The University of Arizona
 

Illicit Drug Screening, Brief Intervention, and Treatment Placement
Brief Interventions: FRAMES Model

The principles underlying most approaches to brief interventions were systemized by Hester and Miller in what is called the FRAMES model:[1]

  • Feedback: Give feedback on the risks and negative consequences of substance use. Seek the client's reaction and listen.
  • Responsibility: Emphasize that the individual is responsible for making his or her own decision about his/her drug use.
  • Advice: Give straightforward advice on modifying drug use.
  • Menu of options: Give menus of options to choose from, fostering the client’s involvement in decision-making.
  • Empathy: Be empathic, respectful, and non-judgmental.
  • Self-efficacy: Express optimism that the individual can modify his or her substance use if they choose.  Self-efficacy is one's ability to produce a desired result or effect. 

Several studies indicate that brief interventions for risky drinking and alcohol abuse are efficacious and feasible in primary health care and other medical settings.[2]  Brief interventions are beginning to be required in some medical settings.  This stated, other studies have reported little effect.  For example, Saitz and colleagues recently found that brief interventions for medical inpatients were not significantly associated with subsequent receipt of alcohol treatment assistance or with amount of drinking.[3]  Other studies have reported that brief interventions are no more effective than other simpler approaches.  For example, Holloway and colleagues found that, regarding changes in subsequent drinking, providing hospital inpatients with a self-help booklet was as effective as a 20 minute brief intervention.[4]

The efficacy of brief interventions for illicit drug use is not yet known because little research on the topic has been conducted.[5]  This notwithstanding, in what appears to be the first randomized, controlled trial for brief interventions with MA users, Srisurapanont et al.  compared a group of young adolescent methamphetamine users who received two 20-minute brief motivational interventions versus students who received one 15-minute psychoeducation session.  Both groups showed a significant decrease in frequency and amount of MA use; however, at eight weeks, the brief intervention group had significantly less days of MA use than the psychoeducation group[3,4,6].

 

References

  • (1) Hester RK, Miller WR. Handbook of Alcoholism Treatment Approaches. 2 ed. Boston, MA: 1995.
  • (2) Whitlock EP, Polen MR, Green CA, Orleans T, Klein J. Behavioral Counseling Interventions in Primary Care To Reduce Risky/Harmful Alcohol Use by Adults: A Summary of the Evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2004 Apr 6;140(7):557-68.
  • (3) Saitz R, Palfai TP, Cheng DM, Horton NJ, Freedner N, Dukes K, et al. Brief Intervention for Medical Inpatients with Unhealthy Alcohol Use. Annals of Internal Medicine 2007 Feb 6;146(3):167-W35.
  • (4) Holloway AS, Watson HE, Arthur AJ, Starr G, McFadyen AK, McIntosh J. The effect of brief interventions on alcohol consumption among heavy drinkers in a general hospital setting. Addiction 2007 Nov 30;102(11):1762-70.
  • (5) Babor T, Kadden RM. Screening and Interventions for Alcohol and Drug Problems in Medical Settings: What Works? The Journal of Trauma Injury, Infection, and Critical Care 2005 Sep;59(3):S80-S87.
  • (6) Srisurapanont M, Sombatmai S, Boripuntakul T. Brief intervention for students with methamphetamine use disorders: a randomized controlled trial. American Journal on Addictions 2007 Mar;16(2):111-6.