Ibem: A Brief Intervention Based on Motivational Interviewing

Introduction: Drugs and alcohol abuse amongst youngsters is a growing problem in many developing and emerging-economy countries. With support of the Panamerican Health Organization (PAHO) and the Colombian Ministry of Health, a pilot of   Communities That Care, CTC (Comunidades Que se Cuidan, CQC,  Colombian version) was carried out in three communities between 2011 and 2012. By the end of 2013 five more communities are involved in this trial with governmental support. The implementation  of CQC  has been limited by the absence of evidence-based, evaluated prevention programs in South America. For this reason, in 2013 a brief intervention (IBEM) was developed based on motivational interviewing, aimed at giving support to adolescents with different levels of risk associated with alcohol use.

Method: On the basis of the answers to the screening tools CRAFFT  and CAR (Knight, Sherritt,  Harrys, Gates & Chang, 2003), four levels of risk were identified (low, moderate, high and severe). This tools were validated in Colombia under the name of CARLOS (Pérez-Gómez & Scoppetta, 2011); another tool developed by Nuevos Rumbos  regarding drugs use was also employed with youngsters at high and severe risk. 1600 students 14 to 17 years of age, in 13 schools at three low-income communities near Bogotá, received both IBEM and a follow-up. The process, which lasts 15 to 20 minutes, includes three steps:  assessment of risk, motivational interviewing (with six steps) and evaluation of motivation for change, intention of alcohol and drugs use, and barriers and facilitators. A follow-up lasting 10 minutes with each person was undertaken three months later; at this time, a new evaluation of risk level was carried out looking at the accomplishment of the self-imposed goals proposed at the first meeting to reduce alcohol or other substances use. Six psychologists and social workers were in charge of the implementation of the IBEM.

Results:  The main results were as follows  (the statistical analysis is still in process):

Levels of risk at first meeting: low: 36%; moderate: 43%; high: 16%; severe: 5%

Levels of risk at follow-up: low: 58%; moderate: 32%; high: 8%; severe: 2%

Conclusions: These results are quite surprising, considering the brevity of the interventions. So far we consider that some of the reasons explaining the positive results were: the fact of receiving a non-judgmental information on the consequences of using alcohol at an early age; the formulation of personal goals associated with drinking; the identification of difficulties and facilitators to reaching those goals; and the support from an adult interested in helping the youngsters to reduce their alcohol use. A second follow-up will be proposed in midst 2014.