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Brief Interventions
Frequently Asked Questions (FAQ’s)
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Brief Intervention Pathway
(click here for diagram)
What are they?
The term 'brief intervention' means an intervention that takes very little time; it can be as brief as 30 seconds and may be only one opportunistic session.
Brief Interventions involve opportunistic advice, discussion, negotiation or encouragement. The interventions vary from basic advice to more extended, individually-focused attempts to identify and change factors that influence health status.
Brief Interventions are motivational; they involve supporting people to change behaviour. Recipients of brief interventions will be at various stage of ‘readiness to change’. (top of page)
Examples of brief interventions
- Getting a person who is at risk of developing diabetes to talk about the food they usually eat, offer healthy eating advice, discuss practical ways to change what they eat
- Showing videos that give suitable information and messages about healthy eating. Taking an opportunity to ask the viewer if he or she wants to talk about the information in the video
Why use them?
You are providing an opportunity for individuals to be able to explore their lifestyle habits, which can impact negatively on their health.
Brief interventions do work. Research shows that a brief intervention can help people decide to change their health behaviours.
Brief interventions are acknowledged to be cheap, easy and effective. Brief interventions are accepted and used as an effective tool for a range of health issues. (top of page)
How do I carry out a Brief Intervention?
Follow the Brief Intervention Pathway – The 4 A’s: Ask, Assess, Advise, Assist (click here for more information)
Before considering how best to help people, it is worth taking a look at what typically happens when people change their behaviour. Change was described by Prochaska and DiClemente (1986) in their ‘stages of change’ model. (Click to see the ‘Stages of Change’ model)
The model is used for matching interventions with a person's readiness to take on information and make changes. (see associated chart) (top of page)
What is my role and what isn’t my role?
Your Role |
To provide opportunistic advice |
To be enthusiastic about the benefits of change |
Identify the state of readiness to change within the individual and respond accordingly |
Select the most appropriate information about services that are available locally |
Referral – have the relevant telephone numbers and info readily available. |
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Not your Role |
To give detailed specialist knowledge to clients |
To assist an individual from the referral through the specialist programme, or to monitor ongoing outcomes |
To prescribe any specialist intervention products |
To act as a Counsellor or to address other personal issues |
To tell a client what to do and to set goals for them |
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When would I carry out a Brief Intervention?
Firstly, the appropriate timing to carry out the intervention is important – the physical setting and emotional setting needs to be right e.g. approach the subject with sensitivity in a quiet, confidential area of the workplace.
Although brief interventions are opportunistic, there are times when people may be reflecting on their lives and considering change.
Significant events or transition points in people’s lives present an important opportunity for intervening at some or all of the levels, because it is then that people often review their own behaviour and contact services. Typical transition points include: leaving school, entering the workforce, becoming a parent, becoming unemployed, retirement and bereavement. (NICE, 2007) (top of page)
When wouldn’t I carry out a Brief Intervention?
- When the person doesn't wish to participate in the brief intervention process
- When a person is in a highly emotional state
- When a person is too sick or injured to share information
- When a person is drunk or intoxicated on any other drug.
Help! I need some tips
Useful opening strategies
What not to do
Traps to be cautious of when carrying out Brief Interventions
Useful opening strategies
Doing brief interventions requires good communication skills. It is important to:
- Listen to what people say
- Notice what they do not say
- Watch what they do
- Think about their situation
- Think about what you know about them
- Talk with them in a way which is not threatening
If you do not feel confident about doing interventions in your daily work, first practise in situations where you feel comfortable. Practise will build confidence and skills. (top of page)
What not to do
It’s important not to:
Be warning or threatening
Give advice, give suggestions, or provide solutions
Persuade with logic, or argue
Be moralizing, preaching, lecturing (e.g. you should/ought)
Be judging, criticizing, disagreeing, or blaming
Be distracting, changing the subject or humouring (top of page)
Traps to be cautious of when carrying out Brief Interventions
- Question/answer trap – The health-care worker and individual fall into a pattern of question/answer, question/answer, and so on. It tends to close off access to deeper levels of the individual’s ‘unhealthy’ experience and the individual-worker relationship may become increasingly hierarchical.
- Confrontation/denial trap – If an individual is not yet ready to change, they may provide a reasonable argument in response to every statement the worker makes. The worker and individual then engage in an argumentative, confrontation/denial trap, in which the individual counters each argument for changing behaviour with an argument for remaining the same. Rather than trying to convince the individual to change, you should try to encourage the individual to voice the reasons for change, with just a little questioning and guidance.
- Expert trap – Workers fall into providing direction to the individual without first helping the individual to determine their own goals, direction and plans to change their health behaviour. Therefore, the individual may tend to passively accept the worker’s suggestions, and may only half heartedly commit to the difficult work involved in changing. In this case, try to offer suggestions for change, at the individual’s request and when their motivation is high.
- Premature Focus trap – The worker should not just simply follow the individual’s lead, focusing too quickly on a specific problem is not recommended. Difficulties with premature focus include raising individuals resistance and focusing on an unimportant or secondary problem.
- Blaming trap – Workers may feel compelled to show the individual how they are at fault for not being able to change their behaviour, this is not seen as useful. Blame is irrelevant and a “no-fault” policy should be established. The following comment is seen as suitable: “I’m not interested in looking for whose responsible, but rather what’s troubling you, and what you might be able to do about it”. (top of page)
Where I can get more information about Brief Interventions
- www.motivationalinterview.org - This is the principal international website for information on motivational interviewing. It provides a comprehensive bibliography of published research, and much other related information and reading material.
- www.stephenrollnick.com – This is an on-line discussion forum designed for practitioners who have some motivational interviewing training and wish to explore, with others, their attempts at implementing what they have learnt.
- www.mi-campus.com – A new web-based learning and practise development initiative.
- William R. Miller & Stephen Rollnick (2002) Motivational Interviewing: Preparing People for Change (2nd Edition) Guildford Press: New York
- Stephen Rollnick, William R. Miller & Christopher Butler (2007) Motivational Interviewing in Health Care Guildford Press: New York
For more information, please contact;
Gemma Baker
Brief Intervention Officer
Health Promotion Service
Kernow Building
Wilson Way
Pool
Redruth
TR15 3QE
Tel: (01209) 313419
Fax: (01209) 314491
E-mail Gemma Baker
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