The Relationship Between Baseline Drinking Status, Peer Motivational Interviewing Microskills, and Drinking Outcomes in a Brief Alcohol Intervention for Matriculating College Students: A Replication

Abstract

The purpose of this study was to replicate and extend previous findings (Tollison, Lee, Neighbors, Neil, Olson, & Larimer, 2008) on the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. This study used a larger sample size, multiple follow-up time-points, and latent variable analyses allowing for more complex models to be tested in a sample with different characteristics than Tollison et al. (2008). Matriculating students who participated in high school sports (N = 327) took part in a Brief Alcohol Screening and Intervention for College Students (BASICS) led by peer facilitators trained in Motivational Interviewing. Participants were assessed pre- and immediately post-intervention on contemplation to change, as well as pre-, 5 months and 10 months post-intervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (MITI, Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence. Contrary to our previous study, results indicated that a higher number of open questions was positively related to increases in drinking, especially for heavier drinkers. Congruent with the previous study, more simple reflections was positively related to increases in drinking. Finally, this study revealed that heavier baseline drinking was associated with more simple reflections. There were no significant results found for changes in contemplation. Results corroborate previous findings that the excessive use of simple reflections may be indicative of counter therapeutic outcomes while raising questions about the relationship between the frequency of open questions and therapeutic outcomes.

A Pilot Study of Two Supervision Approaches for Peer-Led Alcohol Interventions With Mandated College Students

“…This puzzled us, as previous research has linked both global and microskills scores to drinking reductions in treatment-seeking and non-treatment-seeking college students (e.g., Apodaca et al, 2013;Tollison et al, 2008Tollison et al, , 2013. On the one hand, we found that MI global scores were rated below threshold competency, similar to those in previously published studies using peer counselors (e.g., Turrisi et al, 2009).…”

“…On the one hand, we found that MI global scores were rated below threshold competency, similar to those in previously published studies using peer counselors (e.g., Turrisi et al, 2009). However, although other studies examining peer counselor MI microskills have consistently found increases in drinking related to lower level skill demonstration (Tollison et al, 2008(Tollison et al, , 2013, we did not fi nd this relationship.…”

“…It may be that nonprofessional young adult counselors require more time to develop the therapeutic capacities measured within the dimensions of collaboration, evocation, and autonomy/support. This may be particularly relevant given the evidence of a link between MI microskills and student drinking behaviors, as interventions delivered by peer counselors who used lower level MI microskills (i.e., closed questions, simple refl ections) have resulted in poorer drinking outcomes with nonmandated college students (e.g., Tollison et al, 2008Tollison et al, , 2013.…”

Motivating Patient Adherence to Allergic Rhinitis Treatments

“…For example, motivational interviewing (MI) is a counseling technique that aims to engage the patient's intrinsic motivation to change health-related behavior. While MI is an effective communication strategy leading to behavior change, randomized trials using MI have typically required from one to five hours of MI to increase physical activity [42], decrease alcohol use [43,44], or improve adherence to glaucoma [45] or schizophrenia medication [46]. Such time commitments are not feasible in most clinical settings.…”

Alcohol Interventions for Mandated Students: Behavioral Outcomes From a Randomized Controlled Pilot Study

“…Mandated students do not consistently benefi t from interventions found to be effi cacious with volunteers, demonstrating smaller decreases (and sometimes increases) in drinking behaviors and smaller effect sizes when drinking reductions are detected (Carey et al, 2009;Cimini et al, 2009;Doumas et al, 2011;LaBrie et al, 2006). However, MI-based interventions may simultaneously reduce resistance, build rapport, and increase motivation and intent to change (Barthelmes et al, 2010;Miller & Rollnick, 2002), in part through the use of MI-consistent microskills such as open-ended questions and complex refl ections (Tollison et al, 2008(Tollison et al, , 2013. Indeed, MI-based individual and group interventions demonstrate improved outcomes with reductions in consumption and/or consequences in mandated populations (Borsari & Carey, 2005;Borsari et al, 2012;Carey et al, 2006;Hustad et al, 2014).…”