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Few studies exist on the change over time in positive and negative emotions during treatment for alcoholism disorders. We aimed to evaluate relationship between alcohol reduction and change in positive and negative emotions. Chronic HCV patients (n=174) with alcohol use received brief alcohol counseling. Participants completed the PANAS-Short Form, MHC-Short Form, and the Alcohol Timeline Follow back at baseline and 3, 6, and 12 months. Decreases in alcohol use were related to decreased negative emotions from baseline to 3 months, baseline to 6 months and baseline to 12 months. Decreases in alcohol use were associated with increased positive emotions from baseline to 12 months but not sooner.

OBJECTIVE To explore sequential steps of employee engagement in wellness interventions and the impact of wellness interventions on employee health. METHODS Using previously collected survey data from 23,667 UK employees, we tabulated intervention availability, awareness, participation, and associated health improvement and compared engagement by participation and risk status. RESULTS Employees' awareness of wellness interventions at their workplaces was often low (mean 43.3%, range 11.6%-82.3%). Participation was highest in diet/nutrition initiatives (94.2%) and lowest in alcohol counseling and smoking cessation interventions (2.1%). Employees with health risks were less likely than lower-risk employees to report awareness, participation, and health improvements from wellness interventions addressing the relevant health concern. CONCLUSION Employers and policymakers should consider variation in intervention engagement as they plan and implement wellness interventions. Engaging employee populations with higher health risks requires a more targeted approach.

BACKGROUND: Clinical performance measures often require documentation of patient counseling by healthcare providers. Little is known about whether such measures encourage delivery of counseling or merely its documentation. OBJECTIVE: To assess changes in provider documentation of alcohol counseling and patient report of receiving alcohol counseling in the Veterans Administration (VA) from 2009 to 2012. DESIGN: Retrospective time-series analysis. PARTICIPANTS: A total of 5413 men who screened positive for unhealthy alcohol use at an outpatient visit and responded to a confidential mailed survey regarding alcohol counseling from a VA provider in the prior year. MAIN MEASURES: Rates of provider documentation of alcohol counseling in the electronic health record and patient report of such counseling on the survey were assessed over 4 fiscal years. Annual rates were calculated overall and with patients categorized into four mutually exclusive groups based on their own reports of alcohol counseling (yes/no) and whether alcohol counseling was documented by a provider (yes/no). KEY RESULTS: Provider documentation of alcohol counseling increased 23.6% (95% CI: 17.0, 30.2), from 59.4% to 83.0%, while patient report of alcohol counseling showed no significant change (4.0%, 95% CI: −2.3, 10.3), increasing from 66.1% to 70.1%. An 18.7% (95% CI: 11.7, 25.7) increase in the proportion of patients who reported counseling that was documented by a provider largely reflected a 14.7% decline (95% CI: 8.5, 20.8) in the proportion of patients who reported alcohol counseling that was not documented by a provider. The proportion of patients who did not report counseling but whose providers documented it did not show a significant change (4.9%, 95%CI: 0.0, 9.9). CONCLUSIONS: If patient report is accurate, increased rates of documented alcohol counseling in the VA from 2009 to 2012 predominantly reflected improved documentation of previously undocumented counseling rather than delivery of additional counseling or increased documentation of counseling that did not meaningfully occur.

The Veterans Health Administration (VHA) has implemented initiatives to increase rates of brief alcohol counseling (BAC). Half of eligible veterans do not receive such care. Understanding patient characteristics associated with drinking behavior may identify patients for whom BAC may be acceptable. Data collected from veterans between January 2010 and September 2011 (N = 167) were examined. Results find that alcohol-related concerns and perceptions of peer alcohol consumption are associated with reduced drinking behavior. These findings suggests that assessing drinking concerns and perceptions of peer alcohol use may help to identify patients interested in changing drinking behavior, receiving care, and assist providers in delivering appropriate counseling.

The prevalence of alcohol problems is roughly equal in urban and rural communities. In rural areas, however, treatment options for people with problem drinking tend to be limited at best. One way to reach rural populations is to deliver alcohol counseling services via telephone or interactive televideo links, called telecounseling in this paper. Tele-counseling can overcome not only the geographic barriers to treatment, but also concerns with confidentiality and stigma, which may be particularly salient in small rural communities. This approach to service delivery may be particularly important in areas with large rural and frontier regions. This paper reports on current use of common long-distance methodologies, their strengths and limitations.

