Mechanisms of Action of Brief Alcohol Interventions Remain Largely Unknown – A Narrative Review
Open accessAbstract
A growing body of evidence has shown the efficacy of brief intervention (BI) for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings and effectiveness when implemented at larger scale are disappointing. Indeed, BI comprises varying content; exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness. Medline and PsychInfo, as well as references of retrieved publications were searched for original research or review on active ingredients (components or mechanisms) of face-to-face BIs [and its subtypes, including brief advice and brief motivational interviewing (BMI)] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among patients in the emergency room, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such. Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
There is some emerging evidence that motivational interviewing can be more effective than 'traditional' advice across a range of health behaviours, but this is not conclusive.
“Although there is some emerging evidence that motivational interviewing can be more effective than ‘traditional’ advice (based on a provider-centred definition of a problem) across a range of health behaviours,11 this is not conclusive.12”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.51.6.1173 · Cited by 91,542 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
Advances In Experimental Social Psychology
(2022) · Advances in experimental social psychology · doi:10.1016/s0065-2601(22)x0002-6 · Cited by 22,559 · see citing works
The Transtheoretical Model of Health Behavior Change.
Prochaska, J. O., & Velicer, W. F. (1997) · American Journal of Health Promotion · doi:10.4278/0890-1171-12.1.38 · Cited by 7,782 · see citing works
Motivational interviewing: preparing people for change.
Miller, W. R., & Rollnick, S. (2002) · Cited by 7,002 · see citing works
Bem, D. J. (1972) · Advances in Experimental Social Psychology · doi:10.1016/s0065-2601(08)60024-6 · Cited by 5,241 · see citing works
Motivational Interviewing: Helping People Change
Tober, G. (2013) · Alcohol and Alcoholism · doi:10.1093/alcalc/agt010 · Cited by 4,267 · see citing works
Decision making: A psychological analysis of conflict, choice, and commitment
(1978) · Evaluation and Program Planning · doi:10.1016/0149-7189(78)90042-3 · Cited by 3,954 · see citing works
Motivational Interviewing: Preparing People for Change, 2nd ed.
Miller, W., & Rollnick, S. (2003) · Journal For Healthcare Quality · doi:10.1097/01445442-200305000-00013 · Cited by 2,634 · see citing works
(2013) · Cited by 2,393 · see citing works
Toward a theory of motivational interviewing
Miller, W. R., & Rose, G. S. (2009) · American Psychologist · doi:10.1037/a0016830 · Cited by 1,603 · see citing works
Brief interventions for alcohol problems: a review
BIEN, T. H., MILLER, W. R., & TONIGAN, J. S. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00820.x · Cited by 1,577 · see citing works
Glaser, E. (1972) · New England Journal of Medicine · doi:10.1056/nejm197210192871623 · Cited by 970 · see citing works
Hayes, R., & Moulton, L. H. (2009) · Chapman & Hall/CRC eBooks · doi:10.1201/9781584888178 · Cited by 881 · see citing works
Whitlock, E. P., Polen, M. R., Green, C. A., Orleans, T., & Klein, J. D. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-7-200404060-00017 · Cited by 711 · see citing works
Bertholet, N. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.9.986 · Cited by 710 · see citing works
Self-citationSystematic review and meta-analysis of psychological therapies for children with chronic pain
Fisher, E., Heathcote, L., Palermo, T. M., de C Williams, A. C., Lau, J., & Eccleston, C. (2014) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu008 · Cited by 710 · see citing works
Individual-level interventions to reduce college student drinking: A meta-analytic review
Carey, K. B., Scott-Sheldon, L. A. J., Carey, M. P., & DeMartini, K. S. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2007.05.004 · Cited by 699 · see citing works
The impact of brief alcohol interventions in primary healthcare: a systematic review of reviews
O'Donnell, A., Anderson, P., Newbury-Birch, D., Schulte, B., Schmidt, C., Reimer, J., & Kaner, E. (2014) · Alcohol and Alcoholism · doi:10.1093/alcalc/agt170 · Cited by 613 · see citing works
Development of the Protective Behavioral Strategies Survey.
