Psychology Sample Paper on Reflect on the role of a DCP in tackling alcohol misuse



This reflective report aims to discuss the harmful effects of alcohol abuse at global and national scale, and it will also illustrate strategies and barriers of communication when delivering better oral health and tackling Alcohol Misuse (AM). Indeed, the determinants of health and disease, social and psychological bearings on the patients and the society as well as the variations of delivering healthcare in the dental settings and the role of Dental Care Professional’s (DCP) will be demonstrated.


Excessive Alcohol Consumption (AC) is one of the world’s major public health concerns as it is associated with diseases and injuries recorded in more than 30 International Classification of Diseases (ICD)-10 by name or definition. It has also been identified as a factor incising over 200 ICD-10 diseases such as:

  • Cancer and oral cancer include larynx, oesophagus, pharynx and liver
  • Neuropsychiatric disorders include epilepsy and seizures
  • Gastrointestinal diseases include cirrhosis and pancreatitis
  • Intentional injuries include suicide, self indicted and violence
  • Unintentional injuries include accidents, falls, drowning and poisoning
  • Cardiovascular diseases include ischemic heart disease, hypertension, cardiac dysrhythmias, haemorrhagic stroke and ischemic stroke. (WHO, 2011)


Although alcohol has been considered acceptable by many cultures for centuries, its misuse chronically and inappropriately has been increasingly seen as general and oral health issue. In 2012, AC attributed to about 3.3 million deaths which translate into 5.9% of all global deaths and 5.1% of the global burden of diseases and injuries. (WHO, 2015).It is important to note that European Union countries consume more than double the world’s average of alcohol making them the highest and the heaviest drinkers worldwide, and sadly affecting the socially disadvantaged people the most. (WHO, 2013).

In England, excessive AC was equivalent to 6.2 litres of pure alcohol per person aged 15 years or over, which translates into 13.5 grams consumed per day. As a result, 8,758 alcohol related deaths were recorded by the end of 2015presenting the biggest behavioural risk for disease and death nationally after smoking, obesity and lack of physical activity (Gov.UK, 2017). So far, this year it has been approximately 2270 alcohol related deaths in the UK as a direct result of AM (Alcohol Concern, 2017).


In the light of the fact that AC has become a burden on individuals and families, not to mention its impact on the global economy which is costing the society a staggering £21 billion, (WHO, 2015) an action to reduce health inequality and mortality has started in 2001, aiming to develop strategies and finance projects and focusing on protecting children and raise concerns related to harmful and hazardous AC. (WHO, 2012).


In England alone, between 2010 and 2011, consuming alcohol over the guideline’s recommendations caused 1.2 million hospital admissions and around 15,000 deaths.(“Statistics on Alcohol”, 2016), costing the National Health Services (NHS) a staggering amount of £3.5 billion a year. (PHE, 2017).Furthermore, AC related hospitalisation in 2012 was 609 per 100,000in Portsmouth (PHE, 2014)



Effects of Alcohol Globally and Nationally


The global status report discussed the varieties of factors that can affect AC and acknowledged that the impact on the individuals is determined by 3 relevant aspects of drinking: the volume of alcohol, the pattern of drinking and the quality of alcohol consumed. (WHO, 2014).AC which is also influenced by age factors, coupled with behavioural hereditary factors, has significant implications on public health. A greater risk of harm is imposed if combined with obesity and smoking, more so amongst male population than female. Globally, 7.6% of male and 4.0% of female deaths in 2012 was attributable to alcohol. (WHO, p. 7-8, 2014).Equally it is important to consider that cognitive behaviours disorder and mental health such as depression, anxiety and phobia is often tied up with the level of alcohol consumed by individual resulting socioeconomic crises such as loss of earnings, unemployment, family problems and stigma to access health care services. (WHO, p.13, 2014).

In England, children’s AC influenced by the family environment, peer pressure and stress levels has been elevated, imposing a risk factor that impact particularly on children’s oral health. Oral health related problems such as erosion, accidental damage and oral cancer amongst 12 years old has increased by 30% and by 72% of 15 years old in 2012. (HSCIC, 2015).


Since AC is considered a source of global health and financial problems, the need of new guidelines and action plans was proposed by the Chief Medical Officer (CMO) in 2014recommending that health care professionals such as doctors, midwives, nurses and Dental Care Professionals (DCPs) should be equipped to recognise and identify harmful and hazardous drinking behaviours, monitor, then signpost them to access the relevant services provided. (DOH, 2016).


Alcohol Intervention

Prior to identifying the sign and symptoms of AM within the dental environment setting, knowing the reasons affecting patient’s excessive AC is

Important to establish. Some patients lack the knowledge of the impact of AM

To the body and the brain (Alcohol concern, 2016), socioeconomic

Status, depravation, temptations, availability, accessibility and promotional

Scenes also consider as some crucial to consider. (Alcohol concern,



With consideration to the facts and figures discussed earlier in this report and to gain a healthy, productive and employable population as well as to have

great economic and social welfare, a vision of creating a world free form

avoidable burden of Non communicable Diseases (NCD) was conceived by

the World Health Organisation (WHO, 2017).


