A randomized trial of motivational interviewing and feedback with heavy drinking college students

Motivational interviewing (MI) is a brief intervention that has been shown to reduce heavy drinking among college students. Because all college studies of MI to date have included a personalized feedback report, it remains unclear which of the components is necessary to produce behavior change. This study evaluated the separate and collective effects of MI and feedback among 122 "binge" drinking college students. Participants were randomized to: (1) MI with feedback, (2) MI without feedback, (3) Mailed feedback only, (4) MI with mailed feedback, or (5) Assessment only control. At an eight-week follow-up, all groups reduced their consumption, peak BAC, consequences, and dependence symptoms. For females, there were reductions in consequences and dependence symptoms in groups that received feedback, as compared to groups that did not receive feedback. For females, there was an effect of the feedback on consequences and dependence symptoms, but was no overall effect of MI on any outcome measure.     

In Praise of Feedback: An Effective Intervention for College Students Who Are Heavy Drinkers

Abstract

The efficacy of brief motivational feedback to reduce drinking among college students has been reported by several researchers. As an extension of this theoretical and applied framework, the author tested the use of mailed feedback to influence the drinking behavior of students self-identified as moderate-to-heavy drinkers in two randomized trials. A 6-week follow-up of the efforts suggested the efficacy of the feedback intervention at reducing alcohol consumption. The feedback mechanism used in the studies is described in detail and possible reasons for its efficacy are explored. In light of the cost-effective nature of this intervention, it may warrant a place in larger campus prevention programs.     

In praise of feedback: an effective intervention for college students who are heavy drinkers

The efficacy of brief motivational feedback to reduce drinking among college students has been reported by several researchers. As an extension of this theoretical and applied framework, the author tested the use of mailed feedback to influence the drinking behavior of students self-identified as moderate-to-heavy drinkers in two randomized trials. A 6-week follow-up of the efforts suggested the efficacy of the feedback intervention at reducing alcohol consumption. The feedback mechanism used in the studies is described in detail and possible reasons for its efficacy are explored. In light of the cost-effective nature of this intervention, it may warrant a place in larger campus prevention programs.     

Integrating mailed personalized feedback and alcohol screening events: a feasibility study

This study characterized a sample of college students attending National Alcohol Screening Day (NASD), and tested the feasibility of using NASD as a platform for initiating the delivery of mailed personalized feedback forms. Participants (N = 153, 65% female) attended NASD and completed the Alcohol Use Disorders Identification Test (AUDIT [1]). A subset of at-risk drinkers completed additional questionnaires about their alcohol use and received personalized feedback through the mail. Thirty-four percent of the participants scored above the recommended clinical cutoff on the AUDIT. Men reported higher levels of alcohol consumption and alcohol-related negative consequences. The subset of at-risk drinkers reported frequent occasions of binge drinking and relatively high blood alcohol concentrations (BAC). NASD is an effective way of identifying college students with clinically significant levels of alcohol use, and provides an efficient mechanism for initiating the delivery of personalized feedback. More research on the combined effects of NASD and personalized feedback is warranted.     

A Comparison of an Assessment/Information-Based Group versus an Assessment-Only Group

Abstract

The use/abuse of alcohol leading to impaired driving, accidents and even fatalities is a major social concern. National data sets demonstrate that college students abuse alcohol. This research paper outlines a program designed to reduce levels of drinking and presents a format for evaluating its effectiveness. An experimental study (n = 55) was conducted to examine drinking patterns among full-time college students at four-year institutions to observe whether exposure to a personalized feedback pamphlet would reduce the amount of alcohol consumption between a treatment and nontreatment control group. The posttreatment drinking, as defined by the number of times a week participants consumed five or more drinks per setting, between groups was not statistically significant. However, posttreatment drinking, as defined by the average number of drinks consumed in a sitting, between groups was significant. While the treatment group demonstrated a greater decrease in the number of subscales, this difference was not statistically significant.     

