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Alcohol Screening and Brief Intervention for Youth

Why Screen for Underage Drinking?

1. Over the course of adolescence, the proportion of kids who drank in the previous year rises dramatically, from ____ of 12-year-olds to nearly ____ of 18-year-olds.

A. 5%; 72%

B. 7%; 70%

C. 9%; 68%

D. 11%; 66%


Before You Begin-Decide on a Screening Method

2. When screening young people for alcohol use patterns, various methods may be used including a clinical interview, self-report questionnaires, or computer screening that patients complete before seeing the clinician.

A. True

B. False


Four Steps At a Glance

3. For youth who drink alcohol and are considered at moderate risk, clinicians should consider referral to treatment and arrange for followup within 6-8 weeks.

A. True

B. False


Step 2: Guide Patients-For Patients Who Do Not Drink

4. When guiding adolescents who do not drink, each of the following strategies is recommended EXCEPT:

A. Reinforce healthy choices with praise and encouragement

B. Elicit and affirm reasons to stay alcohol free

C. Educate the patient about the harmful effects of alcohol

D. Evaluate other risk factors that may lead to future alcohol use or abuse


Step 3: Advise and Assist-For Patients Who Do Drink

5. For youth who drink and who are at highest risk, clinicians need to take into account the patient's age, the degree of acute risk posed, and other circumstances, and they may consider breaking confidentiality to engage parents in follow-through.

A. True

B. False


Frequently Asked Questions About Underage Drinking Patterns

6. Which of the following is an accurate statement about underage drinking activity?

A. The average age at first drink is about 15, according to national surveys of 12- to 20-year-olds

B. Up to about 9th grade, the percentage of boys and girls who drink is nearly the same, but by 11th grade, boys surpass girls in alcohol use, binge drinking, and incidences of being drunk in the past month

C. Among youth who drink, about half of those ages 12 to 15 and two-thirds of those ages 16 to 20 binge drank in the past 30 days

D. All of the above


What's a “Child-Sized” or “Teen-Sized” Binge?

7. Compared with adults, children and teens are likely to have higher blood alcohol concentrations after drinking similar amounts of alcohol.

A. True

B. False


What Kinds of Alcohol are Kids Drinking These Days?

8. A few limited studies show that hard liquor is gaining on or overtaking beer and flavored alcohol beverages in popularity with youth and that wine is less preferred.

A. True

B. False


Why Are We Asking About Past-Year Drinking Instead of Past-Month Drinking?

9. Children are asked about their past-year alcohol use not because the answers will be completely accurate, but because their responses can better predict:

A. Symptoms and problems

B. Patterns and reactions

C. Causes and indications

D. Signs and implications


How Do I Prioritize Screening for Alcohol in Relation to Other Risk Behaviors Such as Unprotected Sex, Smoking, and Use of Other Drugs?

10. Drinking is associated with three top causes of death among adolescents, which are unintentional injury (usually by car crashes), suicide, and accidental drug overdose.

A. True

B. False


About Risk Assessment-What’s the Basis for the Risk Level Estimates?

11. Researchers have consistently found that the quantity of alcohol consumed or the frequency of binge drinking predicted the presence of alcohol use disorders (AUD) symptoms more accurately than the number of drinking days in the past year. 

A. True

B. False


What Do You Mean By “Incorporate What Else I Know” About My Patient and His or Her Family in My Risk Assessment and Intervention?

12. Which of the following are NOT considered family factors that would heighten concern about the degree of risk for young people? 

A. A history of alcohol problems in parents or siblings

B. Divorce or other challenging transition

C. Low socioeconomic status and poor academic achievement

D. Low parental involvement in kids’ lives and unsupervised time


Should I Recommend any Particular Specialty Treatment for Patients who Need Referrals?

13. Among the longer-term alcohol treatments with larger effect sizes were cognitive-behavioral therapy integrated with a 12-step approach, cognitive-behavioral therapy with aftercare, and:

A. Psychodynamic therapy

B. Multidimensional family therapy

C. Systems therapy

D. Social learning therapy


Confidentiality-Patient Rights

14. Across States, laws vary on provisions, including the definition of a minor (typically under age 18), the ability of a minor to consent to substance abuse treatment, parental notification of treatment, and the disclosure of medical records.

A. True

B. False


Professional Association Guidance

15. To facilitate confidential care, the American Academy of Pediatrics (AAP) recommends establishing a privacy policy and sharing it with parents and children at least by the 9- or 10-year-old checkup, and by the ________ checkup, the clinician should routinely set aside a portion of the visit to spend time alone with the patient.

A. 15-year-old

B. 14-year-old

C. 13-year-old

D. 12-year-old


Practical Recommendations

16. A key intervention goal for patients who have begun drinking but are not in acute danger is to obtain a commitment to stop or cut back drinking, and if the patient refuses to commit to this, the clinician may have to consider breaking confidentiality.

A. True

B. False


When is it Appropriate to Break Confidentiality?

17. Recommendations indicate that it is always appropriate to break confidentiality when middle school youth are using any alcohol at all and when high school students begin having mild problems related to alcohol use.

A. True

B. False


What is Motivational Interviewing?

18. Motivational interviewing is a __________, patient-centered style of counseling that helps patients explore their natural ambivalence about changing.

A. Directive

B. Practical

C. Humanistic

D. Supportive


Setting Individual Goals and Action Plans

19. The abstinence challenge consists of an adolescent making a contract for 8–12 weeks of non-drinking while working with the clinician to determine the severity of the problem.

A. True

B. False


Additional Workup Resources

20. The Alcohol Use Disorders Identification Test (AUDIT) is a brief screening instrument designed for adolescents that will identify alcohol and use and associated behaviors such as riding in a car with someone who has been drinking and using alcohol to relax or forget.

A. True

B. False


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