"Regardless the actual content of the session," said Barnett, "booster sessions provide the individual an opportunity to review their issues around alcohol. In our AE session, it provided the participant more time with the alcohol-information computer program to seek information that they were particularly interested in. In the motivational intervention (MI) approach, the interventionist and the participant had the opportunity to raise issues that were not addressed in the first session or return to topics that warranted more discussion. I think it is likely that issues that are quite important to the participant, and central to their alcohol use, may not be raised by the participant or detected by the interventionist until the two have had more time together. Maybe most importantly, booster sessions provide an opportunity to review alcohol-related experiences that have occurred in the interim. In our case, we conducted the booster sessions one month after baseline so as to provide the participants enough opportunity to make decisions about drinking, possibly try alternatives or adjustments to their drinking patterns, and see the results."
"The biggest benefit of MI approaches is that, unlike most other preventive intervention approaches that have been used and studied to date, they actually work in reducing alcohol use and related problems," said Wood. "Although we don't really know how they work, there are many likely reasons. First, MI is a collaborative, non-confrontational way of addressing behaviors like drinking. It is well suited for use with 'emerging adults,' who are likely to actively resist authoritarian edicts. Second, the approach focuses on assessing where a given student is at motivationally and tailors the intervention accordingly. For example, with a student who is drinking heavily and experiencing substantial negative consequences, but has given little thought to changing this behavior, the intervention would focus on increasing awareness of these negative consequences and both current and future risks related to them. Third, MI is relatively cost effective, can be implemented by trained nonprofessionals such as undergraduates, and may increase the likelihood of additional help seeking. These benefits are particularly pertinent for mandated students who are likely to enter the situation in a more defensive and resistant state."
Targeting the social network of mandated students may be an effective strategy for changing their drinking perceptions and/or behaviors.
"College students typically drink in social situations with friends and roommates," said co-author Tracy O'Leary Tevyaw. "Mandated students drink on average more than students who are not mandated. However, mandated students typically report that their friends drink as much or more than they do. Their perceptions about what constitutes 'normative drinking' are influenced by having peers who also drink heavily. If we can effect changes in these perceptions as well as in the student's social network, by offering a targeted intervention to their heavy drinking peers, many of whose drinking is occurring under the radar, we might see enhanced short- and long-term outcomes."
The Lifestyle Management Project (LMC) – designed to reduce heavy drinking, associated negative consequences of acute intoxication, driving after drinking, and perceived drinking norms – shows promise as both a universal and targeted intervention tool. LMC utilizes both peer and professional leaders.
"LMC was an effective universal intervention because it was successful with voluntary, that is, students not identified as being at-risk," said Barnett, "and it was an effective targeted intervention because it was also successful with referred or at-risk students."
"From a practical standpoint," added Wood, "peer interventions are already a popular approach at universities, and students represent a cost-effective way to deliver interventions. Students can receive course credit and valuable practical experience learning about interventions and research in ways that nicely augment classroom-learning experiences."
"Though there is strong evidence that brief interventions are effective with high-risk college students," said Barnett, "mandated students are a somewhat different population. It is only in the past few years that well-designed studies with these students have been conducted. I think it is important for administrators to remember that many college students can and do change their alcohol use to safer patterns, and there are a number of things that administrators can do to facilitate this."
