Addictive Behaviors 35 (2010) 730–733

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Addictive Behaviors

Short Communication

Brief alcohol intervention for college drinkers: How brief is?

Magdalena Kulesza a, Megan Apperson a, Mary E. Larimer b, Amy L. Copeland a,⁎
a
Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge 70803
b
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195

a r t i c l e i n f o a b s t r a c t

Keywords: Objective: Brief interventions for college student drinkers have been shown to be effective in reducing the
brief intervention amount of alcohol consumed as well as the number of alcohol-related problems. However, the duration of
college students brief interventions varies substantially across studies.
heavy drinkers Method: In the present study 114 undergraduate students who drank alcohol heavily were randomly
alcohol
assigned to a 10-minute brief intervention, a 50-minute brief intervention, or assessment-only control. The
binge drinkers
content of the active interventions was based on the same concept, and both interventions incorporated
motivational interviewing components. Participants were assessed at baseline and 4-week post intervention
on quantity of alcohol use, alcohol-related problems, and protective behavioral strategies.
Results: As hypothesized, there was a significant difference between participants in the 10-minute
intervention and control condition regarding their alcohol consumption at 4-week follow up. However, there
was no significant difference between the 50-minute intervention and the control condition on alcohol
consumption. There were also no significant differences between active intervention conditions, and neither
intervention showed advantages for reducing problems or increasing protective behaviors relative to the
control condition.
Conclusions: Results suggest a very brief intervention can impact short-term alcohol use outcomes, with
potentially no advantage of longer interventions for this population.
© 2010 Elsevier Ltd. All rights reserved.

1. Introduction several questions persist regarding necessary elements of such

Heavy drinking poses a major problem on college campuses
(Wechsler, Lee, Kuo & Lee, 2000). In 2005, 44.7% of college students
reported heavy drinking in the past month, an increase from 41.7% in
1999 (Hingson, Zha & Weitzman, 2009). Heavy drinking is also
associated with high risk and illegal behaviors (Abbey, 2002; Cooper,
2002; Wechsler, Dowdall, Maenner, Gledhill-Hoyt & Lee, 1998).
According to the National Institute on Alcohol Abuse and Alcoholism
(NIAAA) Task Force on College Drinking Prevention, components of a
successful college drinking intervention are: motivational enhance-
ment, cognitive-behavioral intervention, and skills training (United
States Department of Health and Human Services (USDHHS), National
Institute of Alcohol Abuse and Alcoholism, 2002). Brief Alcohol
Screening and Intervention for College Students (BASICS) is a brief
motivational intervention (BMI) incorporating all of these elements
(Dimeff, Baer, Kivlahan & Marlatt, 1999). BASICS and related BMIs have
been found to be efficacious in numerous studies (Marlatt et al., 1998;
Larimer & Cronce, 2002;2007; Carey, Henson, Carey & Maisto, 2007).
Unfortunately, there is a scarcity of research investigating
mechanisms of action of BMIs (Walters & Neighbors, 2005), and
⁎ Corresponding author. 236 Audubon Hall, Department of Psychology, Louisiana
State University, Baton Rouge, LA 70803. Tel.: + 1 225 578 4117; fax: + 1 225 578 4125.
E-mail address: copelan@lsu.edu (A.L. Copeland).
interventions (e.g., Saunders, Kypri, Walters, Laforge & Larimer,
2004). One question concerns the sufficient length or dosage of
intervention necessary to produce effects (Larimer, in Saunders et al.,
2004). For example, both Marlatt et al. (1998) and Dimeff and
McNeely (2000) found BMIs to be efficacious in reducing college
student alcohol use and problems. However, length of the BMIs (i.e. 50
minutes in Marlatt et al. and 5 minutes in Dimeff & McNally) and
delivery method (i.e. health practitioner in medical setting versus
clinical psychology graduate student in mental health clinic) differed
between studies. Findings suggest both 5- and 50-minute BMIs
successfully reduce alcohol use and consequences. However, no
studies to date have directly compared the efficacy of different lengths
of the same intervention in college populations.
Research with other populations suggests that longer and shorter
interventions may achieve similar outcomes in adult problem
drinkers (Wutzke, Conigrave, Saunders & Hall, 2002). Preliminary
evidence also suggests shorter interventions may achieve better
results in some populations. Petry, Weinstock, Ledgerwood and
Morasco (2008) randomly assigned adults with gambling problems
to: a) 10-minutes of brief advice (BA); b) one session of Motivational
Enhancement Therapy (MET); c) one session of MET plus 3 sessions of
Cognitive Behavioral Therapy; and d) assessment only control. At 6-
week follow up, only the BA condition, as compared to control, lead to
significant reductions in gambling. Participants in the BA condition

