Counselling to help young people with drinking problems may have limited benefit

Counselling techniques used to help young people with drinking problems may be of limited benefit, a new study suggests. In a systematic review published in The Cochrane Library, researchers found that an approach known as motivational interviewing did not substantially reduce drinking or alter alcohol-related behaviour.

Globally every year, around 320,000 young people between the ages of 15 and 29 die as a result of alcohol misuse. Most of these deaths are due to car accidents, murders, suicides or drowning. Motivational interviewing is a counselling technique developed in the 1980s that is sometimes offered to people with alcohol problems. It aims to help them overcome ambivalence and change behaviour. Counsellors listen, adopt a non-judgemental, non-confrontational stance and provide support to change by highlighting the negative consequences of drinking.

The researchers reviewed evidence from 66 trials involving a total of 17,901 young people aged 25 and under. Many of the studies recruited young people who were at high risk of alcohol related problems. In 49 trials, those involved attended one individual session. In the others, they attended group sessions or a mixture of group and individual sessions. Four months later, participants who underwent counselling had only slightly reduced the amount they drank and how often they drank compared with people who were untreated. On average participants who had counselling had about 1 and a half fewer drinks per week compared to those who had no counselling (12.2 drinks compared with 13.7). The effect of counselling on the number of drinking days was also very small: 2.57 days per week compared to 2.74 in untreated people). Participants also slightly reduced their maximum blood alcohol levels from 0.144% to 0.129%, but their average blood alcohol levels did not change. Motivational interviewing had no effect on alcohol-related problems, binge drinking, drink-driving and other risky behaviours related to alcohol.

"The results suggest that for young people who misuse alcohol there is no substantial, meaningful benefit of motivational interviewing," said lead researcher David Foxcroft, who is based at the Faculty of Health and Life Sciences at Oxford Brookes University in Oxford, UK. "The effects we saw were probably too small to be of relevance to policy or practice."

The young people involved in trials included university and college students, army recruits, prisoners and young people attending healthcare centres, youth centres and job centres. "There may be certain groups of young adults for whom motivational interviewing is more successful in preventing alcohol-related problems," said Foxcroft. "But we need to see larger trials in these groups to be able to make any firm conclusions."

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