Toward an Understanding of the Effective Mechanisms of Alcohol Brief Interventions
Toward an Understanding of the Effective Mechanisms of Alcohol Brief Interventions
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DOI：
10.1111/acer.12336
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发表时间：
2014-03-01
影响因子：
3.2
通讯作者：
Heather, Nick
中科院分区：
文献类型：
--
作者：
Heather, Nick
关于酒精短暂干预的有效机制的研究一直被忽视，但Bertholet及其同事在重新分析来自3项简短动机访谈（BMI）试验的综合数据时提供了此类研究的一个例子。然而，令人失望的是，在一个精心设计和进行良好的分析，很少支持被发现的高度合理的假设有关的治疗过程的干预结果。有人认为，在这里，因为BMI必须假设工作，增加客户的动机，以减少饮酒，一些措施的整体动机之前和之后的干预是必要的，以阐明治疗过程转化为积极的结果的途径。在罗素及其同事关于医生戒烟建议的开创性研究中，有可能区分干预是否通过激励更多人尝试戒烟，通过增加那些尝试戒烟者的成功率，或通过减少戒烟者的复发率。建议在关于酒精短暂干预如何起作用的研究中采用类似的措施。治疗过程和结果之间关系的进一步考虑是个人是否依赖酒精，这让人想起文献中关于在预测戒烟时应给予动机或依赖变量的相对优先权的争议。为了提高酒精短期干预的有效性，未来的研究应更多地关注行为改变的有效机制。
Research on effective mechanisms of alcohol brief interventions has been neglected, but Bertholet and colleagues provide an example of such research in a re-analysis of combined data from 3 trials of brief motivational interviewing (BMI). However, it is disappointing that, in a well-designed and well-conducted analysis, little support was found for highly plausible hypotheses relating treatment processes to outcome of intervention. It is argued here that, because BMI must be assumed to work by increasing client motivation to cut down drinking, some measure of overall motivation before and after intervention is necessary to elucidate the pathway by which treatment processes are translated into positive outcomes. In pioneering research on physician advice on smoking cessation by Russell and colleagues, it was possible to distinguish between whether intervention worked by motivating more people to try to stop smoking, by increasing the success rate among those who did try, or by reducing the relapse rate among those who quit. It is recommended that similar measures be employed in research on how alcohol brief interventions work. A further consideration bearing on the relationship between treatment processes and outcome is whether or not individuals are dependent on alcohol and this is reminiscent of a dispute in the literature concerning the relative priority that should be given to motivational or dependence variables in the prediction of smoking cessation. In order to improve the effectiveness of alcohol brief interventions, future research should focus more on effective mechanisms of behavior change.