Associated with the top 3 causes of adolescent death (unintentional injuries, homicides, and suicides), underage drinking is annually responsible for 4000 to 5000 deaths and contributes to unprotected sex, social problems, and poor academic performance.1 A substantial body of experimental research indicates screening and brief intervention for risky alcohol use conducted in adult primary care settings is effective in reducing alcohol misuse and related problems.2 Evidence concerning effectiveness among young adults and adolescents is also accumulating.3,4 Unfortunately, screening and brief alcohol counseling for adolescents and college-aged emerging adults is not routine.5 College students more often drink 5 or more drinks on an occasion and drive under the influence of alcohol more than same-age, noncollege peers.6 Important unanswered questions are whether college students are (1) more or less likely than same-age peers to be asked about their substance use, (2) given advice about related health risks, and (3) encouraged to reduce or stop substance use.

The technology for evaluating patient-provider interactions in psychotherapy–observational coding–has not changed in 70 years. It is labor-intensive, error prone, and expensive, limiting its use in evaluating psychotherapy in the real world. Engineering solutions from speech and language processing provide new methods for the automatic evaluation of provider ratings from session recordings. The primary data are 200 Motivational Interviewing (MI) sessions from a study on MI training methods with observer ratings of counselor empathy. Automatic Speech Recognition (ASR) was used to transcribe sessions, and the resulting words were used in a text-based predictive model of empathy. Two supporting datasets trained the speech processing tasks including ASR (1200 transcripts from heterogeneous psychotherapy sessions and 153 transcripts and session recordings from 5 MI clinical trials). The accuracy of computationally-derived empathy ratings were evaluated against human ratings for each provider. Computationally-derived empathy scores and classifications (high vs. low) were highly accurate against human-based codes and classifications, with a correlation of 0.65 and F-score (a weighted average of sensitivity and specificity) of 0.86, respectively. Empathy prediction using human transcription as input (as opposed to ASR) resulted in a slight increase in prediction accuracies, suggesting that the fully automatic system with ASR is relatively robust. Using speech and language processing methods, it is possible to generate accurate predictions of provider performance in psychotherapy from audio recordings alone. This technology can support large-scale evaluation of psychotherapy for dissemination and process studies.

Healthcare providers, and nurses in particular, are increasingly being called upon for health promotion counseling. Alcohol risk assessment is often included in general health screening questionnaires, but often little use is made of this information. Alcohol consumption is infrequently included as a focus of health promotion campaigns. Because alcohol intake influences many other health risks, it is logical and practical to include alcohol risk reduction in general wellness counseling. This article presents evidence that incorporating alcohol counseling lowers alcohol risk and lowers the risk of other chronic diseases. It also provides examples of ways nurses and other health professionals can discuss alcohol risk reduction in the context of general health, thus helping remove the stigma associated with alcohol risk and engage clients in efforts to lower their alcohol risk.

Intercession into collegiate alcohol misuse by the Department of Resident Life (DRL) in freshmen dormitories at one large Mid-Atlantic, diverse, public university was examined. Freshmen dormitory resident drinkers ( n = 357), 71% of whom reported alcohol misuse, were surveyed. Student self-report and DRL documentation, respectively, revealed that 6.4% and 7.8% ( κ = .77) of drinkers were documented with an alcohol violation, 4.2% and 3.4% ( κ = .81) lost housing priority points, 1.4% and .6% ( κ = .28) were referred for alcohol counseling, and 1.4% and .3% ( κ = .33) were taken to the emergency room. DRL infrequently interceded into alcohol misuse, perhaps because most misuse occurred off campus.

Interviews were conducted with forty-two women with extensive abuse histories who had killed their intimates and fifty-nine women with similar abuse histories who were in shelters for battered women. Controlling for demographic and other differences, analyses indicated that alcohol and other drug use ably distinguished between the two groups of women (correctly classifying 89% of the cases), and that alcohol use was more salient than other drug use. The partner's alcohol use and the respondent's alcohol use were significantly higher among the intimate homicide group, suggesting an association between intimate homicide and alcohol use. Alcohol counseling should, therefore, be a significant part of programs for both battered women and for men who batter.