Technology-Based Interventions and Trainings to Reduce the Escalation and Impact of Alcohol Problems

There has been a rapid increase in the development of technological innovations to reduce the escalation and impact of alcohol problems among adolescents and adults. Technology-based interventions offer the possibility of reaching individuals who otherwise might not seek treatment, (e.g., those in remote areas, those not perceiving a need for treatment, or others who might resist treatment). This article describes 4 case examples of technology-based interventions for risky drinking: (a) a freely available and interactive Web site that provides individualized feedback and information on risky drinking patterns; (b) a brief intervention for adolescents that provides individualized feedback to teens regarding their alcohol use; (c) a computer-delivered screening and brief intervention for alcohol use among pregnant women; and (d) a simulation program for training social workers in screening and brief intervention. These case examples highlight how technology could have a role in addressing the Alcohol Misuse Grand Challenge.     

How much is enough? Willingness to participate in alcohol interventions

This study examined the willingness of drinkers to participate in alcohol interventions designed to cut down or stop alcohol use by degree of service-provider contact. One hundred fifty-six university students and staff who attended a campus health fair participated in an alcohol survey. Of the college drinkers, 73.7% reported they were willing to participate in one or more alcohol interventions with minimal provider contact, compared with 48.5% who said they would participate in programs with high provider contact. Respondents preferred minimal-contact strategies (use of nonalcoholic or low-alcohol beverages, information pamphlets, cash awards, television programs, and mailed instructions) to high-contact approaches. Men were significantly more willing (ps less than .05) than women to participate in nearly half (11 to 21) of the alcohol interventions. Three measures indicative of motivation to control drinking were significantly associated with greater willingness to participate in nearly all strategies. This study also suggested that drinkers who were highly motivated to control their drinking did not prefer minimal-contact interventions over high-contact interventions.     

Research-in-Progress Sessions Create a More Inclusive and Engaging Regional Conference

The Pacific Sociological Association annual meeting recently added a new session type called the Research-in-Progress (RIP) session. The purpose of adding these sessions was to provide an opportunity for attendees to present research still in formative stages of completion in order to get useful feedback. Presentations ranged from doctoral dissertation proposals to nearly completed research. Early experience from RIP session organizers and discussants is that these sessions were lively and engaging, sparking a great deal of audience participation. Feedback from presenters indicated that they received useful feedback. Based on our initial experience with the RIP sessions, we believe they are a beneficial addition to the meetings.     

Efficacy of a web-based, tailored, alcohol prevention/intervention program for college students: 3-month follow-up

This study presents the results of an efficacy evaluation of a web-based brief motivational alcohol prevention/intervention program called Michigan Prevention and Alcohol Safety for Students (M-PASS). Four on-line sessions providing individually-tailored feedback were delivered to first-year college students over 9 weeks. Non- and low-risk drinking participants received risk prevention, while high-risk drinking participants received a risk-reduction intervention. Both intervention and control groups were surveyed at baseline and at a 3-month follow-up. Analysis showed positive effects for both men and women on stage of change, drinking behavior, drinking motivation and attitudes, and use of risk-reduction strategies. These results provided evidence of efficacy and found that M-PASS had both intervention and prevention effects, making it unique among currently developed brief alcohol interventions for college students.     

First-session competency: the brief strategic therapy scale-1

The first session in brief strategic therapy is the most critical phase of treatment. More than a mere "assessment phase," the first session in a true intervention sets the stage for all subsequent therapeutic maneuvers. This article presents a supervisory observation tool, the Brief Strategic Therapy Scale-1 (BSTS-1), a fidelity measure proposed as a more formal method of analyzing performance and competency of the therapist for the first session. During scale development, a narrow group of expert judges defined the core skills of therapists and determined the structure/phases of a brief strategic therapy first session. In addition, expert collaborators gave feedback on the scale's usability. This article concludes with the BSTS-1.     

