SAN FRANCISCO — Hospitalization may provide a unique opportunity to offer counseling to patients with alcohol problems.
“As a result of an acute medical event, many patients have a high motivation to change their drinking behavior,” Jennis Freyer, Ph.D., said in an interview. “Hospitalization offers the chance to reach patients with alcohol-attributable disease proactively.”
In a poster presented at the annual meeting of the Society of Behavioral Medicine, Dr. Freyer assessed openness to alcohol counseling in patients who stayed more than 24 hours in one of four German hospitals. Screening with the Munich-Composite International Diagnostic Interview identified 1,150 patients with alcohol problems. She assessed the severity of the alcohol problem with the Alcohol Use Disorders Identification Test and mental health with the Rand Mental Health Index.
Most of the patients (93%) were male; the mean age was 42 years. Dependence was the most frequently identified alcohol problem (49%), followed by alcohol abuse (12%), at-risk drinking (30%), and episodic heavy drinking (9%). The mean Alcohol Use Disorders Identification Test score was 19; the mean Mental Health Index score was 7.
She assessed the patients' openness for counseling by using a simple two-item true-false survey (“I'm open to learn more about help” and “I want to find out how to help myself”). Patients then completed the Readiness to Change Questionnaire and the Treatment Readiness Tool. Overall, 66% of the patients were open to the idea of alcohol counseling. More of those with alcohol dependence were open to counseling than those with alcohol abuse or at-risk drinking (77% vs. 56%).
“Those with alcohol dependence are more likely to have developed problem recognition,” said Dr. Freyer of the University of Greifswald, Germany. “Having identified alcohol as being part of their problem may increase their openness for counseling, especially when they feel helpless about their situation.”
However, she noted, more than half of risky drinkers and those with alcohol dependence were still open to the idea of getting counseling.
In the Readiness to Change scale, those in the contemplation stage were twice as likely to be open to counseling as were those in the precontemplation stage. In the Treatment Readiness assessment, those in the contemplation stage were nine times more likely to accept counseling than were those in the precontemplation stage.