Literature on the drinking practices of Mexican Americans is discussed from the perspectives of three acculturation models: linear acculturation, acculturative stress, and marginality stress. Culturally competent alcohol counseling practices are proposed.

This study examined differences in substance use and related risk factors in a matched sample of Hispanic and White non-Hispanic adolescents receiving brief alcohol counseling. Findings revealed that the White non-Hispanic adolescents reported smoking a higher number of cigarettes per day. The Hispanic adolescents reported perceiving less acceptance from the neighborhood environment in which they live, whereas their parents reported monitoring their teens less than the parents' of White non-Hispanic adolescents. Consistent with the findings found in community samples, the overall findings of this study suggest that Hispanic and White non-Hispanic adolescents enrolled in this alcohol intervention have similar baseline characteristics.

To compare current standard maternity care in Sweden concerning provision of alcohol advice with a more comprehensive questionnaire-based counseling model.The study population included pregnant women in Linköping who were registered at a maternity care center during a 2-year period and whose pregnancies resulted in liveborn infants without birth defects, representing 93% of all pregnant women. Anonymous questionnaires were mailed to the women. The first cohort (registered April 2005 1, to March 31, 2006) received standard care according to a procedure that is common practice in Sweden. The second cohort (April 1, 2006 to March 31, 2007) received alcohol advice based on a comprehensive counseling model, incorporating the use of the three-item Alcohol Use Disorders Identification Test (AUDIT-C) questionnaire and tailored counseling based on the AUDIT-C score.The response rate was 61% in the first cohort (standard care) and 70% in the second cohort (questionnaire-based counseling). The cohorts were similar in sociodemographic variables and prepregnancy drinking characteristics. The proportion of women who continued drinking alcohol during the pregnancy was 6.0% in cohort 1 and 5.8% in cohort 2. Women in cohort 2 were more favorable to the advice and, to a larger extent, perceived the main message to be abstinence from drinking during pregnancy.The questionnaire-based counseling model was more favorably perceived than the standard care model, but the new model was not more effective in terms of its impact on the proportion of women who abstained from drinking during pregnancy.

Extensive harmful drinking of alcohol is a major problem for many groups of Australian Aborigines and western treatment approaches have had limited effect. In order to stress cultural factors in treatment, a program to train indigenous Aborigines as alcoholism counselors for their communities was developed. In its more than 10 years of existence 145 counselors have been graduated. Of those initially entering the two year program 60% have graduated. Most of those have found employment as alcohol counselors for their people, and the numbers of Aborigines treated has increased. About 90% of those who entered the training had severe repeated substance abuse disorders in their recent history. The training and the alcohol counseling employment appears to be highly associated with continuing sobriety. For those who graduated the program only 4.8% returned to drinking. Those who completed only the first phase, 8.4% returned to drinking. Of those who were terminated from the program, 74% returned to drinking. Training alcoholics as alcohol counselors appears to be associated with vocational success and mainte nance of sobriety as predicted by Riessman's "helper-therapy principle."

Some primary care physicians do not conduct alcohol screening because they assume their patients do not want to discuss alcohol use.To assess whether (1) alcohol counseling can improve patient-perceived quality of primary care, and (2) higher quality of primary care is associated with subsequent decreased alcohol consumption.A prospective cohort study.Two hundred eighty-eight patients in an academic primary care practice who had unhealthy alcohol use.The primary outcome was quality of care received [measured with the communication, whole-person knowledge, and trust scales of the Primary Care Assessment Survey (PCAS)]. The secondary outcome was drinking risky amounts in the past 30 days (measured with the Timeline Followback method).Alcohol counseling was significantly associated with higher quality of primary care in the areas of communication (adjusted mean PCAS scale scores: 85 vs. 76) and whole-person knowledge (67 vs. 59). The quality of primary care was not associated with drinking risky amounts 6 months later.Although quality of primary care may not necessarily affect drinking, brief counseling for unhealthy alcohol use may enhance the quality of primary care.

Brief alcohol counseling is a top US prevention priority but has not been widely implemented. The lack of an easy performance measure for brief alcohol counseling is one important barrier to implementation. The purpose of this report is to outline important issues related to measuring performance of brief alcohol counseling in health care settings. We review the strengths and limitations of several options for measuring performance of brief alcohol counseling and describe three measures of brief alcohol counseling tested in the Veterans Affairs (VA) Health Care System. We conclude that administrative data are not well-suited to measuring performance of brief alcohol counseling. Patient surveys appear to offer the optimal approach currently available for comparing performance of brief alcohol counseling across health care systems, while more options are available for measuring performance within health care systems. Further research is needed in this important area of quality improvement.

