Effectiveness of a Feedback-Based Brief Intervention to Reduce Alcohol Use in Community Substance Use Disorders Treatment

Abstract

Feedback brief interventions for alcohol use problems have been highly effective with undergraduate populations. However, there has been little research on the effectiveness of administering feedback alone to community treatment populations. The goal of the current study was to assess the effectiveness of a feedback brief intervention in a community treatment setting with patients characterized largely by dependence on alcohol and drugs, ethnic diversity, and low socioeconomic status. It was hypothesized that pre-treatment brief individualized feedback would reduce alcohol consumption and increase participation in subsequent treatment for a substance use disorder (SUD). Participants were recruited from a public hospital’s SUD clinic. After the intake but prior to entry into the treatment as usual, 121 participants were randomized to receive personalized feedback or a condition without feedback. Eighty-seven participants completed post-intervention follow-up interviews and were included in the final analyses. Repeated measures ANOVAs and MANCOVAs were used to examine variables obtained from the Addiction Severity Index (ASI; McLellan et al., 1992) of drinking quantity and frequency, and motivation for treatment. Results indicated that personalized feedback delivered no benefit beyond that of pre-treatment assessment procedures (phone screening and intake interview) alone. Intervention conditions did not differ on other outcomes at follow-up, including days of heavy drinking, motivation for treatment, or drug use frequency. Therefore, feedback-based brief interventions may be not helpful in reducing the drinking frequency and intensity of individuals presenting to community-based substance use treatment.

Six Month Outcomes of a Peer-Enhanced Community Reinforcement Approach for Emerging Adults with Substance Misuse: A Preliminary Study

“…Community-based non-profit treatment centers treat clientele who are less educated and have more risk factors that are associated with poorer alcohol use treatment outcomes (Worden & McCrady, 2013). EAs obtaining little postsecondary education have higher substance use (Oesterle, Hawkins, & Hill, 2011; Thompson, Stockwell, Leadbeater, & Homel, 2014) and college attendance is associated with both treatment retention and completion (Sahker, Acion, & Arndt, 2014).…”

“…First, studies were located on college campuses, so it is unclear if findings would replicate with EAs treated in off campus community agencies. As noted above, publicly funded treatment agencies typically serve individuals with higher psychiatric comorbidity, lower socioeconomic status, higher unemployment and lower college attendance, as well as other risk factors (e.g., residential instability) that may moderate treatment effectiveness (Worden & McCrady, 2013). Second, although Tevyaw et al (2007) reported significant post-treatment reductions in peer drinking, this study used a short follow up period (i.e., one month).…”

Brief intervention to reduce hazardous drinking and enhance coping among OEF/OIF/OND veterans.

“…beneficial effect (Martens, Smith, & Murphy, 2013;Worden, & McCrady, 2013). The VAMC system does provide brief advice in primary care for veterans who screen positive on the AUDIT, although this is not typically presented with detailed personalized feedback.…”

Normative Feedback and Adolescent Readiness to Change

“…So, it is plausible that this treatment component may be working against the other curative active ingredients when included in MI interventions, and there are anecdotal concerns that this may be more prominent for adolescents. Second, there are important contextual variables that may diminish the effectiveness of NF with adolescents, as brief feedback interventions have rarely been tested in public not-for-profit settings serving racially diverse clients with higher psychiatric comorbidity (Worden & McGrady, 2013). One particular problem with using NF with racial minorities is that they may not believe that norms are specific to their group.…”

“…Also, this pilot study provides preliminary information on whether the study question warrants additional attention and can inform power analyses for future trials. Finally, we also note the importance of replicating work in this area with a sample of adolescents seen in public not-for-profit settings that are known to serve racially and socioeconomically diverse clients with high psychiatric comorbidity (Dennis, White, & Ives, 2009; Worden & McGrady, 2013). As there is no data to guide hypotheses for adolescent samples, we refrained from making directional hypotheses about how NF would impact RTC, treatment satisfaction, or client-perceived quality of MI.…”