Aims: To explore the acceptability and barriers to the introduction of nurse-led routine screening and brief interventions (SBI) for alcohol misuse on general in-patient hospital wards. Methods: Screening was introduced on an in-patient ward at three general hospitals. Screening rates, numbers of referrals to alcohol liaison nurses (ALNs), brief interventions conducted and patients' access to specialist alcohol services at follow-up were measured. Semi-structured qualitative interviews were conducted to explore staff/patient attitudes. Findings: Screening rates ranged from 17.7% to 36.6% in the three wards. The highest rates of screening and positive screening scores were recorded on a gastrointestinal (GI) ward. Attitudes of staff and patients towards the SBI process were generally positive; however, a number of current barriers to its implementation were identified. Conclusions: In order for the SBI approach to be incorporated into routine procedures in in-patient medical settings it may be necessary to provide ongoing support and training from specialist alcohol workers, and to have mechanisms that ensure the screen remains part of routine nursing documentation.

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Background. The GP is central to plans for improved general health care and increased availability and delivery of addiction treatment to drug misusers in the UK. Attention to the actual quality of overall primary care, rather than just the treatment of dependence, has, however, been limited.Objectives. The purpose of this study was to test the feasibility of delivery and potential value of a brief motivational enhancement intervention targeting the quality of primary care given to opiate misusers by GPs.Method. This study had an observational 'before and after' design with follow-up assessment after 2-3 months. The target population was all GPs in two Primary Care Groups who had neither attended training events nor were involved in the treatment of drug dependence (n = 66), who were then approached via a telephone-administered change-orientated reflective listening intervention, based on principles of motivational interviewing, with informational adjunct. Outcome measures for the study sample (n = 29) were overall therapeutic commitment and motivation to follow up and actual clinical activity and willingness to deliver specified general health care interventions for drug misusers.Results. Across the study sample, therapeutic commitment improved over time, whilst motivation did not. Change among individual practitioners in receipt of the intervention was observed in both positive and negative directions, and in four of the positive changers, this was judged attributable to the intervention. Positive changes were more than twice as frequent as negative changes. Conclusions.The direction and extent of change detected were encouraging. Further initiatives are needed to influence practitioner motivation, based on improved understanding of GPs' views on the delivery of primary care for drug misusers.

Mindfulness is an increasingly popular therapeutic approach. Mindfulness-based interventions have been tried out in a wide range of mental disorders, with the strongest evidence for use in depression and anxiety. Mindfulness operates by changing the person's relationship with unhelpful thoughts and emotions. The need for home practice is both a strength and a weakness. Some find home practice too demanding and a barrier to effective utilisation of mindfulness. Others discover a set of practical tools that, once learnt, can be applied to ongoing life difficulties; in this way mindfulness may have a place in promoting recovery beyond the acute treatment of a disorder. Additionally, mindfulness may be beneficial for clinicians to promote well-being and enhance the therapeutic relationship.