It was later suggested that there is a need to update the alcohol guidelines, which was last visited in 1995 and based on the geographical limitations and the lack of guidelines relates to AC and pregnancy, (DOH, 2016),the government initiated a UK wide public consultation period of 10 weeks aimed to revisit the dated alcohol guidelines. Therefore, evidences based commendations of drawing new guidelines to enable people to make informed choices about their alcohol intake were introduced. (DOH, 2016)

Regular facial and oral screenings are the main periodical opportunities that allow recognising patients who may be drinking to excess and deliver appropriate Alcohol Brief Intervention (ABI). ABI is a structured, short and non-confrontational evidence-based conversation. It is motivational and supportive communication technique that helps to educate and advise patients and alter their behaviour towards excessive AC (PHE, 2017)


Role of DCP

The British Dental Association (BDA) aim is to encourage strategic input from all health and social care professionals, particularly DCPs as they are ideally positioned at the frontline, (BDA, 2014) and to adopt a holistic and preventative approach to patient care, communicate effectively considering difficulties and barriers. (, 2017) to build a good rapport with patients and gain their confidence. (Watt, et al., 2014).


Social determinants of health and oral health key messages should be delivered by educated, knowledgeable and skilled DCPs who should demonstrate competency in accurate record keeping and precise medical and social history updating to establish diagnoses and initiate the provision of signposting.(PHE, 2017).


Although the use of reliable models and surveys which are developed to detect alcohol problems among patients, AUDIT; AUDIT-C; AUDIT-PC and FAST models can take too long to undertake. Therefore, the importance of referrals to general practitioners and local alcohol support service should be stressed. (DOH, 2014).


Barriers of Communication

There are many aspects to consider when communicating with patients in the dental setting as well as group educational communications, or in this matter even with other DCPs in oral health education settings. Effective communication involves awareness of a mixture of factors; the most powerful aspect which has 55% effect is given to the paralinguistic communication including gestures, facial expression, eye contact, body language and clothes. Then nonverbal which relates to voice tone, volume and speed of speech was given 38% for its importance. Surprisingly, verbal communication which relates to the information been conveyed was given 7% of the factors. (Vital, 2009).

Additional limitations of communication to consider are social and cultural barriers including ethnic and religious beliefs, family values and spoken language. Therefore, techniques to improve the interaction between individuals or groups should be employed by DCPs to achieve effective outcomes, using frameworks and strategies when interviewing patient such as the acronym ‘CLASS’ which focuses on providing and maintaining empathetic setting, helping people to talk, using open questions, active listening and acknowledging feelings, empathy, clarifying , reflecting, paraphrasing using people’s own words and assessing patient’s treatment expectations, developing, proposing and negotiating treatment and preventive plans and summary of treatment and preventive options and obtaining feedback. (Vital, 2009).


Communication was a substantial proportion of my undergraduate education curriculum. However, communication barriers covered in the Introduction to Behavioural Science modules was an eye-opener. I have learnt that even though alcohol prevention and intervention is relevant to DCP’s roles, its implementation remains restricted, as it can be influenced by personal or environmental reasons. However, recognising effective communication methods and taking into consideration the techniques and the challenges would contribute positively to delivering better oral health messages and overcome the communication barriers. (McAuley, et al., 2011).

Upon reflection, I realised that DCPs, as a part of the wider healthcare community, are in the frontline of prevention and intervention of AM, my motivational interviewing skills in promoting safe drinking among dental patients has improved considerably.

At present, and coming to the end of the CertHE programme, I consider myself a safe beginner who is looking forward to start applying what I have learnt and use it within my scope of practice.









Health and Social Care Information Centre , 2016. Statistics on Alcohol. [Online] Available at:
[Accessed 5 April 2017].


  1. McAuley, C. A. G. G. R. O. S. S. &. K. C., 2011. Delivering alcohol screening and alcohol brief interventions within general dental practice: rationale and overview of the evidence. British Dental Journal, 210(15), pp. 1-4.


Alcohol Concern, 2016. Alcohol and your body. [Online] Available at:
[Accessed 5 April 2017].


Alcohol Concnern , 2015. Price of Alcohol. [Online] Available at:
[Accessed 5 April 2017].


Alcohol Policy Team, Department of Health, 2016. How to keep health risks from drinking alcohol to a low level: Government response to the public consultation. [Online] Available at:
[Accessed 5 April 2017].


BDA, 2014. The British Dental Association. [Online] Available at:
[Accessed 5 april 2017].


DOH, 2015. 2010 to 2015 government policy: harmful drinking. [Online] Available at:
[Accessed 7 April 2017].


Freeman, R., 1999. The psychology of dental patient care: Barriers to accessing dental care: patient factor. British Dental Journal, 187(3), pp. 141-144.

Gov.UK, 2017. Alcohol sales and misuse. [Online] Available at:
[Accessed 6 April 2017].


PHE, 2014. Alcohol treatment in England 2013-14. [Online] Available at:
[Accessed 7 April 2017].


PHE, 2017. Delivering better oral health: an evidence-based toolkit for prevention. [Online] Available at:
[Accessed 5 April 2017].


Roked, Z. W. R. M. S. &. S. J., 2014. Identification of alcohol misuse in dental patients. Faculty Dental Journal, 5(3), pp. 134-137.


Watt, R. W. D. &. S. A., 2014. The role of the dental team in promoting health equity. British Dental Journal, 216(1), pp. 11-14.

WHO, 2013. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. [Online] Available at:
[Accessed 5 April 2017].


WHO, 2014. Global status report on alcohol and health. [Online] Available at:
[Accessed 7 April 2017].


WHO, 2015. Alcohol. [Online] Available at:
[Accessed 5 April 2017].


Williams, L., 2016. UK Chief Medical Officers’ Low Risk Drinking Guidelines August. [Online] Available at:
[Accessed 6 April 2017].