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Practice Profile

Brief Alcohol Interventions for Adolescents and Young Adults

Evidence Ratings for Outcomes:

Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol consumption by adolescents
Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol-related problems of adolescents
Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol consumption by young adults
Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol-related problems of young adults

Practice Description

Practice Goals/Target Population
The goal of Brief Alcohol Interventions (BAIs) is to reduce participants’ alcohol use or alcohol-related problems via a short-term intervention. The target population for this practice includes adolescents, ages 11 to 17, and young adults, ages 18 to 30. BAIs can be delivered as universal, selective, or indicated prevention strategies (CSAT 1999).

Practice Theory
BAIs seek to motivate and provide resources to help participants moderate their drinking in the short term and seek more intensive treatment in the long term, if needed. This practice is based on elements from cognitive–behavioral therapy, motivational interviewing (Miller and Rollnick 1991), the transtheoretical model of behavior change (Prochaska and DiClemente 1984), or social norms theory (Berkowitz 2004). BAIs are designed to harness participants’ abilities, capabilities, and motivations to help them evaluate and regulate their drinking behaviors.

Services Provided
The defining characteristic of a brief intervention is the brief contact time (one to five sessions) with a health care provider (physician, nurse, psychologist, counselor) or other professional. The remaining components (length of session, duration of program, curriculum, theory, and philosophy) may vary by individual program (Heather 1995). For example, BAIs can be delivered in a variety of settings such as primary care/student health centers, schools/universities, and emergency rooms; for young adults, they can also be self-administered by participants. Intervention formats can include group or individual sessions, while interventions for adolescents can also include family components.

Most BAIs include at least one of the following components: a discussion of alcohol consumption, feedback on risk or levels of alcohol use, comparisons with local or national norms, information on potential harms, or coping strategies and goal-setting plans for dealing with drinking situations.

Specific types of BAIs include

  • Therapy-based brief interventions such as motivational enhancement/motivational interviewing therapy (MET), psychoeducational therapy, cognitive–behavioral therapy (CBT), or a combination of CBT plus MET.
  • Other brief interventions such as alcohol expectancy challenges for adolescents and young adults, or programs providing personalized feedback/information about drinking or a mailed 21st birthday informational card for young adults.

Meta-Analysis Outcomes

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Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol consumption by adolescents
Tanner-Smith and Lipsey (2015) reviewed 24 studies that included adolescent samples (ages 11 to 17) and found that adolescents who participated in brief alcohol interventions reported statistically significant reductions in levels of alcohol consumption, compared with control group adolescents. Overall adolescents in the treatment groups drank 1.3 days less per month, compared with adolescents in the control groups.
Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol-related problems of adolescents
Tanner-Smith and Lipsey (2015) reviewed 8 studies that included adolescent samples and looked at alcohol-related problem outcomes (e.g., scores on the Rutgers Alcohol Problem Index). They found that brief alcohol interventions were associated with statistically significant reductions in levels of alcohol-related problems. Overall brief alcohol interventions produced an 8-percentile improvement in alcohol-related problem outcomes for treatment group adolescents, compared with control group adolescents.
Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol consumption by young adults
Tanner-Smith and Lipsey (2015) reviewed 156 studies that included young adult samples (ages 18 to 30) and found that participants in brief alcohol interventions reported statistically significant reductions in levels of alcohol consumption, compared with young adults in the control groups. Young adult participants in the brief alcohol interventions drank 0.8 days less a month, compared with young adults in the control groups.
Effective - One Meta-Analysis Drugs & Substance Abuse - Alcohol-related problems of young adults
Tanner-Smith and Lipsey (2015) reviewed 96 studies that looked at alcohol-related problem outcomes (e.g., scores on the Rutgers Alcohol Problem Index) for young adults and found that brief alcohol interventions were associated with statistically significant reductions in levels of alcohol-related problems. Brief alcohol interventions produced a 4-percentile improvement on alcohol-related problem outcomes for young adult participants, compared with young adults in the control groups.
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Meta-Analysis Methodology

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Meta-Analysis Snapshot
 Literature Coverage DatesNumber of StudiesNumber of Study Participants
Meta-Analysis 11980 - 20121851863

Meta-Analysis 1
Tanner-Smith and Lipsey (2015) conducted a meta-analysis on the effectiveness of brief alcohol interventions for adolescents and young adults. The included studies focused on brief interventions to reduce participants’ alcohol use or alcohol-related problems (e.g., DUI/DWI convictions). Interventions targeted participants at any risk level, who were involved in 5 or fewer contact hours and 4 or fewer weeks between the first and last sessions, excluding the booster session, if applicable. Researchers defined brief alcohol interventions as consistent with the definition of “brief interventions” from the Center for Substance Abuse Treatment (CSAT 1999, 13).

Literature searches included 13 electronic databases and 18 other sources for grey literature that were available through the end of December 2012. Eligible studies had to include a comparison condition of no treatment, a waitlist control, or some form of routine treatment as usual; a participant sample of adolescents and young adults, defined as individuals ages 11 to 18 or 19 to 30, respectively; a research design such as randomized controlled trial or quasi-experimental design that provided enough information to permit estimation of a pretest effect size; and an assessment of intervention effects on at least one outcome variable that measured alcohol consumption (e.g., frequency of consumption, quantity consumed, blood alcohol concentration) or alcohol-related problems (e.g., scores from the Rutgers Alcohol Problem Index, relationship problems, risky sexual behavior, DUI/DWI convictions). The search provided 185 studies, 24 studies with adolescent samples, and 161 studies with young adult samples, for a total of 1,863 participants.