Martens, M. P., Ferrier, A. G., Sheehy, M. J., Corbett, K., Anderson, D. A., & Simmons, A. M. (2005) · Journal of Studies on Alcohol · doi:10.15288/jsa.2005.66.698 · Cited by 398 · see citing works
Brief interventions for heavy alcohol users admitted to general hospital wards
McQueen, J., Howe, T. E., Allan, L., Mains, D., & Hardy, V. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005191.pub3 · Cited by 284 · see citing works
Kaner, E., Bland, M., Cassidy, P., Coulton, S., Dale, V., Deluca, P., Gilvarry, E., Godfrey, C., Heather, N., Myles, J., et al. (2013) · BMJ · doi:10.1136/bmj.e8501 · Cited by 277 · see citing works
Carey, K. B., Scott‐Sheldon, L. A. J., Elliott, J. C., Garey, L., & Carey, M. P. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.08.001 · Cited by 250 · see citing works
Brief motivational interventions for heavy college drinkers: A randomized controlled trial.
Carey, K. B., Carey, M. P., Maisto, S. A., & Henson, J. M. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.5.943 · Cited by 243 · see citing works
A systematic review of emergency care brief alcohol interventions for injury patients.
Nilsen, P., Baird, J., Mello, M. J., Nirenberg, T., Woolard, R., Bendtsen, P., & Longabaugh, R. (2008) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2007.09.008 · Cited by 207 · see citing works
Walters, S. T., Vader, A. M., Harris, T. R., Field, C. A., & Jouriles, E. N. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0014472 · Cited by 193 · see citing works
Murphy, J. G., Benson, T. A., Vuchinich, R. E., Deskins, M. M., Eakin, D. E., Flood, A. M., McDevitt‐Murphy, M. E., & Torrealday, O. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.200 · Cited by 164 · see citing works
Motivational Interviewing and Decisional Balance: Contrasting Responses to Client Ambivalence
Miller, W. R., & Rose, G. S. (2013) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465813000878 · Cited by 164 · see citing works
The effects on mortality of brief interventions for problem drinking: a meta‐analysis
Cuijpers, P., Riper, H., & Lemmers, L. (2004) · Addiction · doi:10.1111/j.1360-0443.2004.00778.x · Cited by 158 · see citing works
Treatment of Alcohol Abuse: An Evidence‐Based Review
Berglund, M., Thelander, S., Salaspuro, M. P., Franck, J., Andréasson, S., & Öjehagen, A. (2003) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000090144.99832.19 · Cited by 151 · see citing works
Vader, A. M., Walters, S. T., Prabhu, G. C., Houck, J. M., & Field, C. A. (2010) · Psychology of Addictive Behaviors · doi:10.1037/a0018749 · Cited by 142 · see citing works
Butler, C., Simpson, S. A., Hood, K., Cohen, D. R., Pickles, T., Spanou, C., McCambridge, J., Moore, L., Randell, E., Alam, M. F., et al. (2013) · BMJ · doi:10.1136/bmj.f1191 · Cited by 136 · see citing works
Self-citationBacon, T. R. (2003) · Industrial and Commercial Training · doi:10.1108/00197850310463797 · Cited by 129 · see citing works
Gaume, J., Gmel, G., & Daeppen, J.-B. (2007) · Alcohol and Alcoholism · doi:10.1093/alcalc/agm141 · Cited by 122 · see citing works
Self-citationGaume, J., Bertholet, N., Faouzi, M., Gmel, G. E., & Daeppen, J. (2010) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2010.06.010 · Cited by 119 · see citing works
Self-citationAdolescent change language within a brief motivational intervention and substance use outcomes.
