Out of the Shadows
Uncovering Substance Use and Elder Abuse

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FRAMES

The acronym FRAMES stands for six key elements that have been shown to be effective in assisting persons with at-risk or problem drinking to change their drinking behavior.

F Feedback: Provide useful feedback based on screening. People are motivated to change when they get feedback on their personal situation. You can let clients know how their drinking patterns compare to the norm and what the effects of drinking will be on their health and lives.

R Responsibility: Rather than telling the client what she can and can't do, emphasize personal responsibility and freedom to choose. "No one can change for you. It's up to you." People are more likely to stick to changes when they have made a choice to change.

A Advice: Give specific recommendations about how drinking patterns can be changed (e.g., drinking below the recommended limit of one drink per day or seven drinks per week).

M Menu: Provide the client with options, such as reducing drinking or abstaining. This allows the person to be involved in the decision-making process and thus more willing to change. You can say, "Here are a number of approaches for dealing with drinking problems. Which one might work best for you?"

E Empathy: A counselor who is warm, supportive, sympathetic, and attentive will be more motivational than one who is confrontational and aggressive with clients. Show an understanding of the person's goals and the role of alcohol in her life. This will help you identify ways to help her make changes.

S Self-Efficacy: The person must believe that she can change. Convey the message, "You can change." Encourage optimism.

Miller, W., & Rollinck, S. (1991). Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press.

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