Personalized boosters for a computerized intervention targeting college drinking: The influence of protective behavioral strategies

ABSTRACT

Objective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback. Participants: Participants were 213 student drinkers at a southeastern public university, ages 18–24. Methods: Students were randomized into (1) intervention only, or (2) intervention plus booster. Alcohol consumption and related problems were assessed at baseline, 2 weeks post, and 4 weeks post. Results: Boosters yielded reductions in drinking, but not alcohol-related problems. Boosters were associated with significant reductions for drinking frequency, heavy drinking days, peak drinks, and associated blood alcohol concentration (BAC). Protective behavioral strategies (PBS) moderated this effect, with significant reductions for students low in PBS, but not students already highly engaged in PBS use. Conclusions: Easy dissemination and low cost make e-mailed boosters a very efficient way to promote student health.     

Reducing High-Risk Drinking Among Student-Athletes: The Effects of a Targeted Athlete-Specific Brief Intervention

Abstract

Objective: This study examined the effects of a single-session motivational interviewing–based in-person brief alcohol intervention that contained student-athlete–specific personalized drinking feedback. Participants: Participants were 170 National Collegiate Athletic Association Division I student-athletes meeting screening criteria for heavy episodic drinking. Methods: Baseline assessments of alcohol use frequency and quantity, norm perceptions of peers' alcohol use, experiences of negative consequences, and use of protective behaviors were administered to student-athletes prior to a 1-session brief intervention containing personalized feedback highlighting the relationship between alcohol use and athletic performance. Follow-up assessment was conducted 3 months post intervention. Results: Student-athletes participating in the athlete-specific brief intervention showed significant reductions in their alcohol use and alcohol-related negative consequences, increases in use of protective behavioral strategies, and corrections in norm misperceptions at 3 months post intervention relative to a no-treatment comparison group. Conclusions: Student-athlete–specific brief alcohol interventions show promise in addressing high-risk drinking, reducing associated harms, and supporting health.     

Rates of Asymptomatic Nonurethral Gonorrhea and Chlamydia in a Population of University Men Who Have Sex With Men

ABSTRACT

Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and provided tailored feedback for 6 weeks. Response rates to SMS drinking-related queries and the associations between weekend drinking plans, drinking-limit goal commitment, and alcohol consumption were examined. Gender differences were explored. Results: Ninety percent of SMS queries were completed. Weekend binge drinking decreased over 6 weeks, and drinking-limit goal commitment was associated with less alcohol consumption. Compared with women, men had greater reductions in alcohol consumption when they committed to a drinking-limit goal. Conclusions: Preliminary evidence suggests that an SMS program could be useful as a booster for helping mandated students reduce weekend binge drinking.     

How Routine Patient‐Centered Monitoring Relates to Therapeutic Gains in Family Therapy: A Single‐Case Study

As routine outcome monitoring systems develop, questions emerge about how therapists incorporate feedback into their practice, and how this relates to therapeutic gains. A case of covert grief was monitored in each session with the Personal Questionnaire and the Helpful Aspects of Therapy instruments. At 4 months follow‐up, the Change Interview was administered. Individualized items facilitated access to the private views and needs of each member, which was useful for case formulation and ongoing personalization of the intervention. Qualitative feedback of treatment experiences helped therapists confirm the impacts of interventions, monitor therapeutic alliance, reformulate clinical hypothesis, and plan sessions. Therapists followed a critical triangulation process to decide the clinical meaning of feedback, according to his/her intervention model, expertise, and case‐specific context.     

Examination of the relationship between social support and treatment outcomes in mothers referred by Child Protective Services utilizing the Significant Other Support Scale

ABSTRACT

Supportive social networks may play an important role in recovery for mothers within the umbrella of Child Protective Services (CPS). However, investigators have yet to develop methods of measuring how significant others contribute to the treatment and recovery process. In this study, the influence of significant others was examined in the family-based treatment of 38 mothers who were referred for Family Behavior Therapy by CPS. The Significant Other Support Scale (SOSS) was empirically developed and subsequently utilized to assess the extent to which participants’ significant others were perceived by treatment providers to support the participants’ goals during treatment sessions. Results indicated that SOSS scores (but not participant and significant other session attendance) were associated with lower participant child abuse potential and drug use frequency at the conclusion of treatment. There was no relationship found between SOSS scores and participant session attendance. However, there was a positive correlation between SOSS scores and significant other session attendance (r = .489, p < .01). The results of this study suggest the quality of significant other support during treatment sessions in this population of mothers may be more important to improving treatment outcomes than session attendance per se. Future directions are discussed in light of the results, including methods of using SOSS scores to assist family-based treatments.     

