Table 1 Summary of blended MI and PST sessions and objectives

At baseline

· Conduct screening/assessment of alcohol use

30 min

· Provide feedback on results of screening/assessment

· Increase knowledge of how alcohol use impacts on physical and mental health

· Use MI to build rapport and develop readiness to change

° Assess readiness to change (using readiness ruler for confidence and importance)

° Assess pros and cons of change (Decision-balance exercise)

° Use MI to try and shift participant and elicit a commitment to change

Session 1

Patient check-in (using MI) (5 min)

60 minutes

· Build the Rationale for PST (15 min):

  · Explain the structure of PST

  · Explain the link between problems and alcohol use, and the rationale for PST

  · Establish positive problem orientation

  · Describe the steps of PST

  · Build the rationale for activity scheduling

· Describe the steps of Problem Solving (15 min)

· First Problem Solving Session with counsellor (using the steps) and describe homework (25 min)

Session 2

· Patient check-in (using MI) (5 min)

40 minutes

· Review homework from previous week and challenges/difficulties (5 min)

° Elicit positive change talk and affirm commitment to change using MI techniques

° Review PST steps and affirm attempts to change

· Explain what can be done about problems that are not important (coping with negative thoughts) (10 min)

· Second Problem Solving Session with counsellor and an exercise (25 min)

Session 3

· Review practice exercises from session 3 (5 min)

40 minutes

· Explain what can be done about problems that are important but cannot be solved (5 min)

· Third Problem Solving Session with counsellor and an exercise (30 min)

Session 4

· Review practice exercises from session 3 (5 min)

40 minutes

·  Fourth Problem Solving Session with counsellor and an exercise (30 min)

· Use MI to affirm progress to date and discuss way forward and follow-sup (5 min)