A brief intervention for screened problem drinking in an employee assistance program.

摘要

Alcohol-related problems are costly and are often undetected and undisclosed in employee assistance programs (EAPs). Screening and brief interventions (SBI) utilizing a motivational interviewing style have been shown to reduce substance use in a variety of settings, yet little research has been conducted in the EAP.The current study examined the effectiveness of a SBI for problem drinking in the EAP. The primary aims were to (1) increase identification of problem drinking among EAP clients through a health screen, (2) evaluate the effectiveness of a brief intervention (BI) compared with EAP services-as-usual (SAU) in reducing alcohol consumption, alcohol-related consequences, and work consequences, and (3) evaluate gender and readiness to change as moderators to treatment effectiveness.Clients (N=1197) were screened prior to the first EAP session using the AUDIT-C. The AUDIT-C was effective in identifying 56% of clients for problem drinking. Of those eligible, 135 (27.5%) consented to study participation and were assigned to therapists based on the first available appointment available. Therapists (N=9) were stratified, and then randomly assigned to either the BI or SAU study condition.Participants in the final analyses consisted of 69 (38 BI, 31 SAU 68% women) EAP clients that completed three-month follow-up. Participants in the BI group had significant reductions in alcohol-related consequences, peak BAC, and absenteeism at follow-up, while participants in the SAU group had increases in these variables over time. The BI showed a stronger effect for men. Men in the BI group had greater reductions in alcohol-related problems compared with women in the BI group. Readiness to change also moderated treatment outcome such that participants in the SAU group with higher readiness had decreased peak BAC at follow-up, while SAU participants with lower readiness had increased peak BAC. Both groups showed decreases in drinks per week, AUDIT total scores, drinks per occasion, and work performance impairment over time. Satisfaction ratings were high and did not differ by group. Results support the integration of screening and brief intervention within existing EAP services as a low-cost and effective method of identifying and intervening with clients with problem drinking.