What are the Key Components of Brief Interventions?

There is considerable variability in the content and length of brief interventions. The majority of brief interventions contain screening, feedback, information and MI strategies. There are a number of frameworks with comparable structures which can be used to guide the delivery of a brief intervention including: FLAGS (feedback, listen, advice, goals, strategies; see Table 6.1), FRAMES (feedback, responsibility, advice, menu, empathy, self-efficacy; see Table 6.2). The treatment context and clinical skills of workers are key determinants of which components are delivered.

TABLE 6.1: FLAGS

Feedback	Provide individualised feedback about the risks associated with continued drinking, based on current drinking patterns, problem indicators, and health status. Discuss the potential health problems that can arise from risky alcohol use.
Listen	Listen to the patient’s response. This should spark a discussion of the patient’s consumption level and how it relates to general population consumption and any false beliefs held by the patient.
Advice	Give clear advice about the importance of changing current drinking patterns and a recommended level of consumption. A typical five to 10 minute brief intervention should involve advice on reducing consumption in a persuasive but non-judgemental way. Advice can be supported by self-help materials, which provide information about the potential harms of risky alcohol consumption and can provide additional motivation to change.
Goals	Discuss the safe drinking limits and assist the patient to set specific goals for changing patterns of consumption. Instil optimism in the patient that their chosen goals can be achieved. It is in this step, in particular, that motivation-enhancing techniques are used to encourage patients to develop, implement and commit to plans to stop drinking.
Strategies	Ask the patient to suggest some strategies for achieving these goals. This approach emphasises the patient’s choice to reduce drinking patterns and allows them to choose the approach best suited to their own situation. The patient might consider setting a specific limit on alcohol consumption, learning to recognise the antecedents of drinking, and developing skills to avoid drinking in high-risk situations, pacing one’s drinking and learning to cope with everyday problems that lead to drinking.

TABLE 6.2: FRAMES

Feedback	Provide feedback about the patient’s AOD use and related-problems, and the risks associated with them, as well as general information about AOD related harm. Feedback can include a comparison between the patient’s AOD use and population norms.
Responsibility	Acknowledge the patient is responsible for their own behaviour and that they can make choices about their AOD use.
Advice	Provide clear advice about the current and future potential harms associated with continued AOD use.
Menu	Provide the patient with a range of alternative strategies to choose from to help them cut down or cease AOD use. Examples include: AOD use monitoring, engaging in alternative activities instead of AOD use, identifying high risk situations and strategies to avoid them, providing other self help resources.
Empathy	Deliver the brief interventions using a warm, empathic and understanding approach.
Self-efficacy	Build the patient’s confidence in their ability to make a positive change in their AOD use.