Summary

An underlying theme for this discussion is that the range of interventions into Aboriginal alcohol misuse and abuse needs to be broadened. At present, as I shall show, there is a narrow focus on very early prevention, and very late treatment for Aboriginal people, or expressed another way, there is primary and tertiary prevention, but little secondary prevention. In a wide-ranging and thoughtful review of all aspects of the 'treatment' of alcohol problems in the United States, published in 1990, a committee of the Institute of Medicine offered their vision of a multi-faceted effort in alcohol misuse which included both community-wide and specialised approaches (Institute of Medicine 1990). The emphasis of their review is reflected in its title: broadening the base of treatment for alcohol problems. 'The role of community agencies in treatment', the report states, 'would include the identification of individuals with alcohol problems, the provision of brief interventions to a portion of those identified, and the referral of others to specialised treatment' (10M 1990:6). The role of the specialised agencies is to focus on matching clients to appropriate treatment interventions. It is my view that we need to apply these principles to the treatment of alcohol problems among Aboriginal and Torres Strait Islander people in Australia, so that a much wider range of approaches becomes available to them. Included in this possible wider range of approaches is brief interventions (which take a variety of forms), and this paper is offered as a contribution to the growing body of work in the area of brief interventions and on the role of health professionals as appropriate people to broach the issue of alcohol intake with their patients.