Emergency Room Counseling Decreases Risky Teen Behaviors

The university’s SafERteens trial was conducted among 726 teens ages 14 to 18 who had visited a level I trauma center ED in urban Flint, Mich., between noon and 11 p.m. over a three-year period (September 2006 to September 2009), and who had screened positive for both prior year alcohol use and aggression (less than 25% of all screened). The study found that a 35-minute intervention with a therapist reduced the risk of subsequent aggression toward, or violence from, their peers -- and its consequences -- during the next three months by 24 percent to 30 percent. The study was reported this in the Journal of the American Medical Association.

By six months, those effects had dissipated, but were replaced by substantial reductions in the negative consequences of alcohol use, such as missed school, according to researcher Maureen A. Walton, MPH, PhD, and her colleagues. Targeting the intervention to at-risk teens yielded a number needed to treat of just eight to prevent severe peer aggression, six to reduce the consequences of violence, and 17 to prevent alcohol consequences in one.

Use of alcohol and binge drinking, though, appeared unaffected by the intervention, the researchers wrote. However, they called the results clinically meaningful -- especially since teens seen in the emergency department often lack other medical contacts and typically carry higher risk of alcohol- and violence-related problems. The intervention was designed to help teens review their goals, balance decisions, and role play their actions through use of motivational interviewing, tailored feedback, and skills training with referrals as needed.

The most significant benefit of the therapist-led intervention at the six-month follow-up was a self-reported reduction in the consequences of drinking -- missed school, trouble getting along with friends because of drinking.

The project was supported by National Institute on Alcohol Abuse and Alcoholism.