Concrete plans in brief interventions for heavy drinkers

A recent study showed that very brief interventions with heavy drinkers were far more effective when the participants were asked to choose or to make concrete plans for alcohol reduction.

The British study was carried out in public places, such as shopping centres, where 471 people were asked to take part in a survey about alcohol. Around half agreed and were then given a questionnaire to fill in that contained information about safe drinking levels. The participants were randomly given one of four versions of the questionnaire, three of which had a different instruction at the end. The three instructions to participants were either:

  1. A request to write down a plan for reduced consumption.
  2. A choice between one of three pre-set reduction plans based upon an if-then model.
  3. An instruction to formulate their own if-then plan.

(An if-then plan makes an intention for future behaviour change more concrete by putting it into the format of ‘if this happens, then I will do/not do this‘.)

Around a third of the respondents were exceeding recommended safe drinking levels.

Follow up surveys a month later showed no changes to the drinking levels of the two-thirds of respondents who were not exceeding safe drinking levels. However, amongst the heavier drinkers there was a marked difference between those given the questionnaire with no instructions, who reported almost no change, and those given questionnaires with one of the three instructions listed above. Those given instructions tended to reduce their alcohol consumption, with the more concrete if-then plans prompting a significantly greater change.

The period before follow-up was fairly short and the effects of these interventions may not be long lasting. However, the study suggests that even a very brief, self-administered intervention can have an impact upon heavy drinking, particularly if the intervention includes support in making a simple, concrete plan for behaviour change. Asking participants to choose or to make an if-then plan may help to fix an intention and to rehearse its implementation.

A report and discussion on the study can be found here.

Morality and empathy in babies

Recent research is throwing more light on the moral understanding that young infants have of the world. Paul Bloom, a professor of psychology at Yale, has written a New York Times article about research at the Infant Cognition Center into the moral life of babies. As well as showing how even very young infants start to develop an understanding of how the world functions, the research also demonstrates the early existence of empathy and identification.

Bloom’s article begins by describing the baby’s early understanding of physics and psychology, and the techniques used to investigate this understanding. Rather than living in a completely chaotic world, eye tracking techniques show that even very young babies have realistic expectations about such things as the operation of gravity and the movement of objects through space and time. For example, babies show surprise when objects appear not to conform to these laws. While their expectation of the external world may be relatively naive, these babies nonetheless show an early understanding of how the world is structured.

As well as this understanding of the external physical world, toddlers also show some early understanding of the existence of internal world within others. Bloom quotes a study which shows that 15 month-old toddlers are able to conceive of the mental life of other people. The toddlers are shown an adult watching an object being placed inside a box. The object is then removed from the box without the adult’s knowledge. However, the infants still expect the adult to look for the object in the now empty box. For this to be the case the toddlers must understand how the adult mistakenly views the world, the infant must have an idea of the adult’s internal world.

The researchers at the Infant Cognition Centre have gone on to use these techniques to explore what moral understanding babies have of the world. Their investigations involve showing babies puppets or geometrical shapes as characters in situations in which they helped or hindered someone else. Babies who were as young as 5 months old showed a preference for the helpful shapes or puppets over the unhelpful ones. To get closer to ideas of justice, the investigators then introduced situations of reward or punishment. Helpful characters were rewarded or punished by another puppet, and unhelpful characters were treated likewise. When the character was helpful, the babies preferred the puppet that was rewarding it rather than the puppet which punished. However, with the hindering characters the preference was reversed, with the babies preferring the puppet who punished the character. The babies demonstrated a sense of fairness.

In Bloom’s discussion he argues that these experiments show the early existence of a naive moral understanding held by infants, similar to their naive understanding of the physical and psychological worlds. At an early stage we have the tools with which to judge the actions of others and to respond to kindness and meanness. However, Bloom points out that this understanding is still very undeveloped and unmodified by culture and rationality.

These are interesting findings which show the infant’s early understanding of the world, including the internal worlds of other people. The findings join a growing body of evidence for our early capacity for empathy and identification. In their preferences for ‘nice’ characters it is likely that these babies were identifying with the characters in these vignettes. As well as understanding the internal worlds of others, these babies were internalising the external world, becoming involved in these dramas and making judgements about the participants. These are processes which lie at the heart of a psychoanalytic understanding of human development.