The adolescent sample was predominately male (53 percent), nonwhite (51 percent), and the average age of participants was 15. One half of the adolescent studies were conducted in the United States. The majority of adolescent studies used randomized controlled trials (79 percent) and had results published in a journal article (71 percent). The most common intervention modalities for adolescents were motivational enhancement/motivational interviewing (MET; 42 percent) and psychoeducational therapy (36 percent). Most of the interventions were delivered at school (82 percent) and included either group (42 percent) or individual (39 percent) formats. The average intervention length for the studies with adolescent samples was two sessions for a total of 100 minutes over 6 days.

The young adult sample was predominantly female (53 percent), white (76 percent), and the average age of participants was 20. The majority of the young adult studies (81 percent) were conducted in the United States. Most studies with young adults used randomized controlled trials (90 percent) and had results published in a journal article (75 percent). The most common intervention modalities for young adults were MET (35 percent) and programs focused on providing personalized feedback about drinking (28 percent). Most of the interventions were delivered at participants’ universities (55 percent) or were self-administered (34 percent). The average intervention length for the studies with young adult samples was one session for a total of 55 minutes over 3 days.

Effects were represented with standardized mean difference effect sizes (Cohen’s d) and were adjusted to provide unbiased estimates (Hedges’ g). All analyses used robust variance estimates, inverse variance weighting, and a random-effects model.
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Cost

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There is no cost information available for this practice.
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Other Information

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Tanner-Smith and Lipsey (2015) conducted moderator analyses on the studies included in their meta-analysis to explore when and for whom brief alcohol interventions (BAIs) were effective. In terms of intervention characteristics of BAIs, researchers found no statistically significant differences in effect sizes across intervention characteristics such as delivery site (i.e., school/university, primary health care clinics, or self-administered), format (i.e., self-administered/computerized, self-administered/not computerized, one-on-one sessions, or group sessions), or length (i.e., single session/less than 5 minutes, single session/5 to 15 minutes, single session/more than 15 minutes, or multi-session). These effects were similar for both adolescent and young adult populations. In terms of therapeutic components of BAIs, researchers found a statistically significant positive effect on reducing alcohol consumption for adolescent participants, compared with the control group, in studies that included decisional balance or goal-setting exercises as a part of the intervention. However, they did not find this effect for the young adult participants.

Further, the authors examined whether the following characteristics of the participant samples were associated with the magnitude of effects: race composition, average age, gender composition, or whether samples were selected based on high-risk drinking at baseline screening. The researchers found that BAI were more effective in reducing alcohol consumption for adolescent samples with a greater proportion of minority participants. However, they did not find this effect for the young adult samples. Researchers also found that the age of the participants was not associated with the intervention effects for alcohol consumption outcomes; however, among adolescent samples, the effects on alcohol-related problems were significantly smaller in older samples.

In regard to gender, the researchers found no evidence of association with was alcohol consumption or alcohol-related problems for adolescent and young adult populations. Finally, the researchers did find statistically significant reductions in alcohol-related problems for high-risk screened participants, compared with low-risk participants. This indicates that adolescents who already exhibit heavy alcohol consumption patterns may exhibit greater positive intervention effects, given that they have more room for improvement.
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Evidence-Base (Meta-Analyses Reviewed)

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These sources were used in the development of the practice profile:

Meta-Analysis 1
Tanner-Smith, Emily E., and Mark W. Lipsey. 2015. “Brief Alcohol Interventions for Adolescents and Young Adults: A Systematic Review and Meta-Analysis.” Journal of Substance Abuse Treatment 51:1–18.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346408
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Additional References

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These sources were used in the development of the practice profile:

Berkowitz, Alan D. 2004. The Social Norms Approach: Theory, Research, and Annotated Bibliography. Traumansburg, NY: Independent Consultant.
http://www.alanberkowitz.com/articles/social_norms.pdf

CSAT [Center for Substance Abuse Treatment]. 1999. Brief Interventions and Brief Therapies for Substance Use. Treatment Improvement Protocol (TIP) Series 34. Rockville, Md.: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. DHHS Publication No. SMA 99-3353.
https://www.ncbi.nlm.nih.gov/books/NBK64947

Heather, Nick. 1995. “Interpreting the Evidence on Brief Interventions for Excessive Drinkers: The Need for Caution.” Alcohol and Alcoholism 30:287–96.

Miller, William R., and Stephen Rollnick. 1991. Motivational Interviewing: Preparing People to Change Addictive Behavior. New York, N.Y.: Guilford Press.

Prochaska, James O., and Carlo C. DiClemente. 1984. The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy. Homewood, Ill.: Dow Jones-Irwin.
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Related Programs

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Following are CrimeSolutions.gov-rated programs that are related to this practice:

Brief Alcohol Screening and Intervention of College Students (BASICS) Effective - More than one study
This is a preventive intervention designed to help college students make better decisions about alcohol use. The program is rated Effective. The intervention group showed statistically significant reductions in negative consequences of drinking (for example, accidents, violence or academic problems) and peak blood alcohol content. However, findings were mixed with regard to quantities consumed, and there was no statistically significant difference between groups in frequency of drinking.
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Practice Snapshot

Age: 11 - 30

Gender: Both

Targeted Population: Alcohol and Other Drug (AOD) Offenders

Settings: Campus, Inpatient/Outpatient, Other Community Setting, School

Practice Type: Alcohol and Drug Prevention, Alcohol and Drug Therapy/Treatment, Cognitive Behavioral Treatment, Group Therapy, Individual Therapy, Motivational Interviewing

Unit of Analysis: Persons

Researcher:
Emily Tanner-Smith
Associate Professor
University of Oregon, College of Education, Department of Counseling Psychology and Human Services
5251 University of Oregon
Eugene OR 97403
Phone: 541.346.6592
Website
Email