The Systematic Development and Pilot Randomized Evaluation of Counselling for Alcohol Problems, a Lay Counselor‐Delivered Psychological Treatment for Harmful Drinking in Primary Care in India: The PREMIUM Study
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BACKGROUND: Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems (CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India. METHODS: CAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment. RESULTS: CAP is a 3-phase treatment delivered over 1 to 4 sessions based on a motivational interviewing (MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem-solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol-dependent patients and the extension of the delivery settings to include home-based delivery. There was preliminary evidence of the effectiveness of CAP. CONCLUSIONS: CAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India.
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Most commonly, psychotherapy or counseling interventions used MI techniques or cognitive behavioral therapy (CBT).
“Most commonly, interventions used MI techniques [22,23,61,69,72,83] or cognitive behavioral therapy (CBT) [53,64,68,77,78,87].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [69]
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- Authors
- Nadkarni, A., Velleman, R., Dabholkar, H., Shinde, S., Bhat, B., McCambridge, J., Murthy, P., Wilson, T., Weobong, B., & Patel, V.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Sangath (IN)
- Parivartan Satara India
- National Institute of Mental Health and Neurosciences (IN)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Patel, Vikram
- ORCID
- Venue
- Alcoholism: Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2015-02-19
- Volume
- 39
- Issue
- 3
- Pages
- 522-531
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- PMC
- PMC4862032
- OpenAlex
- W2047912216
- Cited by
- 59
- References
- 39
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 10 · 2018: 3 · 2017: 5 · 2016: 6 · 2015: 1
- FWCI
- 3.92
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- The University of Bath Online Publications Store (The University of Bath) (submittedVersion)
- Pure (University of Bath) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (091834/Z/10/Z)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- hazardous drinking, lay counselors, primary care, motivational interviewing, treatment development, acceptability, feasibility, relapse prevention, alcoholism, men, treatment gap, low- and middle-income countries
- MeSH terms
- Alcohol Drinking, Alcoholism, Counseling, Female, Humans, India, Male, Patient Acceptance of Health Care, Pilot Projects, Primary Health Care, Random Allocation, Treatment Outcome
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