Developing Partnerships Between Research Centers and Military Mental Health Clinics to Adapt, Implement, and Evaluate a Brief Counseling Intervention for Alcohol Misuse

In an effort to increase translational research opportunities and develop collaborative relationships between research and military institutions, a partnership has been created between a university research center and a military mental health clinic. The focus of the partnership is to evaluate, adapt, implement, and reevaluate the targeted prevention intervention, Alcohol Brief Counseling (ABC), for Service Members who misuse alcohol. ABC is a targeted, brief, individual prevention intervention program that uses structured assessment of drinking behavior, reflective feedback and educational information to encourage the patient to make behavioral changes. The ABC Counselor’s Manual was developed in 2006 based on several existing programs from the Addictive Behavior Research Center at the University of Washington. The ABC Manual pulled heavily from the evidence-based Drinker’s Checkup program (DCU; Miller & Sovereign, 1989).

An evaluation of ABC indicated that although the program was empirically informed, incorporating evidence based components and techniques (e.g., DCU; Motivational Interviewing, Miller & Rollnick, 2013), there were significant limitations. Based on the five primary components of program fidelity (Dane & Schneider, 1998), there was no standardization related to adherence of delivery, exposure to the intervention, or the quality of program delivery. No data were available related to participant responsiveness or program differentiation. Specific limitations included a lack of standardized protocols or decision points and inconsistent training for practitioners.

Based on the initial evaluation results, the partnership has allowed for further collaboration related to adaptation and standardization of ABC. Specifically, development has focused on refinement of ABC manual including (1) clarification of goals, (2) inclusion of base skills, (3) standardization of program content including semi-structured interview formats, and (4) explicit guidance on decision points. In addition, to ensure consistent and sustainable delivery of training, the research center has developed computer-based training modules that include multimedia presentation of content, interactive knowledge quizzes, and video vignettes.

The partners plan to implement the ABC program and evaluate fidelity of implementation, short-term (increased knowledge of negative consequences of drinking and motivation for change, improved coping skills, and implementation of a change plan) and long-term (absence of recidivism of alcohol-related incidents, decreased problematic drinking behaviors; increased readiness to change, improved fitness for duty, work performance, mood, and improved coping skills) outcomes. Future directions include further adaptations to the ABC program and technology-based trainings and an evaluation of Level 1 treatment for Service Members diagnosed with a Substance Use Disorder.