Wellness Protocol: Alcohol Reduction

PHILOSOPHY:   For persons who desire to lower their risk of alcohol consumption without attending a formal class. This is designed to meet the client's individual needs and increase the chance for success.

FORMAT:   The client and the counselor will meet at an agreed-upon time and place.

Session I. Establish Rapport

1. Make introductions and explain that you are there for the client's overall health.



2. Review health findings from initial screening, including alcohol consumption, and establishing the most accurate, days per week and drinks per day that client usually consumes. (Do not disregard the few times the client may have more drinks than usual.) Ask client if he/she feels that his/her consumption is light, moderate or heavy.



3. Counsel client on moderate consumption guidelines.
   
   It is important to learn how much alcohol your body can digest easily within a given time period. Here is why this is important: When you drink more alcohol than your liver can handle within an hour's time, the undigested alcohol goes directly into your blood stream. Undigested alcohol and toxins from the digested alcohol begin to damage your various organ systems. If excessive alcohol is drunk regularly the long term health consequences will be weight gain, greater risk for higher triglyceride levels, impaired liver functions, high blood pressure, heart failure, stroke, certain cancers. It also increases the risk of accidents, violence, suicides, and risk of birth defects in the next generation.



• Men: no more than two drinks per day, and not every day of a week.



• Women: no more than one drink per day, and not every day of a week.



• For elderly men and women no more than one drink per day, and not every day of a week.



(One drink equals 12 oz. of beer or wine cooler, 5 oz. of wine, or 1½ oz. of 80 proof spirits.)


4. Explain where these guidelines come from; that they are national guidelines; that they are not just from a few research studies but from several.



5. Explain to client that previous education has been vague, not giving definitive numbers for alcohol consumption, as are given for cholesterol and blood pressure.



6. Where does client feel his/her consumption level is now? Does (s)he feel (s)he wants to choose to drink less?



7. Assess if client needs outside counseling, make appropriate referral.



8. Go over the handout Alcohol Facts: A guide for making choices.



9. Ask client to keep an alcohol diary.



10. Set a date and place of next appointment. (1 week if client willing to work on alcohol, 1 month if not) Set up goals for alcohol or other risk factors.



11. Complete Follow-up form, making sure to write complete notes.

• Alcohol Diary
• Alcohol Facts
• Messages Regarding Alcohol

Session II

1. Go over alcohol diary of number of drinks per day and days per week.



2. Praise client for days that were within limits.



3. Discuss days that were over moderate guidelines. How was client feeling? Did (s)he realize how many drinks (s)he was drinking? Give options for limiting number of drinks. Discuss negative physical symptoms during or after heavy consumption. Ask questions about when and why the client drank.



4. Check other health risk factors, if appropriate. Relate how alcohol affects these risk factors.



5. Have client set goals for upcoming week (or weeks) and to keep alcohol diary.



6. Set up next appointment. 1 week if client is over guidelines, 2 weeks within guidelines, 1 month if client not willing to work on alcohol.



7. Complete follow-up form and write appropriate notes.

Session III

1. Review alcohol diary of number of days per week and number of drinks per day that alcohol was consumed since last visit.



2. Check other health risk factors.



3. Congratulate client on any positive changes in any risk factors.



4. Ask client how he/she is dealing with temptations to consume alcoholic beverages. Help client develop strategies to cope with any temptations.



5. Have client set goals for upcoming week (or weeks), keep alcohol diary.



6. Set up next visit, 1 week if client is over guidelines, 1 month within guidelines, 1 to 2 months if client not willing to work on alcohol.



7. Complete follow-up form and write notes.

Session IV

1. Review alcohol consumption.



2. Check other health risk factors.



3. Congratulate client on positive changes.



4. Set long-term goals for clients within CDC-recommended limits.



5. Review knowledge and ways of reducing alcohol consumption.



6. Set up next appointment: 3 months if now drinking within the guidelines; 1 to 2 weeks if drinking over the guidelines; 1 to 2 months not willing to work on alcohol.



7. Complete follow-up form and notes.