Who needs IBA?

16 Apr

Recognising the ‘right’ group of patients or service users for delivering identification and brief advice is one of the first hurdles to be overcome by non-specialists getting to grips with delivery.  Most IBA guidance, based on reasonable evidence, suggests that those who might benefit from brief advice are drinking at increasing or higher risk levels.  We spend quite a bit of time on training talking about how you can identify these people using screening questions, and crucially, how you can’t identify them by looking, guessing or assuming!

So why is it then that when we follow-up participants some months after training courses, some still report that they have not delivered IBA because ‘my clients don’t need it’?  Some say that all their clients are drinking too much to benefit from IBA; others that their service users do not drink enough to need help, but these conclusions are not necessarily based on screening.  Why?

Well, I have a few theories…firstly I think it is worth acknowledging that this could just be an excuse, perhaps training participants just feel bad if they haven’t delivered and so they want to give us a good reason why.

Or perhaps it is true – though it seems unlikely that practitioners working with the general public, have not come across anyone at all who is drinking more than the recommended limits, but not in a dependent way!

I think the former is more likely, but it is not as simple as them making it up to satisfy us.  I think they are rationalising to themselves as well as us, why they haven’t delivered.  And I think (among other reasons) it comes down to the fact that in order to truly recognise the target groups for IBA, we need to recognise that included in the target group are folk, well, just like us.  Or if not us, like folk we know and like.  Not a stereotype ‘heavy drinker’, never mind ‘alcoholic’.  And that might mean recognising that we, or our family or friends, have a choice to make too…enjoy our drink and accept the risks, or cut the drink and cut the risk…

Delivering IBA is just about giving everybody that information, and that choice.

One Response to “Who needs IBA?”

  1. James Morris April 18, 2012 at 11:27 pm #

    The issue of IBA trainining participants not going on to deliver IBA is a big one. We all know how hard it can be to change a habit or get into a new routine, and I think that’s a key barrier. We are relying on them to break the mould, but with no real nudges in place to remind or encourage them once the session is over.

    I think another factor is anxiety of asking about alcohol. I always try to reassure people that by making it clear you are not picking them out (i,e “I usually ask some questions about alcohol here…”), and making it clear it is not cumpulsory, that people won’t be angered by the initial question. I can see why people would think that though.

    I think we need to do a lot more to ‘nudge’ and support people who have been trained to remember that they should be seeking to screen (‘Identify’) people whenever they get the chance.. and they don’t have anyhting to worry about!

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