Levy Sharon, Vaughan Brigid L, Knight John R
Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
Pediatr Clin North Am. 2002 Apr;49(2):329-43. doi: 10.1016/s0031-3955(01)00007-4.
Because substance use is highly prevalent among teens, primary care clinicians may not be able to refer all adolescents to drug counselors or mental health care professionals. Pediatricians may therefore find it useful to use the basic principles of office intervention and reserve referral for those patients with the most significant drug and alcohol problems. Brief interventions have proven effective in reducing problematic drinking among adults, and early work among adolescents is promising. Effective interventions include feedback on risks and problems, an emphasis on personal responsibility, a menu of alternatives for change, an empathetic approach, and reinforcement of patient self-efficacy. Motivational interviewing is an effective means of enhancing success in counseling. When a referral is necessary, motivational interviewing can be used to maximize adherence.
由于物质使用在青少年中非常普遍，初级保健临床医生可能无法将所有青少年都转介给药物顾问或心理健康护理专业人员。因此，儿科医生可能会发现运用办公室干预的基本原则并将转介保留给那些有最严重药物和酒精问题的患者是有用的。简短干预已被证明在减少成年人的问题饮酒方面有效，而在青少年中的早期工作也很有前景。有效的干预措施包括对风险和问题的反馈、对个人责任的强调、一系列改变的选择、共情的方法以及增强患者的自我效能感。动机性访谈是提高咨询成功率的有效手段。当有必要进行转介时，动机性访谈可用于使依从性最大化。
