A randomised controlled trial of personality risk-targeted coping skills training for young people with alcohol related-illnesses/injuries

Introduction and Aims: The efficacy of brief motivational interviewing (MI) interventions for reducing alcohol use and related-harm in young people been questioned, following a series of meta-analyses. The efficacy of personality-targeted copings skills training interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This randomized controlled trial determines if MI enhanced with PI s more efficacious than MI alone or an assessment feedback/information (AFI) only control.

Method: Participants were 398 young people accessing an emergency department (ED) or rest-recovery service with an alcohol related injury/illness in Brisbane, Australia. Young people were randomized to receive (i) 2 sessions of MI; (ii) 2 sessions of PI or (iii) 1-session of AFI. Participants were followed up at 1, 3, 6 and 12 months (80% retention). The primary outcomes were total drinking days, mean standard (10 grams of alcohol) drinks/drinking day and total standard drinks in the past month and alcohol-related problems in the past 3 months

Results: Reductions in alcohol use and related problems were seen across the sample at all post-baseline assessments. Significantly greater reductions in total standard drinks were found in the PI group compared to the MI and AFI groups at 1 month follow up. At 12 months, this effect was maintained and was joined by differential effects on drinking days. PI also resulted in greater reductions in drinks/drinking day than AFI at 12 months. MI only had slightly better effects than AFI on drinking days at 6 months. No between group differences in alcohol-related problems were found

Conclusion: PI had stronger effects on the alcohol consumption than AFI or MI at 1 month, and effects are well maintained to 12 months. Telephone-delivered brief interventions appear acceptable to young people with alcohol related injuries/illness accessing EDs or rest-recovery services. All three brief interventions resulted in reductions in alcohol-use and related-harm, but the addition of coping skills training targeted at personality risks appears to enhance the efficacy of AFI and MI.