Discussion of alcohol consequences during a brief motivational intervention session: comparing those who do and do not increase readiness to change

Abstract

The present study was designed to take an inductive, qualitative approach to understanding how discussion of alcohol-related consequences during brief motivational interventions (BMI) relate to readiness to change (RTC) prior to versus at the end of a session. Participants were 34 adults (35% female) recruited from the emergency room and enrolled in a randomized clinical trial of a BMI for risky alcohol use and risky sex. Seventeen participants both began and remained low on RTC over the course of the session. We selected 17 additional participants, matched on demographics, but who increased RTC over the session. Transcripts were qualitatively coded and analyzed separately within groups. Among participants who increased their RTC relative to participants who remained low on RTC by BMI end, evaluation of alcohol consequences as negative was more typical. In both groups, several consequences were neutrally evaluated. Many who remained low on RTC attributed consequences to something other than alcohol and/or minimized consequence severity. Study findings highlight the value for clinicians in eliciting and maximizing the importance of subjectively negative recent consequences to perhaps increase readiness to decrease heavy alcohol use.

Keywords:

• Alcohol consequences
• subjective evaluation
• brief intervention
• readiness to change
• qualitative

Ethical statement

All procedures were approved by the hospital and university institutional review boards. All participants provided informed consent.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 As shown in Table 3, almost all participants reported at least some low perceived risk. However, for those in Increasing RTC, many comments were not specific to consequences of drinking; rather, they were in response to denial that the normative feedback on drinking was accurate, the risks of binge drinking, and/or that their personal typical number of drinks was problematic.

Additional information

Funding

Support for this work was provided by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) grants U24AA022003, R01AA009892, P01AA019072, and K02AA027546. This work was facilitated by the Providence/Boston Center for AIDS Research [P30AI042853]. PM's effort was supported in part by P20GM130414, an NIH Center of Biomedical Research Excellence (COBRE).