Sexual assaults vary in terms of severity from molestation, which involves touching, stroking, fondling or grabbing of any part of the victim's body, to rape, where victims have been known to suffer severe emotional trauma. The aim of the study is to compare molesters with rapists using hypotheses that molesters and rapists commit their offences at different times of the day, at differing locations and with differing relationships with their victims. The influence of alcohol on both groups was also studied. Convicted molesters and rapists were given a semi-structured interview in prison. Demographic information and details of each offence were obtained from prison records. Comparisons were made of the demography, time, place, reasons for assault, relationship of offender to victims and the role of alcohol and drugs consumed by the perpetrators. Molesters and rapists were of similar age and ethnicity, but differed in that rapists had attained a lower educational level and were more likely to be single. Rapists were more likely to report having drunk alcohol, committing rape after midnight and in secluded places. Molesters struck in the afternoon hours and usually in crowded places. Victims of molesters tended to be relatives whereas victims of rapists were more likely to be ex-spouses or ex-lovers. Molesters tended to give other reasons for their offences. Differences between molesters and rapists could lead to intervention strategies chiefly targeting the issues of poor socialisation skills in molesters and alcohol counselling for rapists.

Introduction. A pilot study was conducted concerning the first onset time, period of blackout, and their impact on cognitive functions. Methods. Patients at PNUYH and Busan Alcohol Counseling Center were the subjects of the study. They were investigated for age at their first blackout and the number of years with blackout episodes. The subjects were divided into three groups by the first onset age of blackout ( 40 years: O3) and by the number of years with blackout episodes ( 30 years: P3), and we examined the differences in neurocognitive functions among the groups. Results. Significant differences in memory were observed between the groups O1 and O2 (t = -2.32, p < .05). Significant differences were observed in attention and executive functions between the groups P1 and P3 (attention t = 2.18, p < .05, executive function t = 2.79, p < .05). Conclusion. More memory impairments were detected in the subjects with the earlier onset age of their first blackout. The longer the blackout years, the more impaired attention and executive function experienced. These pilot study results suggest that more studies on the mechanisms are needed in the future.

Purpose: This study was done to describe the forgiveness experience following participation in forgiveness therapy of wives of men who abuse alcohol. Methods: A qualitative research method was used to describe the lived experiences of the participants in forgiveness therapy. Sixteen wives of alcoholic men were purposefully sampled from two alcohol counseling centers located in South Korea. Forgiveness therapy consisted of 120-minutes sessions once weekly. The data were collected from four groups. Conversations in forgiveness therapy were recorded and dictated. Data were analyzed using the Fullilove's problem-oriented analysis method. Results: The experience of wives of alcohol abusing husbands can be described as “Resistant,” “Self-understanding,” “Understanding her spouse,” and “Growth” following forgiveness therapy. Conclusion: The results indicate that wives of men who abuse alcohol experienced recovery through forgiveness. Therefore forgiveness therapy can be used as an useful nursing intervention for inner healing and growth.

Treatment data were collected on 134 clients of the Alcohol Counseling and Education Program, Taunton, Massachusetts: 31 of these clients were collateral clients; 103, primary users. Short-term improvements in the emotional status (i.e., improvements that occurred within the period of treatment) of collateral clients seem dependent upon different treatment modalities than do those of primary users. Collateral clients seem, on the one hand, responsive to individual counseling; primary users, on the other, to group (including self-help, Alcoholics Anonymous) therapy.

Treatment data were anlyzed on 134 clients of the Alcohol Counseling and Education Program, Taunton, MA. One hudnred three of these clients were primary users; 31, significant other. Short-term improvements (i.e., improvements that occurred within the treatment period) in four measured attributes-sobriety, emotional status, employment status and family situation-as well as in an index of overall improvement suggest not only that different treatment modalities are more appropriate for different kinds of improvement, but also that different treatment modalitites may be effective for primary users and significant others. In terms of the index of overall improvement used in this study, for instance, primary users appear responsive to Anonlymous-group referrals, wheras significant others appear to be responsive to individual counseling alone.