Zusammenfassung
Der vorliegende Beitrag fasst die Studienlage zu Kurzinterventionen auf der Basis des Motivational Interviewing (MI) bei alkoholbezogenen Störungen zusammen. Als Datengrundlage dienen aktuelle Metaanalysen zu Kurzinterventionen sowie ergänzende aktuelle MI-Studien. Die Ergebnisse belegen eine hinreichende Evidenz von MI-Kurzinterventionen im Vergleich zu Kontrollgruppen, die keine Intervention erhalten haben. Dies gilt vor allem für Menschen mit leichten bis mittelgradigen alkoholbezogenen Problemen. Die Effektstärken liegen im unteren bis mittleren Bereich. Spezifische Wirkfaktoren werden diskutiert. Die praktische Umsetzung von MI-Kurzinterventionen in Deutschland befindet sich in den Anfängen. Außerhalb der traditionellen Suchtkrankenhilfe wurden verschiedene Modellvorhaben und Weiterbildungscurricula unter Einbezug des MI-Kurzinterventionskonzepts entwickelt und erprobt.
Abstract
This paper summarizes the current evidence on MI-based brief interventions for people with alcohol problems. Data are used from two current meta-analyses published in 2001 and four additional randomized controlled trials mostly published in the following years. There is a substantial evidence for MI-based brief interventions when compared to controls. Results are best for people with mild to moderate alcohol problems, but even for people with substantial or severe alcohol problems MI-based brief interventions lead to a higher specialized treatment attendance rate. Effect sizes are on the small to medium range.
The question of specific effective elements is discussed. It seems to be that rather unspecific elements like empathy, feedback, responsiblity and non-aggressive counselling style than raising specific substance use or lifestyle topics are responsible for the effectiveness of interventions.
Current applications of MI-based brief interventions in Germany are described. There are some encouraging experiences in the primary health care and general hospital but due to a lack of financial support there is no transfer in routine care. Three curricula for the training of non-specialists in dealing with substance use problems are described. Main part of all curricula is information about MI-based brief interventions and appropriate practical exercises.
Schlüsselwörter
Kurzinterventionen - Motivational Interviewing - alkoholbezogene Störungen - Effektivität - Implementierung
Key words
Brief interventions - motivational interviewing - alcohol problems - effectiveness - implementation
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Dr. Georg Kremer
Zentrum für Psychiatrie und Psychotherapeutische Medizin, Krankenanstalten Gilead, von Bodelschwinghsche Anstalten Bethel
Remterweg 69/71
33617 Bielefeld
Email: kremer@psychiatrie.gilead.de