. Motivational interviewing had no effect on alcohol-related problems, binge drinking, drink-driving and other risky behaviours related to alcohol.
“The results suggest that for young people who misuse alcohol there is no substantial, meaningful benefit of motivational interviewing,” said lead researcher David Foxcroft, who is based at the Faculty of Health and Life Sciences at Oxford Brookes University in Oxford, UK. “The effects we saw were probably too small to be of relevance to policy or practice.”
The young people involved in trials included university and college students, army recruits, prisoners and young people attending healthcare centers, youth centers and job centers. “There may be certain groups of young adults for whom motivational interviewing is more successful in preventing alcohol-related problems,” said Foxcroft. “But we need to see larger trials in these groups to be able to make any firm conclusions.”
Citation: Foxcroft D.R., Coombes L., Wood S., Allen D., Almeida Santimano NML. 'Motivational interviewing for alcohol misuse in young adults', Cochrane Database of Systematic Reviews 2014, Issue 8. Art.No.:CD007025. DOI: 10.1002/14651858.CD007025.pub2
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