How simple, innovative practices can support people to reduce their alcohol use
Alcohol is a Problem
It’s a truism that people in Ireland know all too well: alcohol is prevalent, and it’s a problem, particularly among young people (1,2). There were only 8,366 cases of people treated for problem alcohol use in Ireland in 2012. Based on the estimate by the National Institute for Health and Care Excellence that only 6% of people aged 16–65 years who are alcohol dependent receive treatment (3), there may be over 130,000 people needing support to reduce or stop alcohol use in Ireland who are not receiving it.
There were days I didn’t want to go in and I’d stay in bed. We’d get a call asking if we’re ok and if we were coming in, and then you’d go in.
(ARC Participant)
Community Supports
There is no ‘one-size fits all’ solution for alcohol problems. For many people successful programmes such as Alcoholics Anonymous and residential centers are not suited to their needs.
We did research with the staff and clients of Addiction Response Crumlin, a local community based programme, where people are free to set their own goals, free of judgment, and receive practical support to reduce their alcohol use.
The results were impressive: the 10-week programme had a 77% retention rate, almost all participants reduced their alcohol use with most showing significant reductions. To illustrate this, before the programme, 63% of participants drank every day; after the programme, no participant drank every day.
Why was it So Successful?
Most of the participants said that the following things were particularly important for them:
Accessible Programme: the organisation and the staff ‘spoke their language’ and met them at a level.
Flexible Goal Setting: There was no requirement to become alcohol free. Despite this, most people became alcohol free anyway.
Filling the Void: Considerable time was spent exploring how to socialize and fill time, without alcohol.
Facilitator’s Warmth: All participants said that they felt welcomed, accepted, cared for, appropriately challenged and did not feel judged.
Facilitators Going the Extra Mile: Facilitators gave their work mobile numbers and told the participants to call them any time the service was open. Most participants called facilitators outside of normal programme hours for additional support. Facilitators also made non-judgemental calls to check on participants if they were late, which encouraged them to make it in.
Breakfast: 100% of participants felt that breakfast was a very important part of the programme. Participants said that that prior to the programme, they would habitually drink first thing in the morning and that having breakfast in ARC helped them to change this habit.
Kindness and Breakfast
The results of this research reveal success factors that are more than instinctively effective; the model is based in evidence. The programme was based on an adapted version CBT programme ‘Reduce the Use’ developed by the SAOL project. Gary Broderick, Manager of the SAOL Project notes:
Miller notes that fundamental aspect of Motivational Interviewing is the therapeutic alliance and engagement. We cannot just walk straight up to someone and ask intimate, possibly dangerous personal questions.
How and when do we get permission to do that? .How can we communicate respect and understanding? The phone calls and reminder phone calls, the check in at every group, getting good biscuits in… that’s vital. We want to create a sense that this is a special group and a group that deserves kindness. When you’re asked by someone who is kind and accepting, it’s a completely different experience.
To see the full report: Choose to Change
1. National Advisory Committee on Drugs and Public Health Information and Research Branch. Drug use in Ireland and Northern Ireland. Alcohol consumption and alcohol-related harm in Ireland: 2010/2011 Drug Prevalence Survey. Bulletin 7. Dublin: NACD and PHIRB.
2. World Health Organisation. European Status Report on Alcohol and Health. WHO: Copenhagen; 2010.
3. NICE Clinical Guideline 115. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence.