0306-4603/$ – see front matter © 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.addbeh.2010.03.011
 M. Kulesza et al. / Addictive Behaviors 35 (2010) 730–733 731

also showed clinically significant reductions in gambling at 9-month
follow up.
These studies suggest that, at least for adult nondependent
drinkers and problem gamblers, short interventions may be at least
as effective as longer ones. Still, this question has not been tested with
college populations. If a shorter interventions is as effective as a longer
intervention, the least invasive and burdensome treatment should be
employed (Sobell & Sobell, 2000). Additionally, it is reasonable to
assume shorter interventions are less costly than longer ones; thus,
shorter interventions are a more economically prudent choice if both
are found to be equally effective.
The present study addressed this question through conducting a
clinical trial with heavy drinking college students randomized to a 10-
minute BMI, a 50-minute BMI, or a six week wait-list control group.
Both BMIs were based on BASICS (Dimeff et al., 1999). We assessed
participants’ drinking, drinking related problems, and protective
behavioral strategies 4 weeks post intervention (both intervention
groups) and 4 weeks post assessment (control group) to determine
efficacy of the interventions in comparison to each other and to the
control group. We hypothesized that both the 50-minute and 10-
minute BMIs would produce significantly greater reductions in
alcohol use and related problems and significantly greater increases
in use of protective behavioral strategies than the control condition.
We further tested whether the 50-minute BMI would be more
efficacious than the 10-minute BMI on these outcomes.
2. Method
2.1. Participants
Participants were recruited through the Psychology Subject Pool
and received course credit for participation. Consistent with prior
BASICS research (Marlatt et al., 1998; Baer, Kivlahan, Blume, McKnight
& Marlatt, 2001) students were high risk if they: a) drank at least
monthly and consumed at least 5 drinks (men) or 4 drinks (women)
on at least one occasion in the past month or b) reported three or
more alcohol-related problems on 3 to 5 occasions in the past 3 years.
A total of 536 participants completed screening, of whom 134 (25%)
met inclusion criteria and were invited to participate. One hundred
fourteen (85%) eligible students agreed to participate in the
longitudinal trial, and 100% of these were retained through 4-week
follow-up. The remaining 15% of eligible students were not interested
in participating and did not differ significantly on any variables of
interest from those who participated. Our sample of 114 students was
representative of the population enrolled in Psychology courses, and
was predominately Caucasian (84.2%) and female (71.9%), with an
average age of 20 years. There were no differences across conditions
in age, gender, or ethnicity.
Martens et al., 2005) is a 25-item instrument assessing students’ use
of various cognitive-behavioral strategies to reduce harm associated
with alcohol consumption.
2.3. Procedure
Students were randomized to either a 10-minute or a 50-minute
BMI session, or to assessment-only control. BMIs took place
approximately two weeks after baseline assessment. BMI sessions
were individually tailored based on baseline information. and were
conducted by clinical graduate students trained to criterion in MI as
outlined by Miller and Rollnick (1991), using a written BASICS manual
(Dimeff et al., 1999). The following topics were addressed: a)
evaluation of typical drinking patterns from diary cards and baseline
assessment; b) comparison of typical patterns of alcohol use and
perceived norms to actual norms; c) review of the biphasic effects of
alcohol; d) personalized review of drinking consequences; and e)
placebo and tolerance effects of alcohol. Each participant received a
handout with a list of strategies to encourage moderate drinking
(Dimeff et al., 1999).
3. Results
We conducted separate analyses of covariance (ANCOVAs) for each
of our three dependent variables (DDQ, RAPI and PBSS), covarying
baseine scores on each dependent variable. Table 1 displays means and
standard deviations for all outcomes at baseline and 4-week follow-up.
For the DDQ, the ANCOVA was significant, F (2, 110)= 3.5, p b .05, partial
η2 = .06. Pairwise post-hoc comparisons with Bonferoni correction
indicated participants in the 10-minute intervention had significantly
fewer drinks per week at follow-up compared to the control condition,
p = .03, d = .53.
Alcohol-related negative consequences were lower in all groups at
follow-up compared to baseline but did not differ across conditions,
F (2,110) = 1.9, p = .16, partial η2 = .03). Effect sizes for comparisons
between the 10-minute BMI and control condition, the 50-minute and
10-minute BMIs, and the 50-minute BMI and control condition were:
d = .02, d = .22, d = .18 respectively. Similarly, there was no effect of
either BMI on use of protective behaviors as measured by the
PBSS, F (2, 110) = .78, p = .5, partial η2 = .01). Effect sizes comparing
the 10-minute BMI to the control condition, 50-minute to 10 minute
BMIs, and 50-minute BMI to control were: d = .06, d = .16, d = .20
respectively.
4. Discussion
We investigated whether length of a BMI for college student
problem drinkers affected its efficacy. Specifically, we compared