Baer, J. S., Beadnell, B. A., Garrett, S. B., Hartzler, B. J., Wells, E. A., & Peterson, P. L. (2008) · Psychology of Addictive Behaviors · doi:10.1037/a0013022 · Cited by 115 · see citing works
Counselor skill influences outcomes of brief motivational interventions
Gaume, J., Gmel, G. E., Faouzi, M., & Daeppen, J. (2009) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2008.12.001 · Cited by 112 · see citing works
Self-citationModerators and mediators of two brief interventions for alcohol in the emergency department
Barnett, N. P., Apodaca, T. R., Magill, M., Colby, S. M., Gwaltney, C. J., Rohsenow, D. J., & Monti, P. M. (2010) · Addiction · doi:10.1111/j.1360-0443.2009.02814.x · Cited by 105 · see citing works
Tollison, S. J., Lee, C. M., Neighbors, C., Neil, T. A., Olson, N. D., & Larimer, M. E. (2007) · Behavior Therapy · doi:10.1016/j.beth.2007.07.001 · Cited by 103 · see citing works
(2012) · Europe PMC (PubMed Central) · Cited by 100 · see citing works
de Lange, J., & Baas, E. M. (2010) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2009.12.025 · Cited by 99 · see citing works
Gaume, J., Gmel, G. E., Faouzi, M., & Daeppen, J. (2008) · Addiction · doi:10.1111/j.1360-0443.2008.02337.x · Cited by 90 · see citing works
Self-citationField, C. A., Baird, J., Saitz, R., Caetano, R., & Monti, P. M. (2010) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2010.01297.x · Cited by 80 · see citing works
McNally, A. M., Palfai, T. P., & Kahler, C. W. (2005) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.19.1.79 · Cited by 80 · see citing works
Change talk sequence during brief motivational intervention, towards or away from drinking
Bertholet, N., Faouzi, M., Gmel, G. E., Gaume, J., & Daeppen, J. (2010) · Addiction · doi:10.1111/j.1360-0443.2010.03081.x · Cited by 68 · see citing works
Self-citationBorsari, B. E., Murphy, J. G., & Carey, K. B. (2008) · Addictive Behaviors · doi:10.1016/j.addbeh.2008.10.010 · Cited by 64 · see citing works
LaBrie, J., Pedersen, E. R., Earleywine, M., & Olsen, H. (2006) · Addictive Behaviours · doi:10.1016/j.addbeh.2005.05.001 · Cited by 63 · see citing works
The early history of ideas on brief interventions for alcohol
McCambridge, J., & Cunningham, J. A. (2013) · Addiction · doi:10.1111/add.12458 · Cited by 61 · see citing works
Self-citationThe route to change: Within-session predictors of change plan completion in a motivational interview
Magill, M., Apodaca, T. R., Barnett, N. P., & Monti, P. M. (2010) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2009.12.001 · Cited by 56 · see citing works
A Randomized Trial of Motivational Interviewing and Feedback with Heavy Drinking College Students
Juárez-Carrillo, P. M., Walters, S. T., Daugherty, M., & Radi, C. (2006) · Journal of Drug Education · doi:10.2190/753n-8242-727t-g63l · Cited by 55 · see citing works
Gaume, J., Bertholet, N., Faouzi, M., Gmel, G. E., & Daeppen, J. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.04.005 · Cited by 51 · see citing works
Self-citationFeldstein, S. W., & Forcehimes, A. A. (2007) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990701522690 · Cited by 51 · see citing works
Do Brief Alcohol Motivational Interventions Work Like We Think They Do?
