Objective The technical hypothesis of motivational interviewing (MI) posits that therapist implemented MI skills will be related to client speech regarding behavior change and that client speech will predict client outcome. The current meta-analysis is the first aggregate test of this proposed causal model. Method A systematic literature review, using stringent inclusion criteria, identified k = 16 reports describing 12 primary studies. Review methods calculated the inverse-variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple targeted behaviors (i.e., alcohol or illicit drug use, other addictive behaviors). Results Therapist MI-consistent skills were correlated with more client language in favor of behavior change (i.e., change talk; r = .26, p < .0001), but not less client language against behavior change (i.e., sustain talk; r = .10, p = .09). MI-inconsistent skills were associated with less change talk (r = −.17, p = .001) as well as more sustain talk (r = .07, p = .009). Among these studies, client change talk was not associated with follow-up outcome (r = .06, p = .41), but sustain talk was associated with worse outcome (r = −.24, p = .001). In addition, studies that examined composite client language (e.g., an average of negative and positive statements) showed an overall positive relationship with client behavior change (r = .12, p = .006; k = 6). Conclusions This meta-analysis provides an initial test and partial support for a key causal model of MI efficacy. Recommendations for MI practitioners, clinical supervisors, and process researchers are provided.

ABSTRACT. Objective:The current study is a multisite randomized alcohol prevention trial to evaluate the effi cacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Method: Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention effi cacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. Results:The overall results revealed that the combined-intervention group had signifi cantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. Conclusions: The fi ndings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the effi cacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session. (J. Stud. Alcohol Drugs 70: [555][556][557][558][559][560][561][562][563][564][565][566][567] 2009)

Objective Over the past two decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on campus alcohol programs. Method Participants in the study (N = 598) were college students mandated to attend an alcohol program following a campus-based alcohol citation. All participants received Step 1: a 15-minute Brief Advice session that included the provision of a booklet containing advice to reduce drinking. Participants were assessed six weeks after receiving the Brief Advice, and those who continued to exhibit risky alcohol use (n = 405) were randomized to Step 2, a 60–90 minute brief motivational intervention (BMI) (n = 211) or an assessment-only control (n = 194). Follow-up assessments were conducted 3, 6, and 9 months after Step 2. Results Results indicated that the participants who received a BMI significantly reduced the number of alcohol-related problems compared to those who received assessment-only, despite no significant group differences in alcohol use. In addition, low risk drinkers (n = 102; who reported low alcohol use and related harms at 6-week follow-up and were not randomized to stepped care) showed a stable alcohol use pattern throughout the follow-up period, indicating they required no additional intervention. Conclusion Stepped care is an efficient and cost-effective method to reduce harms associated with alcohol use by mandated students.

Problem drinking and related consequences are a major social issue plaguing college campuses across the United States. Each year, alcohol is responsible for fatalities, assaults, serious injuries, and arrests that occur among college students. The authors review and discuss the risk factors, drinking patterns, and consequences that are relevant to the general student population. In addition, the authors highlight individuals at an increased risk of experiencing alcohol-related problems, such as Greek-letter social organization members and student athletes. The authors also discuss the interventions that attempt to reduce risky drinking and related problems in these subgroups as well as the future directions for research. Keywordsalcohol; college drinking; high-risk drinking COLLEGE STUDENT HEAVY DRINKING and alcohol-related consequences are major social problems in the United States (Perkins, 2002; Wechsler, Dowdall, Maenner, GledhillHoyt, & Lee, 1998). Twenty years of research has revealed that the highest proportion of heavy drinkers and individuals with diagnosable alcohol-use disorders and multiple substance dependencies are in the age range encompassing over 90% of all enrolled college students, the majority of these individuals being between the ages of 18 and 21 (Grant, 1997;O'Malley & Johnston, 2002). Alcohol drinkers are more likely to have been insulted by others; been confronted with unwanted sexual advances; been a victim of date rape or sexual assault; been in a serious argument or quarrel; been pushed, hit, or assaulted; had their property damaged; been in a situation where they had unplanned sexual activity; put themselves in situations where they were more susceptible to sexually transmitted diseases such as HIV; been injured or had life-threatening experiences; driven while intoxicated, or ridden in a car with an intoxicated driver (Abbey, 2002;Cooper, 2002;Hingson, Heeren, Zakocs, Kopstein, & Wechsler, 2002). Reports such as the following are not uncommon (Turrisi, Jaccard, Taki, Dunnam, & Grimes, 2001):"My friend had a drinking contest with her boyfriend. They each had five shots of Wild Turkey, two beers, and then started a 'power hour' or 'century'--one shot of beer per minute for 60 minutes. My friend began falling down and looked ill. She laid down to go to sleep and began throwing up for two hours straight. She rolled over and almost choked in her vomit" (anonymous college freshman).Address correspondence to Rob Turrisi, PhD, Prevention Research Center, The Pennsylvania State University, 109 Henderson South Building, University Park, PA 16802; rturrisi@psu.edu (e-mail).. NIH Public AccessAuthor Manuscript J Gen Psychol. Author manuscript; available in PMC 2008 February 12. Published in final edited form as:J Gen Psychol. 2006 October ; 133(4): 401-420. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptHeavy drinkers are not the only ones who have experienced adverse consequences. Nondrinking college students have their own stories to tell about how others...