2.2. Measures
Table 1
Pre and Post-intervention comparisons on outcome variables.
Consistent with BASICS protocol, all participants completed a
clinical interview based on the Brief Drinker Profile (Miller & Marlatt, Overall 50-minute 10-minute Control P-value
(n = 114) (n = 35) (n = 39) (n = 40)
1984) at baseline and online self-report assessments of perceived
norms (Baer, Stacy & Larimer, 1991), readiness to change (Rollnick, DDQ, M (SD)
Heather, Gold & Hall, 1992), and alcohol expectancies (Fromme, Scott Baseline 16.1 (6.5) 16.9 (6.8) 15.5 (5.4) 15.9 (7.2)
Follow-up 11.9 (7.8) 12.1 (8.1) 9.9 (7.2)a 13.9 (7.6)a 0.03
& Kaplan, 1993) for use in the BMIs. Also, participants completed the
RAPI, M (SD)
following outcome measures at baseline and follow-up: The Rutgers Baseline 11.7 (8.1) 13.0 (9.9) 10.6 (6.3) 11.5 (7.9)
Alcohol Problem Inventory (RAPI; White & Labouvie, 1989) is a 23 Follow-up 6.1 (6.6) 5.1 (6.1) 6.5 (7.3) 6.7 (6.3) ns
item instrument assessing whether and how often students had PBSS, M (SD)
Baseline 29.4 (7.6) 29.2 (7.1) 30.3 (7.9) 28.8 (7.8)
experienced consequences impacting personal, social, or academic
Follow-up 30.6 (8.6) 31.7 (7.9) 30.4 (7.8) 29.9 (9.9) ns
functioning in the past three years, on a Likert-type scale from 1
(never) to 5 (more than 10 times). The Daily Drinking Questionnaire Note. P-values provided are for ANCOVA comparing 50-minute, 10-minute and control
condition follow-up values, while controlling for baseline values. DDQ = Daily Drinking
(DDQ; Collins, Parks & Marlatt, 1985) assesses the typical number of Questionnaire; RAPI = Rutgers Alcohol Problem Inventory; PBSS = Protective Behavior
drinks consumed and hours spent drinking on each day of the week Strategies Survey. Means in the same row that share subscripts are significantly
over the past month. Protective Behavioral Strategies Survey (PBSS; different at the p b .05 value in follow-up tests.
732 M. Kulesza et al. / Addictive Behaviors 35 (2010) 730–733
efficacy of 50-minute and a10-minute formats of the BASICS
intervention (Dimeff et al., 1999) in reducing alcohol use and
related problems among high-risk college drinkers. Alcohol use
was reduced for participants in the 10-minute BMI as compared to
the control condition. However, alcohol use did not differ at follow-
up between the 50-minute BMI and the control condition or the 10-
minute BMI.
Although findings are contrary to our hypothesis, they are
consistent with recent work by Petry et al. (2008) demonstrating
10 minutes of brief advice for pathological gambling was more
effective than a longer intervention. Perhaps such brief interventions
allow participants to absorb and focus on the most salient aspects of
their problem behavior without raising defensiveness or over-
whelming them. Given the preponderance of women in our study,
results should also be interpreted in light of preliminary support in
the literature for a moderating effect of gender (see Larimer &
Cronce, 2007 for review), whereby female college drinkers benefit
than males from brief interventions (Larimer et al., 2007; Murphy
et al., 2004).
Contrary to our hypothesis, post-intervention alcohol-related
problems did not differ significantly between groups, though all
groups reduced negative consequences. There are several possible
explanations for this. First, after evaluating closely the structure
and content of our BMI sessions, it is possible that insufficient time
was devoted to discussing strategies for reducing alcohol-related
problems, in comparison to time spent discussing alcohol use and
