Creating Opportunities for Reducing Alcohol Related Harm in the Veteran Community
Alcohol Screening and Brief Intervention
AS+BI
A Training Program for Veteran Service Providers
(Version 2.3 December 2002)
An Initiative of the Department of Veterans’ Affairs, Developed
by Maurie O’Connor and Max Simmons, Alcohol and Mental Health Policy
Section, Younger Veterans and VVCS Branch,
Health Division.
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ALCOHOL SCREENING AND BRIEF INTERVENTION (AS+BI)
COURSE CONTENT
Session 1: RATIONALE & CONTEXT
Aims of the Course
Learning Objectives
The DVA Alcohol Management Project
Lifestyle Risk Factors
Veterans and the General Population
NH&MRC Alcohol Guidelines and their Applicability
to Veterans and Families
Session Summary
Session 2: ALCOHOL – THE DRUG
Pharmacology of Alcohol
Effects of Alcohol Consumption—Short
& Long Term
A Model for Conceptualising Alcohol Problems
Contextualising Alcohol Use
Harm Minimisation
Relative Harms—Group Activity 1
The Concept of the Standard Drink—Group
Activity 2
Alcohol Use and Risk Levels
Session Summary
Session 3: ALCOHOL SCREENING
Safe and Unsafe Drinking Levels
Screening
Alcohol Screening & Brief Intervention
Flow Chart
Session 4: AUDIT SCREENING
Alcohol Use Disorders Identification Test
(AUDIT)
The AUDIT – Interview Version
The AUDIT – Self-Report Version
Steps in the Identification of a Drinking
Problem
The World Health Organisation Alcohol Risk
Zones
Session 5: AUDIT PRACTICE SKILLS
AUDIT Practice Session—Group Activity
3
AUDIT Appraisal—Group Activity 4
Session 6: BRIEF INTERVENTION
Introduction to Brief Intervention
From Screening to Brief Intervention AS-BI
Intervening in Risky and High-Risk
Drinking Behaviour
The Stages of Change Model
Applying the Stages of Change in Brief
Intervention
The Stages of Change and Associated Brief Intervention
Elements
AS+BI – Determining Action
Basic Steps for Zone-based Brief Interventions
Effective Elements of Two Additional
Brief Intervention Models—Frames & Flags
Session 7: BRIEF INTERVENTION PRACTICE SKILLS
Reflection on the Use of Brief Interventions—Group
Activity No. 5 (continued)
Brief Intervention Practice—Group Activity
6
Feedback from Role Plays
Concluding Reflections on Screening
and Brief Intervention
Session 8: REFERRAL AND PATHWAYS TO CARE
Veteran Specific Counselling Services
Department of Veterans’ Affairs
Referral Sources for State-based Alcohol
Treatment Services
Web-based Information Services
APPENDICES
Appendix A Review of the AUDIT QuestionnaireAppendix B Review of Brief Intervention
Appendix C AUDIT: Interview Version
Appendix D AUDIT: Self-Report Version
Appendix E Standard Drinks Comparison Chart
Appendix F The Drinkers Pyramid
Appendix G Quick Tips For Changing Your Drinking
Appendix H Brief Intervention Case Studies for Community Nurses
Appendix I Basic Scripts for Screening and Brief Interventions
Appendix J Effective Elements of Two Brief Intervention Models – Frames and Flags
Appendix K Key Ideas Underlying Motivational Interviewing
Appendix L ICD-10 Criteria for the Alcohol Dependence Syndrome
Appendix M DSM-IV Criteria for Alcohol Dependence
Appendix N Drink Diary
Appendix O Short Alcohol Dependence Data questionnaire (SADD)
ABOUT THIS MANUAL
This manual has been developed as a training tool for teaching the skills of alcohol screening and brief intervention to those who deliver front line services to the veteran community and who are in a unique position for early and appropriate intervention for alcohol use. It is also intended to be used as a resource manual for continuing reference by service providers as part of their skill development for alcohol intervention.
The manual will be one of a range of resources being developed as part of the Australian Government Department of Veterans’ Affairs (DVA) Alcohol Management Project. For example, The Australian Centre for Posttraumatic Mental Health (ACPMH) has been contracted to develop clinical guidelines for alcohol treatment including problem drinking, alcohol dependence, relapse prevention and the treatment of alcohol with co-occurring mental health disorders such as PTSD. These guidelines along with other information leaflets and self-help resources will be available by the end of 2002.
The manual is divided into eight sections each of which represents a session of the training. Session One gives a background and context for the course, while Sessions Two, Three, Four and Five provide relevant information on alcohol, screening and the use of AUDIT. Sessions Six and Seven explain brief intervention and its practice and Session Eight provides information on the pathways to care for veterans with alcohol problems.
This manual should be read in conjunction with the World Health Organisation primary care manuals for AUDIT and Brief Intervention. Other primary sources to be acknowledged include:
Brief Interventions and Brief Therapies for Substance Abuse, Treatment Improvement Protocol (TIP) No 34. US Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Centre for Substance Treatment, 1999.
A Guide to Substance Abuse Services for Primary Care Clinicians, Treatment Improvement Protocol (TIP) No 24. US Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Centre for Substance Treatment, 1997.
Australian Alcohol Guidelines: Health Risks and Benefits. National Health and Medical Research Council (NH&MRC), Commonwealth of Australia, 2001.
Diagnosis and Management of Alcohol Misuse, a Guide for General Practice in Australia. Alcohol Pharmacotherapy Forum, Sydney, 2001.
Effective Brief Intervention, a Resource Manual for Health Professionals in the Early Identification of Alcohol Problems. ACT Alcohol and Drug Service, 1997.
Key Principles and Practices Vol. One, Clinical Treatment Guidelines for Alcohol and Drug Clinicians. Turning Point Alcohol and Drug Centre Inc., 2000.
A Study of Alcohol Use among the Australian Veteran Community: Stage 1. Elliott & Shanahan for the Alcohol Management Project, Commonwealth Department of Veterans’ Affairs, 2002.
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