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[Drug and Alcohol Findings] (2012) Effectiveness Bank Bulletin. [Cognition, readiness to change & brief alcohol intervention]. Drug and Alcohol Findings.

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Thinking about drinking: need for cognition and readiness to change moderate the effects of brief alcohol interventions.
Capone C., Wood M.D. Psychology of Addictive Behaviors: 2009, 23(4), p. 684–688.

This US study found that different types of heavy-drinking college students responded best to different types of brief intervention to promote moderation; a novel finding was that the thinkers among them were most affected by being led to reflect on how their drinking compared to that of the average student.

Summary
The featured report derives from a study of brief interventions to reduce drinking and drink-related problems in heavy-drinking US college students. It is concerned less with whether the interventions were effective, than with whether they were more or less effective with different types of individuals or people at different stages in their readiness to change their drinking.

Via flyers and advertisements, the original study recruited 335 20–24-year-old students whose screening responses indicated they were heavy drinkers. They were randomly assigned to:
• Only be assessed with no intervention – the control group against whom the interventions could be benchmarked;
• A brief (one session up to one hour) intervention based on motivational interviewing which featured feedback on how the student's drinking compared to the average, the risks it posed, and strategies to reduce these risks;
• A two-session 'alcohol expectancy' intervention which challenged beliefs about the effects of drinking. In a simulated bar students were offered alcoholic or mock alcoholic drinks and asked to identify who including themselves had drunk alcohol. Guided discussions highlighted mistaken beliefs about how alcohol affected the students and the positive and negative effects of alcohol in social (session 1) and sexual contexts (session 2);
• A combination of both the above interventions.

Follow-up assessments one, three and six months later re-assessed the drinking of from 82% to 72% of the students. Among those missing were 44 deliberately omitted because they could not attend one of the alcohol expectancy sessions. An earlier report established that (relative to assessment only) the interventions did reduce drinking and that the motivational session also reduced related problems. People who scored more ready to reduce their drinking at the start of the study made the greatest reductions.

Did certain types of students respond better to the interventions?
The featured report investigated whether three characteristics of the students affected how much they cut their drinking and related problems in response to the interventions.

The first was their need for cognition. Individuals highly endowed with this need tend to make sense of their world through reflection and inquiry and like tasks which require reasoning and problem solving. Brief interventions based on motivational interviewing which require reflection on individualised feedback on the participant's drinking seem particularly suited to this type of personality. In line with this expectation, it was thought that in response they would curb their drinking more than people less keen on thinking things through.

Another potential influence on intervention effectiveness is readiness to change, as measured along the continuum described by Prochaska and DiClemente from precontemplation (not considering change) through several stages to action (taking steps to implement a plan for change) and beyond. People who are more ready to contemplate change should be more responsive to interventions promoting change.

The opposite can be expected of people characterised by impulsivity and sensation seeking. Associated with greater alcohol use and problems, these traits can be expected to reduce responsive to interventions which try to promote control over drinking.


Item Type:Evidence resource
Publication Type:Review
Drug Type:Alcohol
Intervention Type:Psychosocial treatment method
Source:Drug and Alcohol Findings
Date:25 January 2012
Publisher:Drug and Alcohol Findings
Volume:25 Jan
EndNote:View
Accession Number:HRB (Not in collection)
Subjects:HJ Treatment method > Treatment outcome
F Concepts in psychology > Cognition
N Communication, information and education > Educational environment (school / college) > Student behaviour and participation
A Substance use, abuse, and dependence > Prevalence > Problem substance use
HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention
F Concepts in psychology > Motivation
G Health and disease > Substance use disorder > Alcohol use
T Demographic characteristics > Undergraduate or graduate student

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