other aspects of the interventions. Second, improvements in the
control condition may have been a result of assessment reactivity
(Kaminer, Bureson & Burke, 2008; Kypri, Gallagher & Cashell-
Smith, 2004). Third, some research (Carey et al., 2007) suggests the
impact of BMIs on alcohol-related problems emerges at later
follow-ups, which may not have been captured during the 6-week
follow-up period. Finally, this unexpected finding is not isolated.
For example, Monti et al. (2007) recently reported adolescent
problem drinkers showed significant reductions in alcohol use but
not in alcohol-related problems post intervention. This finding was
unexpected as previous studies (Marlatt et al., 1998; Monti et al.,
1999) with similar samples have achieved the opposite effect of
participants showing significant reductions in negative conse-
quences with smaller or no reductions in consumption. More
research is needed to understand the differential impact of BMIs on
consumption and consequences.
The current study has several limitations. First, examination of
effect sizes suggests a larger sample size may have improved our
ability to evaluate our hypotheses. Although the sample size is
relatively small, one strength of the study is that the majority of
eligible participants enrolled, and all participants were retained
throughout follow-up. Another limitation involves concerns re-
garding validity of college students’ self-reports of alcohol use. Still,
such measures have been successfully employed in previous
research in the field (i.e. Borsari & Carey, 2000;2005; Larimer
et al., 2001;2007).
Although all assessments and interventions were provided by
clinical graduate students trained in MI, we do not have treatment
fidelity data. Additionally, recent work by Barnett, Goldstein, Murphy,
Colby and Monti (2006); Barnett et al. (2008) indicates the extent to
which student drinkers are bothered by a recent alcohol-related
negative consequence significantly influences their motivation to
change drinking. Unfortunately, we are not able to assess the
relationship between proximal negative events and motivation to
change in our study due to lack of data. This and other limitations
should be addressed in future investigations.
Although the current study is a preliminary step toward evaluating
the relationship between length of intervention and outcomes, results
nonetheless make a contribution to the college drinking prevention.
Specifically, very brief intervention can have demonstrable impact on
drinking, at least in the short run, though no effects on consequences
were noted. Results failed to support our hypothesis that longer
intervention would achieve better outcomes, thus from a cot-
effectiveness standpoint the shorter intervention may represent a
better initial step. Further research is needed to replicate these
findings.
Conflicts of Interest
None.
References
Abbey, A. (2002). Alcohol-related sexual assault: A common problem among college
students. Journal of Studies on Alcohol, Supplement, 118−128.
Baer, J. S., Kivlahan, D. R., Blume, A. W., McKnight, P., & Marlatt, G. A. (2001). Brief
intervention for heavy drinking college students: 4-year follow up and natural
history. American Journal of Public Health, 91, 1310−1316.
Baer, J. S., Stacy, A., & Larimer, E. M. (1991). Biases in the perception of drinking norms
among college students. Journal of Studies on Alcohol, 52, 580−586.
Barnett, N. P., Borsari, B., Hustad, J., O'Leary-Tevyaw, T., Colby, S. M., Kahler, C. W., &
Monti, P. M. (2008). Profiles of college students mandated to alcohol intervention.
