A brief intervention to help reduce the harm of alcohol consumption

by Helen Ginman on July 4, 2024

Cube letters spelling Harmless or Harmful

Evidenced-based conversations for everyone

Whether you are a healthcare professional, social support worker, carer, librarian, manager, or retail assistant, we all play a critical role in helping people to live healthier lives.

Engaging in evidence-based conversations about alcohol can guide people towards healthier choices and reduce the overall harm of alcohol use. This blog outlines an evidence-based approach with practical tips to have effective conversations about alcohol consumption.

Understanding the risks

Screenshot 2024 07 04 121453

There are no completely safe levels of drink – all and any amount of alcohol consumption carries risk (WHO, 2023). The national guidelines recommend drinking no more than 14 units a week (equivalent to 6 medium glasses of wine or 6 pints of beer), and sticking to these guidelines lowers the risk of harm. Many of us (58%) consume alcohol within these recommendations. However, 22% of the population regularly drink more than the recommended guidelines, significantly increasing the risk of harm.

Alcohol has far-reaching impacts, affecting our health and wellbeing on a daily basis, from harming our quality of sleep and encouraging engagement with riskier behaviours, to affecting the relationships we hold with others. Alcohol misuse is the biggest risk factor for death, ill-heath and disability amount 15-49 year- olds in the UK and the fifth biggest risk factors across all ages (Alcohol Change, 2024). It is a causal factor in more than 60 medical conditions, including mouth, throat, stomach, liver and breast cancers, high blood pressure, cirrhosis of the liver and depression (Alcohol Change, 2024).

The power of opportunistic conversations

Picture3

There are millions of interactions about health and wellbeing happening all over the country, every single day. One of the most effective ways to encourage positive behaviour change is through these opportunistic conversations. These brief discussions can be effective because:

  • They can incorporate behaviour change theory, providing a structured approach to guide individuals towards positive lifestyle changes.
  • They use evidence-based approaches, ensuring a grounding in scientific research of what works!
  • They typically occur in a trusted setting where individuals are more likely to be receptive to health and wellbeing conversations.
  • They develop and provide timely interventions that can lead to immediate and actionable changes.

Leveraging these moments can significantly impact individual’s lifestyle choices and overall health.

You don’t need to be an expert in alcohol to have these types of conversations. The key is to use the opportunity to encourage and motivate someone to change, and then provide them with information about how to go about it.

What does the evidence say?

Picture4

There is strong evidence that suggests brief interactions and discussions such as these can help reduce alcohol consumption and the risk to health and wellbeing (GOV.UK, 2020)

Evidence-based conversations see individuals reduce their alcohol intake by 4-5 units per week (Kaner et al, 2009).

Setting yourself up for success

For any conversation about health and wellbeing, there are a few essential skills you need at your disposal, so you are armed and ready to optimise those opportunistic conversations.

  • Resisting the Righting Reflex – Challenge that instinctive desire to provide a solution to the person’s challenges. Whilst this impulse comes from a place of care and concern, it can often lead to push back and disengagement from the individual. Change is also more likely to occur when someone develops their own solution or way forward.
  • Empathy – See the world through the person’s eyes – avoid jumping to conclusions, refrain from sharing opinions, use listening skills to help the person feel heard and validated.
  • Open Discovery Questions – Use questions that begin with WHAT and HOW, helping to remove judgement, enabling you to act with curiosity and allowing the individual to guide the conversation.
  • Affirmations – Recognise and acknowledge the small steps someone is making, helping them to overcome self-doubt and feel supported regardless of the point they are at on their journey,
  • Reflections – Reflect by repeating or paraphrasing what the person has said – helping the person to make sense of what they are feeling. When someone expresses a strength or intention, or a commitment and we repeat it back to them, they hear it twice.
  • Summaries– Periodically summarising what has been said – showing the person you are listening and hearing them.

Once you have these tools in your toolbox, you can bring them together into an effective framework that can help to guide your conversations.

A simple technique

Picture1

Evidence-based conversations about alcohol consumption that are grounded in scientific research, can be crucial for:

  • Identifying people who might be at risk of alcohol-related harm.
  • Providing tailored advice and support.
  • Encouraging healthier behaviours and reducing overall alcohol consumption.

The 3 A’s – Ask, Assess, Assist, provides a structured framework that helps guide the conversation in a meaningful way and can be easily incorporated into those daily opportunistic conversations. Conversations using this approach can last anywhere between 30 seconds and 3 minutes – the idea is they are brief!

Ask

Start by asking the person what they already know about alcohol consumption and the risks, or ask for permission to discuss the topic.

Example: What do you know about the risks of drinking alcohol?

Or

Example: Would it be okay if we talked about that (alcohol) a bit more?

Asking for permission, or asking what is already known empowers the individual to take control of the conversation. If the person says they don’t want to talk about it, we respect that and do not continue.

Assess & Advise

This is the main part of the conversation, and we can use this time to explore what the person wants to change, how much they want to change and what resources they have to change.

Example: It sounds like you may be interested in making some changes to your drinking. What would you like to change?

Or

Example: What do you think stops you from drinking less?

There are lots of opportunities here for affirmations, reflections and summaries. If the person says they don’t want to talk about it, we respect their decision and do not continue.

Assist

This final part creates the opportunity to provide further support to help people with behaviour change and reduce their alcohol intake. Here, you can signpost people to relevant local or national services, information and support.

Example: There’s a useful tool to understand the risk of drinking habits, would you like me to give you the details?

Or

Example: There is a local service for people who are thinking of cutting down their drinking. They can provide information and tips and different types of support, depending on what you feel you need. Would you like the information?

Putting it into practice

If you are new to this, it might seem quite daunting, but sometimes the best way to learn is by doing – so give it a try! Brief conversations do take practice. Embrace the opportunity to develop and refine your skills.

By engaging in evidence-based conversations, you can help people reduce their risk of alcohol-related harm and achieve healthier lifestyles.

Where can I get further information?

Sign-up to our newsletter and gain access to Healthy Dialogues resources and training.

Newsletter

For further advice and guidance on having effective conversations to reduce the risk of alcohol harm, as well as some example conversations, take a look at this online toolkit developed by Healthy Dialogues – Toolkit to support alcohol behaviour change | Healthy Surrey

Useful resources

Find out more about Alcohol Awareness Week here – About Alcohol Awareness Week | Alcohol Change UK

Alcohol