David Brown PhD and Wayne Skinner MSW have developed a person-centred guidebook for supporting individuals who are trying to reduce their alcohol intake entitled: Going Forward: First Steps in Changing Your Relationship with Alcohol. It is published by Pathways Research in Winnipeg. They briefly describe their new resource below.

Alcohol use is a major determinant of health problems experienced by Canadians and places a heavy burden on health care systems. The largest share of this burden is associated with alcohol’s toxicity leading to FASD as well as illness and death due to preventable diseases such as cancers, stroke, and diabetes. The next largest share of health harms and costs is tied to alcohol’s capacity for impairment leading to injuries and death due to accidents and violence during intoxication.

The adverse consequences of alcohol’s toxicity and impairment properties are independent of it being potentially addictive. Most people who will die this year from alcohol-related diseases or injuries will not meet criteria for a severe alcohol use disorder. They will simply have had patterns of alcohol use frequency and quantity beyond quite low levels identified in evidenced-based guidelines. For example, a woman’s risk for breast cancer increases dramatically over time with every additional drink per average week.

Brief Interventions 

We can help people reduce their alcohol use when they come to us for care in our communities, primary care clinics, and counseling programs, even if alcohol use is not their reason for seeking help. A large body of international research over the past decades tells us that we can offer people help in reducing their drinking through brief intervention counseling. The evidence indicates that these interventions can result in positive outcomes while being cost-effective and efficient to deliver.

Brief interventions typically involve a few sessions of about 20-60 minutes each, separated by two or three weeks during which the patient or client works on reaching their chosen change goals. The counseling during these sessions takes the form of a compassionate dialogue grounded in principles of motivational interviewing (MI) and cognitive behavioural therapy (CBT). Critical to the process is giving the person space to assess their alcohol use and make their own behavioural change choices.

The Guidebook

We developed the guidebook to complement brief intervention counseling. It was designed to integrate closely with the therapeutic approach described above, in a way that has the potential to strengthen both modalities. The guidebook leads the user through a 6-week process of self-reflection and assessment of their relationship with alcohol, including invitations to consider their change options, make change plans and monitor change efforts in 2-week periods between counseling visits.

PULSE

The guidebook leads the user through three cycles of a sequence that we refer to as PULSE, an acronym that stands for: Preparing yourself to work on change, Unpacking your experiences with alcohol and prior efforts to change, Learning from your experiences, Selecting change goals from possible options and Empowering yourself to work on change. This corresponds to what we see as the core practitioner PULSE roles in brief intervention: prepare, unpack, listen, suggest and encourage.

Modes of Use

While the guidebook is designed to be used in sync with a counseling process, it can also be used by the person alone. Or it can be used with a mix of both. For example, the client or patient might start out working through the guidebook in close dialogue with their practitioner and then shift to working more independently, always with the option to return to the supportive dialogue. Our work on a problem gambling guidebook suggests that the mixed approach is preferred by many users.

Formats and Copies

The guidebook can be printed as a 52-page booklet or downloaded and used as an interactive digital tool. Copying can be done by us, for a nominal cost, or by your own printing service. As well, a very simple print copy can be made using your office copier, if it has a ‘print booklet’ option. To use it in interactive digital format, each user would download a copy and save it to their own PC or wireless device. They can then open it with Acrobat Reader, a free application.

We can provide technical support or advice for any of the uses mentioned above. A review copy of the guidebook can be downloaded from this link.

Access and Training

We are making the digital version of the guidebook available at no cost to Canadian clinics, community agencies, and counseling programs if they lack funds to purchase this kind of resource. Organizations with funding or from outside Canada are invited to connect with us about options for using the guidebook.

Please contact us before using the guidebook with clients or patients. This enables us to provide formal permission and ensure that you always have the most up to date version. We will continually revise it based on feedback.

We also offer fee-based training and materials on how to most effectively integrate the use of the guidebook with counseling programs and practices. Questions and suggestions on any of the above are always welcome.

If you would like to get in touch with David you can reach him at: dbrown@pathwaysresearch.org.

Related Content  

Found this blogpost interesting? We’d recommend checking out the following webpages:      

• Donate to the FASD Lived Experience Leadership Fund – support people with living experience to participate in research.
• Become a member of CanFASD – be the first to know about the latest FASD news.  
• Foundations in FASD – training course intended for everyone that will come into contact with individuals with FASD.