Journal of Studies on Alcohol and Drugs, 69, 684−694.
Barnett, N. P., Goldstein, A. L., Murphy, J. G., Colby, S. M., & Monti, P. M. (2006). “I will never
drink like that again”: Characteristics of alcohol related incidents and predictors of
motivation to change in college students. Journal of Studies on Alcohol, 67, 754−763.
Borsari, B., & Carey, K. B. (2000). Effects of a brief motivational intervention with college
student drinkers. Journal of Consulting and Clinical Psychology, 4, 728−733.
Borsari, B., & Carey, K. B. (2005). Two brief alcohol interventions for mandated college
students. Psychology of Addictive Behaviors, 19, 296−302.
Carey, K. B., Henson, J. M., Carey, M. P., & Maisto, S. A. (2007). Which heavy drinking
college students benefit from a brief motivational intervention? Journal of
Consulting and Clinical Psychology, 75(4), 663−669.
Collins, R. L., Parks, G. A., & Marlatt, G. A. (1985). Social determinants of alcohol
consumption: The effects of social interaction and model status on the self
administration of alcohol. Journal of Consulting and Clinical Psychology, 53, 189−200.
Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and
youth: Evaluating the evidence. Journal of Studies on Alcohol, Supplement, 101−117.
Dimeff, L. A., Baer, J. S., Kivlahan, D. R., & Marlatt, G. A. (1999). Brief alcohol screening
and interventions for college students: A harm reduction approach. New York:
Guilford Press.
Dimeff, L. A., & McNeely, M. (2000). Computer-enhanced primary care practitioner
advice for high risk college drinkers in a student primary health-care setting.
Cognitive and Behavioral Practice, 7, 82−100.
Fromme, K., Scott, E. A., & Kaplan, D. (1993). Comprehensive Effects of Alcohol;
Development and psychometric assessment of a new expectancy questionnaire.
Psychological Assessment, 5, 19−26.
Hingson, R. W., Zha, W., & Weitzman, E. R. (2009). Magnitude of and trends in alcohol-
related mortality and morbidity among U.S. college students ages 18-24, 1998-
2005. Journal of Studies on Alcohol(Supplement, 16), 12−20.
Kaminer, Y., Bureson, Y. A., & Burke, R. (2008). Can assessment reactivity predict
treatment outcome among adolescent with alcohol and other substance use
disorders? Substance Abuse, 29(2), 63−69.
Kypri, K., Gallagher, S. J., & Cashell-Smith, M. L. (2004). An Internet-based survey method
for college student drinking research. Drug and Alcohol Dependence, 76, 45−53.
Larimer, M. E., & Cronce, J. M. (2002). Identification, prevention and treatment: A
review pf individual-focused strategies to reduce problematic alcohol consumption
by college students. Journal of Studies on Alcohol. Supplement, 14, 148−163.
Larimer, M. E., & Cronce, J. M. (2007). Identification, prevention and treatment
revisited: Individual-focused college drinking prevention strategies, 1999-2006.
Addictive Behaviors, 32, 2439−2468.
Larimer, M. E., Lee, C. M., Kilmer, J. R., Fabiano, P. M., Stark, C. B., Geisner, I. M., Mallet, K.
A., Lostutter, T. W., Cronce, J. M., Feeney, M., & Neighbors, C. (2007). Personalized
mailed feedback for college drinking prevention: A randomized clinical trial.
Journal of Consulting and Clinical Psychology, 75, 285−293.
Larimer, M. E., Turner, A. P., Anderson, B. K., Fader, J. S., Kilmer, J. R., Palmer, R. S., &
Cronce, J. M. (2001). Evaluating a brief alcohol intervention with fraternities.
Journal of Studies on Alcohol, 62, 370−380.
Marlatt, G. A., Baer, J. S., Kivlahan, D. R., Dimeff, L. A., Larimer, M. E., Quigley, L. A.,
Somers, J. M., & Williams, E. (1998). Screening and brief intervention for high-risk
