My patient is 22 year old lady who was admitted many times for alcohol intoxication and alcohol withdrawl. She is homeless and does not have health insurance. She was denied entry to many rehabilitation institutions due to lack of insurance.
As Primary care providers, we play a key role in facilitating patient engagement in health-related behavioral change, such as smoking cessation or abstinence from alcohol or illicit substance use. Indeed, formal drug and alcohol treatment programs are not readily available in some settings, and other patients may decline to enter or cannot enter a formal program. In this role, primary care clinicians must not operate from the belief that providing information alone will change behavior, as provider-directed instruction for implementing behavior change has proven ineffective. A far more effective approach to facilitating behavioral change is based on two complementary frameworks: readiness-for-change, and self-efficacy. Following assessment of a patient’s readiness-for-change and self-efficacy, those working with patients around health-related behavioral change should provide brief, patient-centered interventions, referrals, and information. This should be individualized to the situation of every single patient.
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