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BMC Psychiatry. 2019 Jul 8;19(1):213. doi: 10.1186/s12888-019-2199-z.

A pragmatic randomised trial of two counselling models at the Swedish national alcohol helpline.

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Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden.
Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden.
Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm County Council, 104 31, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
The Swedish Council for Information on Alcohol and Other Drugs (CAN), 107 25, Stockholm, Sweden.



Alcohol telephone helplines targeting alcohol consumers in the general population can extend the reach of brief interventions while preserving in-person counselling. So far, studies of client outcomes in the setting of alcohol helplines are scarce. This study aims to compare the 6-months alcohol-related outcomes of two counselling models delivered at the Swedish National Alcohol Helpline.


A pragmatic randomised trial was set up at the Swedish National Alcohol Helpline. First-time callers with current hazardous or harmful alcohol use who contacted the helpline, from May 2015 to December 2017, were invited to participate. Clients were allocated with 1:1 ratio to two groups: (1) brief, structured intervention (n = 128), including self-help material and one counsellor-initiated call, and (2) usual care (n = 133), i.e. multiple-session counselling using Motivational Interviewing (MI). The primary outcome was a downward change in AUDIT risk-zone between baseline and 6-months follow-up. The analysis followed an intention-to-treat approach.


Recruitment ended in December 2017. At 6-months follow-up, 70% of the enrolled participants had data on the outcome. In the brief, structured intervention (n = 107) 68% changed to a lower risk-level, compared to 61% in the usual care group (n = 117), yielding a risk ratio (RR) of 1.12 (95% CI 0.93 to 1.37) and risk difference of 0.08 (95% CI -0.05 to 0.20). The total AUDIT score and the scores from the AUDIT consumption questions (AUDIT-C) did not reveal any between-group differences in the mean change at follow-up.


The counselling at the Swedish National Alcohol Helpline was followed by a significant decrease in alcohol use among clients, without clear superiority for either counselling model.


This trial was retrospectively registered with (ID: ISRCTN13160878 ) 18/01/2016.


Brief intervention; Counselling; Drinking; Harmful alcohol use; Hazardous alcohol use; Randomised controlled trial; Telephone helpline

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