Bertholet, N., Palfai, T. P., Gaume, J., Daeppen, J., & Saitz, R. (2013) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.12274 · Cited by 50 · see citing works
Self-citationStein, L. A. R., Minugh, P. A., Longabaugh, R., Wirtz, P. W., Baird, J. R., Nirenberg, T. D., Woolard, R. H., Carty, K., Lee, C. S., Mello, M. J., et al. (2009) · Psychology of Addictive Behaviors · doi:10.1037/a0015648 · Cited by 49 · see citing works
Magill, M., & Longabaugh, R. (2012) · Addiction · doi:10.1111/add.12013 · Cited by 47 · see citing works
Gaume, J., Magill, M., Longabaugh, R., Bertholet, N., Gmel, G., & Daeppen, J.-B. (2014) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.12469 · Cited by 47 · see citing works
Self-citationCollins, S. E., & Carey, K. B. (2005) · Addictive Behaviors · doi:10.1016/j.addbeh.2005.01.004 · Cited by 34 · see citing works
A Procedure for Establishing Therapeutic Contact with the Alcoholic
Chafetz, M. E. (1961) · Quarterly Journal of Studies on Alcohol · doi:10.15288/qjsa.1961.22.325 · Cited by 32 · see citing works
Lee, C. S., Baird, J. B., Longabaugh, R., Nirenberg, T. D., Mello, M. J., & Woolard, R. H. (2010) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2010.71.726 · Cited by 31 · see citing works
Tollison, S. J., Mastroleo, N. R., Mallett, K. A., Witkiewitz, K. A., Lee, C. M., Ray, A. E., & Larimer, M. E. (2012) · Behavior Therapy · doi:10.1016/j.beth.2012.09.002 · Cited by 30 · see citing works
Post-treatment Stage of Change Predicts 12-month Outcome of Treatment for Alcohol Problems
Heather, N., & McCambridge, J. (2013) · Alcohol and Alcoholism · doi:10.1093/alcalc/agt006 · Cited by 28 · see citing works
Self-citationBrief intervention content matters
McCambridge, J. (2013) · Drug and Alcohol Review · doi:10.1111/dar.12044 · Cited by 28 · see citing works
Self-citationCowell, A. J., Brown, J. M., Mills, M. J., Bender, R. H., & Wedehase, B. J. (2012) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2012.73.226 · Cited by 27 · see citing works
Fifty years of brief intervention effectiveness trials for heavy drinkers: Editorial
McCAMBRIDGE, J. (2011) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2011.00379.x · Cited by 24 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Connor, J. P., Haber, P. S., & Hall, W. D. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00122-1 · Cited by 389 · see citing works
Behavior Change Techniques in Popular Alcohol Reduction Apps
Crane, D., Garnett, C., Brown, J., West, R., & Michie, S. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4060 · Cited by 177 · see citing works
Rethinking brief interventions for alcohol in general practice
McCambridge, J., & Saitz, R. (2017) · BMJ · doi:10.1136/bmj.j116 · Cited by 146 · see citing works
Self-citationPlatt, L., Melendez-Torres, G. J., O'Donnell, A., Bradley, J., Newbury-Birch, D., Kaner, E., & Ashton, C. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011473 · Cited by 136 · see citing works
Tanner‐Smith, E. E., Parr, N. J., Schweer‐Collins, M., & Saitz, R. (2022) · Addiction · doi:10.1111/add.15674 · Cited by 54 · see citing works
Bertholet, N., Godinho, A., & Cunningham, J. A. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.12.002 · Cited by 40 · see citing works
Self-citationRosário, F., Santos, M. I., Angus, K., Pas, L., & Fitzgerald, N. (2018) · Acta Médica Portuguesa · doi:10.20344/amp.9753 · Cited by 16 · see citing works
- Authors
- Gaume, J., McCambridge, J., Bertholet, N., & Daeppen, J.-B.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Gaume, Jacques
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2014-08-26
- Volume
- 5
- Pages
- 108-108
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC4143721
- OpenAlex
- W2124736189
- Cited by
- 137
- References
- 64
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 8 · 2023: 3 · 2022: 10 · 2021: 7 · 2020: 53 · 2019: 9 · 2018: 11 · 2017: 5 · 2016: 12 · 2015: 14
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, other-oa)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- IRIS (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Wellcome Trust (WT086516MA)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- brief alcohol intervention, mechanism of action, brief motivational interviewing, active ingredients, personalized feedback, decisional balance, change talk, readiness to change, normative influence, self-efficacy, hazardous drinking, primary care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
