IBA – who should do it and how do we convince them?

4 Dec

we not meOne of the big IBA challenges is that those who we really need to do IBA are not likely to see it as part of their job role. We need doctors, nurses, Criminal Justice roles and other front line professionals to routinely ask (screen) about alcohol – of course these are not exactly people with plently of spare time on their hands.

So the challenge facing IBA delivery is not just to equip front line roles with the knowledge, skills and resources to do IBA, but also motivate them to embrace it as a worthwhile cause – despite all the other pressures they face.

There are also still some big challenges regarding the perceptions of IBA amongst those that know something about it. IBA is not for drug and alcohol workers in the main – only a tiny fragment of at-risk drinkers could be reached this way. Nor is IBA to help front-line workers identify people for referral to treatment (though that may be considered a secondary outcome).

This may be stating the obvious to you but it seems that many suitable roles fail to recognise IBA an effective ‘early intervention’ in itself. “How do I change someone in denial” is a common ‘hope’ identified pre-training, suggesting the fixation with dependence that must be shifted.

The goal of IBA is reducing risky drinking and preventing problems developing – NOT unearthing dependent drinkers for referral!

So how do we convince nurses, doctors, offender manager, pharmacists, sexual health roles etc to do IBA? Even if we accept that the evidence base beyond Primary Care is less extensive, there are still a lot of practice nurses and GPs still to convince. Whilst there is no single answer, broadly:

  • We need to further ensure front-line roles are aware of the case for IBA, and provide the resources and skills to do it.
  • We need to establish better systems for monitoring whether and how IBA is happening where staff are expected, paid or trained to do IBA.
  • We need to continue to identify, explore and work on the barriers and facilitators to IBA delivery
  • We need to continue to champion IBA delivery as a short, effective and easy intervention to do.
  • We need to continue to ensure national level policies are in place to support the above and lead the agenda.

I think in time we’ll get there. The IBA agenda has momentum, but it still needs to gather more if it is to play a meaningful role in the long game of reducing alcohol misuse.

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