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If you screen a patient who is identified as increased risk, high-risk for alcohol abuse, or high-risk for alcohol dependency, your next step is to conduct a brief intervention. A brief intervention is a non-confrontational counseling session between a medical professional and patients. Brief interventions can take as little as two minutes, and it's best to do them immediately after a positive screening. Our goal is to change patients' behavior.

You might ask: if it's a brief counseling session, why here in the E.D.? Why not just wait until the patient is referred for further services?

It's because the occurrence of an injury can serve as a teachable moment that may motivate patients to change.

There are a variety of frameworks you can use to provide a brief intervention. I prefer FLO:

F. Feedback: First, ask patients how they think they did on the screening, and then tell them what low-risk scores are. Give patients their score from the screening.

L. Look: Look for patients' reasons to change. You might ask, "On a scale of 1-10 how important is it to you to make a change in your drinking?" Then ask, "If you decided to make a change how confident are you that you would succeed, on a scale of 1-10?"

O. Option: Finally, ask what options patients think they have, and provide patients with a menu of options.