Pre‐teenage Children's Experiences with Alcohol

This article reports on the drinking experiences and motivations of 77 pre‐teenage children. The main reason which the children gave for occasional or regular drinking was the pleasure which they derived both from the effects of the alcohol and from the social interaction which accompanied the activity. Several of the children claimed that they were partly motivated by boredom. Peer influence appeared to play a minor role as far as the recurrent consumption of alcohol was concerned. A number of causes for concern are identified in the article. These include the frequency of the children's drinking and the volume of alcohol consumed by some of them; their tendency to combine different types of alcoholic drink in the same session; the unreliability of measures undertaken by the children to reduce risk and ensure their safety and the ease with which alcohol could be obtained. These findings emphasise the need for drug education programmes to alert children to the dangers of alcohol consumption and equip them with the skills to deal effectively with peer pressure. There is also a pressing need to improve the leisure facilities available for young people as alternatives to drinking and other problem behaviour. © 2007 The Author(s). Journal compilation © 2007 National Children's Bureau.     

Relationship of Work Hours With Selected Health Behaviors and Academic Progress Among a College Student Cohort

Approximately 57% of college students work while attending school. Health risks related to working while in college have not been widely studied. Objective: The authors' purpose in this study was to determine associations between hours worked, binge drinking, sleep habits, and academic performance among a college student cohort. Participants and Methods: The authors randomly selected a sample of 1,700 undergraduates from a southeastern US university and mailed to them a survey requesting a variety of self-reported health behaviors and hours worked. A total of 903 completed questionnaires were received, indicating a response rate of 57.3%. Results: Binge drinking, less sleep, and lower academic performance were significantly associated with working 20 or more hours per week. Those variables were not associated with working fewer than 20 hours per week. Conclusions: Although administrators and others in higher education are aware of the impact of economics on a school's ability to operate, they may not be aware of the impact on students' health.     

Clients' Perceptions of Single Session Consultations as an Option to Waiting for Family Therapy

A single-session program was mailed at Bouverie Family Therapy Centre (BFTC), Melbourne, and results indicated a high level of client satisfaction with the service. Within the review period 53% of clients chose to attend for a one off consultation only, with the option of an ‘open door’ to return far therapy if they felt the need. The BFTC outcome supported findings of Moshe Talmon (an international advocate of the effectiveness of single session therapy), and also of two other Australian agencies whose research was reviewed and compared with the BFTC results.     

Relationship of work hours with selected health behaviors and academic progress among a college student cohort

Approximately 57% of college students work while attending school. Health risks related to working while in college have not been widely studied. OBJECTIVE: The authors' purpose in this study was to determine associations between hours worked, binge drinking, sleep habits, and academic performance among a college student cohort. PARTICIPANTS AND METHODS: The authors randomly selected a sample of 1,700 undergraduates from a southeastern US university and mailed to them a survey requesting a variety of self-reported health behaviors and hours worked. A total of 903 completed questionnaires were received, indicating a response rate of 57.3%. RESULTS: Binge drinking, less sleep, and lower academic performance were significantly associated with working 20 or more hours per week. Those variables were not associated with working fewer than 20 hours per week. CONCLUSIONS: Although administrators and others in higher education are aware of the impact of economics on a school's ability to operate, they may not be aware of the impact on students' health.     

Walk-in Together: A pilot study of a walk-in online family therapy intervention

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk-in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof-of-concept study investigating the acceptability and short-term effectiveness of an online walk-in family therapy service, Walk-in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk-in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre-session, post-session, and at 6 weeks follow-up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi-structured interview data. Post-session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post-session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well-received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk-in delivery model. This proof-of-concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk-in, telehealth model to meet the rising demand for therapeutic support for families in distress.