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Secondary Prevention of Alcohol Problems in Rural Areas Using a Bibliotherapy-Based Approach.

Gerard J Connors1, Kimberly S Walitzer1, Mark A Prince2

  • 1Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY 14203.

Rural Mental Health
|December 19, 2017
PubMed
Summary

Bibliotherapy, with or without telephone support, effectively reduced heavy drinking days for rural individuals with problem drinking. This approach offers a viable secondary prevention strategy for those not severely dependent on alcohol.

Keywords:
bibliotherapymotivational interviewingproblem drinkersruralsecondary preventiontelephone therapy

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Area of Science:

  • Public Health
  • Behavioral Science
  • Addiction Medicine

Background:

  • Problem drinking affects rural communities, necessitating accessible secondary prevention interventions.
  • Individuals with heavy drinking patterns, even without severe dependence, benefit from targeted support.
  • Rural populations often face unique barriers to accessing traditional addiction treatment services.

Purpose of the Study:

  • To compare the effectiveness of three 12-week interventions for problem drinking in rural New York.
  • To evaluate bibliotherapy alone versus bibliotherapy combined with telephone-based motivational interviewing and therapy.
  • To assess the long-term impact of these interventions on alcohol consumption and consequences.

Main Methods:

  • 111 self-referred men and women with heavy drinking but not severe dependence were randomly assigned to interventions.
  • Interventions included bibliotherapy (self-directed manual), bibliotherapy with one motivational interview, or bibliotherapy with interviews and therapy sessions.
  • All interventions were delivered over 12 weeks, with follow-up assessments at 12 months.

Main Results:

  • Participants in all groups significantly increased abstinent/light drinking days and decreased heavy drinking days.
  • Moderate reductions in alcohol-related consequences and increased self-efficacy for non-heavy drinking were observed.
  • Treatment gains, including strategy use, remained stable at 12-month follow-up.

Conclusions:

  • Bibliotherapy is a supported intervention for rural problem drinkers not severely dependent on alcohol.
  • Telephone-based support can augment bibliotherapy, offering flexible treatment options.
  • These findings support the consideration of accessible, non-intensive interventions for problem drinking in underserved areas.