The present study used perspectives from the general literature on college alcohol consumption to examine mediational influences of peer, environmental, and parental variables on heavy drinking for student athlete and nonathlete samples. Eight hundred thirty-five freshmen who differed in organized sports involvement were compared on heavy drinking outcomes, peer norms, environmental influences, and parental communication. College athletes reported significantly more heavy drinking experiences than nonathletes. Peer norms, environmental influences, and parental communication were all significant mediators of the athlete-heavy drinking relationship. Athletes reported a higher perception of peer drinking, peer approval of drinking, higher alcohol availability, and direct drink offers, which, in turn, were related to higher rates of heavy drinking. Parental communication mediated the athlete-heavy drinking relationship differently, depending on the specific topic of conversation. Discussion surrounding the importance of incorporating a variety of interventions aimed at reducing collegiate athlete drinking on the basis of the peer, environmental, and parental influences observed in the present analyses are presented. Limitations and directions for future research are also noted.Keywords college students; athlete; alcohol Alcohol is consistently cited by researchers, college administrators, and students as the most pervasively misused substance on college campuses (Dimeff, Baer, Kivlahan, & Marlatt, 1999;Perkins, 2002 (Dawson, Grant, Stinson, & Chou, 2004). Furthermore, reports continue to document the negative consequences associated with college student drinking such as academic problems, injuries, alcohol poisonings, unintended and unprotected sexual activity, and impaired driving (Wechsler, Molnar, Davenport, & Baer, 1999).Baer (2002) has noted that there is significant variability within the college population, with the heaviest drinkers consuming almost 70% of the alcohol (see also Wechsler et al., 1999). Meilman, Leichliter, and Presley (1999) observed the highest consumption tends to occur in individuals who combine Greek membership and athletics, followed by Greek nonathletes, and non-Greek athletes. Although many studies have examined the psychological constructs related to Greek students' alcohol consumption (Bartholow, Sher, & Krull, 2003;Caron, Moskey, & Hovey, 2004;Larimer, Anderson, Baer, & Marlatt, 2000;Presley, Meilman, & Leichliter, 2002;McCabe et al., 2005; Weschler, Kuh, & Davenport, 1996), researchers have noted far fewer studies examining such variables in athletes (Damm & Murray, 1996;Evans, Weinberg, & Jackson, 1992;Martens, Cox, Beck, & Heppner, 2003; Martens, Dams-O'Connor, DuffyPaiement, & Gibson, 2005;Nattiv, Puffer, & Green, 1997;Thombs, 2000;Wilson, Pritchard, & Schaffer, 2004). Theory-driven interventions for alcohol misuse by athletes are scarcer (Larimer & Cronce, 2002;Thombs & Hamilton, 2002).One explanation for the paucity of studies is the misperception that sport participa...

Importance of peer counselor post-training supervision on Motivational Interviewing microskills and post-intervention drinking outcomes were evaluated in a sample of heavy drinking undergraduate students completing BASICS (Dimeff et al., 1999). Two peer counselor groups were trained using identical protocols. Post-training, one group was randomized to receive supervision, while the other received no supervision. Groups were subsequently compared on MI microskills. College students (N=122) were randomly assigned to either assessment-only control, supervision, or no supervision groups and completed a BASICS intervention. Post-intervention drinking outcomes were examined. Results suggested supervision aided peer counselors in reducing use of closed-ended questions. Both treatment groups reduced total drinks per week and heavy drinking behaviors compared to control. No differences on peak BAC or alcohol related consequences were observed. Differences in supervision did not influence drinking outcomes; however post-training supervision for peer counselors deficient in MI microskills may be needed to improve BASICS fidelity.

Objective To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions. Method Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using The Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral). Results Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p = .013), open question (p < .001), simple reflection (p < .001), and complex reflection (p < .001)], but significantly less likely to immediately follow others (giving information (p < .001) and closed question (p < .001)]. Sustain talk was significantly more likely to follow therapist use of open questions (p < .001), simple reflections (p < .001), and complex reflections (p < .001), and significantly less likely to occur following therapist use of therapist affirm (p = .012), giving information (p < .001), and closed questions (p < .001). Conclusions Certain individual therapist behaviors within motivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk.

In MSM living with HIV, MI shows substantial promise for reducing heavy drinking and for reducing condomless sex among those at risk. (PsycINFO Database Record