ER Alcohol Intervention Reduces Teen Depression, Partner Violence

Quyen Ngo, PhD, LP

A behavioral intervention for teenagers in emergency rooms that was designed to decrease risky drinking may also lower the risk of depression and partner violence—and it may not even require a human to administer.

“The ER is a busy setting and implementing an intervention that does not interrupt the flow of clinical care can be challenging,” lead author Quyen Ngo, PhD, LP, Research Assistant Professor at the University of Michigan Medical School told MD Magazine ®.

Emergency rooms tend to see a high proportion of at-risk patients, but due to time and personnel constraints, they are often unable to provide the types of interventions that may decrease future risky behaviors. “Given the limited resources in time and staffing in the emergency room, interventions that are implemented need to maximize impact,” she explained.

Ngo and her team suspected that the U-Connect intervention, a brief behavioral intervention that could be conducted by therapists or computers, which had previously been shown to reduce risky drinking in teens, might be able to help reduce other risks as well.

The researchers screened 4389 patients between the ages of 14 and 20 who arrived in the emergency room to see if they participated in risky drinking behaviors. Of the 836 patients who screened positively, 278 were randomly assigned a behavioral intervention given by a therapist, 277 were assigned to the behavioral intervention conducted on a touch-screen tablet without a therapist, and 281 were assigned to a control condition in which they did not receive an intervention. The intervention uses motivational interviewing techniques to discuss the effects of risky drinking. These effects included dating violence and symptoms of depression.

“There was some concern that adolescents would be unwilling to talk about these risk behaviors, but our work shows that with a nonjudgmental and supportive approach, adolescents were more than willing to share important information about their risk behaviors,” Ngo added.

The researchers then followed up with the patients at 3, 6, and 12-month intervals. In addition to questions about the risky drinking behaviors, the researchers asked about dating violence and depression symptoms.

Those who received a therapist intervention had lower rates of dating violence perpetration for all of the follow up time points. These participants also had lower depression symptoms at the 3-month mark. The patients who received the computer intervention had reduced rates of dating violence perpetration and depression symptoms at 6 months after the intervention.

“It was surprising to see how long the effects of this intervention lasted given the relatively short interaction in the emergency room. These results are very promising and exciting,” said Ngo, but she emphasized that more still needs to be done. “It’s important to remember that this singular intervention, while very promising given its potential broad impact, cannot be a stand-alone intervention for every youth. There must be options for referring youth to additional treatment in the community should an adolescent need additional care and support.”

The study, “Emergency Department Alcohol Intervention: Effects on Dating Violence and Depression,” was published in Pediatrics.