college student drinkers: Results from a 2-year follow-up assessment. Journal of
Consulting and Clinical Psychology, 66, 604−615.
Martens, M. P., Taylor, K. K., Damann, K. M., Page, J. C., Mowry, E. S., & Cimini, D. M.
(2005). Protective behavioral strategies when drinking alcohol and their
relationship to negative alcohol-related consequences in college students.
Psychology of Addictive Behaviors, 18(4), 390−393.
Miller, W. R., & Marlatt, G. A. (1984). Brief Drinker Profile. Odessa, FL.: Psychological
Assessment Resources.
Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: Preparing people to change
addictive behavior. New York: Guilford Press.
 M. Kulesza et al. / Addictive Behaviors 35 (2010) 730–733
Monti, P. M., Barnett, N. P., Colby, S. M., Gwaltney, C. J., Spirito, A., Rohsenow, D. J., &
Woolard, R. (2007). Motivational interviewing versus feedback only in emergency
care for young adult problem drinking. Addiction, 102, 1234−1243.
Monti, P. M., Colby, S. M., Barnett, N. P., Spirito, A., Rohsenow, D. J., Myers, M., Woolard,
R., & Lewander, W. (1999). Brief intervention for harm reduction with alcohol-
positive older adolescents in a hospital emergency department. Journal of
Consulting and Clinical Psychology, 67(6), 989−994.
Murphy, J. G., Benson, T. A., Vuchinich, R. E., Deskins, M. M., Eakin, D., Flood, A. M., et al.
(2004). A comparison of personalized feedback for college student drinkers delivered
with and without motivational interview. Journal of Studies on Alcohol, 65, 200−203.
Petry, N. M., Weinstock, J., Ledgerwood, D. M., & Morasco, B. (2008). A randomized trial
of brief interventions for problem and pathological gamblers. Journal of Consulting
and Clinical Psychology, 76(2), 318−328.
Rollnick, S., Heather, N., Gold, R., & Hall, W. (1992). Development of a short “Readiness
to Change Questionnaire” for use in brief opportunistic interventions among
excessive drinkers. British Journal of Addictions, 87, 743−754.
Saunders, J. B., Kypri, K., Walters, S. T., Laforge, R. G., & Larimer, M. E. (2004). Approaches
to brief intervention for hazardous drinking in young people. Alcoholism, Clinical
and Experimental Research, 28, 322−329.
733
Sobell, M. B., & Sobell, L. C. (2000). Stepped care as a heruistic approach to the treatment
of alcohol problems. Journal of Consulting and Clinical Psychology, 68, 573−579.
United States Department of Health and Human Services (USDHHS), National Institute
of Alcohol Abuse and Alcoholism (2002). A call to action: Changing the culture of
drinking at U.S. colleges. (Publication No. 02-5010). Bethesda, MD.
Walters, S. T., & Neighbors, C. (2005). Feedback interventions for college alcohol
misuse: What, why and for whom? Addictive Behaviors, 30, 1168−1182.
Wechsler, H., Dowdall, G. W., Maenner, G., Gledhill-Hoyt, J., & Lee, H. (1998). Changes in
binge drinking and related problems among American college students between
1993 and 1997. Journal of American College Health, 47, 57−68.
Wechsler, H., Lee, J. E., Kuo, M., & Lee, H. (2000). College binge drinking in the 1990 s: a
continuing problem: results of the Harvard School of Public Health 1999 College
Alcohol Study. Journal of American College Health, 48, 199−210.
White, H. R., & Labouvie, E. W. (1989). Toward the assessment of adolescent problem
drinking. Journal of Studies on Alcohol, 50, 30−37.
Wutzke, S. E., Conigrave, K. M., Saunders, J. B., & Hall, W. D. (2002). The long-term
effectiveness of brief interventions for alcohol consumption: a 10-year follow-up.
Addiction, 97, 665−675.