Who to Target for Brief Interventions?

The effects of Brief Interventions (BIs) on alcohol outcomes are likely to vary between different target groups.

Meta-analyses report age and sex have no impact on alcohol outcomes in adolescent, young adult or adult populations. However, females in university and prison settings have been found to have significantly better alcohol outcomes in several meta-analyses. Research has found differential effects for BIs in some ethnic groups, but the majority of research has been conducted among Caucasians in first world countries.

Only one meta-analysis has examined whether the effects of MI delivered across multiple settings varied by help seeking status. No differences in the effects of MI compared to no treatment were found. MI was more effective than active treatments in one study of treatment seekers, compared to six studies of non-treatment seeking samples. More recent studies have not examined the influence of help seeking status on MI outcomes, as help-seeking status tends to vary by the setting the MI is delivered in.

There has been debate about whether BIs are effective among people with more severe alcohol use and dependence. While some early trials excluded people with dependence, more recent studies have typically not measured dependence and only used a minimum inclusion threshold for alcohol consumption with no upper limit for exclusion. This means people with alcohol dependence have likely been included in these studies. As a result, it remains unclear if the impact of BIs differs among people with high levels of risky alcohol use and/or dependence. Nevertheless, existing research suggest that MI may be more effective than no treatment for reducing alcohol use among young people and adults, regardless of the severity of their alcohol use. Consistent with stepped care models of care, more intensive treatment should be offered if this is clinically indicated (e.g. presence of alcohol withdrawal symptoms) or they do not respond.