Approximately thirty to sixty percent of college students in the United States report hazardous drinking in the past year, which includes a combination of heavy drinking episodes and alcohol related problems. Many college drinkers use alcohol to cope with anxious and depressed affect, and these coping motives for drinking are associated with current alcohol-related problems and greater risk for developing future alcohol dependence. Brief interventions with a dual focus on managing negative affective states and reducing hazardous drinking may therefore represent an improvement over extant approaches that target alcohol use only, particularly given our prior findings that students are more interested in learning skills to reduce their anxiety and depression than their alcohol use. The long-term goal of our research program is to develop efficacious and cost-effective brief interventions that can be tested and subsequently implemented as standard care at college health and counseling centers. The focus of this Exploratory/Developmental Research proposal is to develop and to pilot test the implementation and efficacy of a novel one-session intervention, the Motivational and Cognitive Intervention for Drinkers (MCID), which combines motivational interviewing to reduce hazardous drinking and cognitive restructuring to address anxious and depressed affect related to alcohol use. Phase I (n=20) of the study will involve the development of a web-based assessment program, treatment manuals and treatment integrity measures, as well as the training of two counselors to deliver MCID or a brief motivational intervention (BMI) targeting only hazardous drinking during an individual in-person session. During Phase II, we will conduct a pilot randomized controlled trial (n=72) to address two goals. First, we will test the efficacy of MCID against two efficacious alcohol interventions: (1) a comparison alcohol BMI equal to MCID in session length and counselor participation and (2) a minimal control condition consisting of only written alcohol feedback. Second, we will obtain data on the direct costs of implementing the three interventions and their preliminary cost-effectiveness. This Phase II pilot study will be conducted with a sample of college students who meet criteria for hazardous drinking, have subclinical levels of anxiety and/or depression, and report coping motives for drinking. Two-, four- and six-month follow-ups will be conducted via web-based assessment to examine alcohol-related and affective outcomes from the interventions.
The results of this study will provide the preliminary data necessary to design a full-scale clinical trial that will have sufficient power to test the efficacy and cost-effectiveness of the novel brief intervention in reducing hazardous drinking and negative affect. The combination of web-based assessment and counselor- delivered MCID presents a promising intervention that may be feasibly implemented as standard care at college health and counseling centers.
