A new briefing Clarifying alcohol brief interventions: 2013 update [pdf] has been released by the Alcohol Academy. It updates the 2010 briefing to account for new developments in the field and key issues relating to the national implementation effort.
In particular, the briefing paper explores 'IBA lite' or 'minimal brief intervention' - an approach whereby at-risk drinkers are offered only feedback and a leaflet, as opposed to structured brief advice offered as part of IBA. Such 'minimal' or 'lite' approaches appear to have been increasingly popular, in part following the SIPS Primary Care findings which did not show better outcomes for longer intervention approaches.
The appeal of shorter approaches is understandable given the real world challenges for routine IBA delivery, particularly time pressures on busy front line roles. However the briefing cautions that although 'lite' approaches may be easier to achieve, there is a risk that brief intervention will be prematurely reduced to less than it should be. Therefore full IBA approaches, including the offer of verbal brief advice, should be sought wherever possible - but minimal approaches may be acceptable where not.
Another issue is whether shorter screening tools such as AUDIT-C or FAST can be used to lead straight to brief advice without first completing the full AUDIT. Shorter tools do not tend to differentiate risky drinking (suitable for brief advice) from probable dependent drinking (suitable for referral). Again the answer is not clear cut - ideally full AUDIT should always be used, but if time or other issues prevent this there is still likely to be value in using shorter tools alone to lead to brief advice.
The paper includes a table identifying the key brief intervention approaches and differences, now including exploration of 'minimal' or 'lite' approaches. The briefing was co-authored by Professor Nick Heather, Don Lavoie and James Morris.