When Less is More for Students Mandated to a Brief Motivational Intervention
Brief Motivational Intervention (BMI) is one of the most researched intervention approaches for college students. Brief Alcohol Screening and Intervention for College Students (BASICS) is the most well-known and leading BMI program administered at college and universities with students demonstrating issues with alcohol use. Yet, based on interviews conducted by EVERFI with prevention specialists on college campuses over the past 10 years, we know that many institutions struggle to implement BMIs with the rigor outlined in the BASICS protocol. BMIs implemented at different institutions often share common core tenants, but the content and delivery tends to vary depending the resources available to conduct the programming.
Here are some questions you may have thought about as you are implementing a BMI with college students: How brief is a brief motivational intervention? When conducting a BMI what is the ideal number of components to include? Should the intervention be focused and concise, or is a broader approach covering a variety of content areas more impactful?
How personalized should the content of the BMI be to students? You may be delivering this intervention to students of different backgrounds and experiences with alcohol. This may include students who are judicially mandated, those referred to counseling, or students who have experienced alcohol overdoses. When conducting this intervention at the individual-level it is fairly straightforward to provide personalized feedback, but if the intervention is delivered at the group-level then that becomes a bit trickier.
Researchers were able to identify which specific variations are most impactful in reducing alcohol use, so we will look in-detail at two studies that provide insights on variations of BMIs that work well to reduce alcohol use among different profiles of students.
In the first study, researchers set out to determine:
- if variations in the breadth of BMI content (i.e., the number of different components covered) would impact outcomes
- how personalization of content would impact outcomes
- the extent of interaction between personalization and the breadth of content
Researchers looked at alcohol outcomes data from students included in 24 different research studies on BMIs with college students. They found that covering a variety of content areas is more impactful at reducing alcohol use and related problems when BMIs are highly personalized to the students receiving them. However, when students received a BMI that is not highly personalized, they actually increased their alcohol use when more components were included in the intervention. In other words, reductions in alcohol use are greater following a BMI that either provides highly personalized information on a variety of topics—or that provides more generic information on a limited number of topics.
If your institution has the resources to gather the appropriate information from students in an effort to personalize the BMI (i.e., typical number of drinks, normative beliefs of peer drinking, etc.), then it is well worth your time to include a variety of content in the intervention because it will resonate with students and reduce drinking rates. However, if resources are not available to deliver a personalized intervention, then it is wise to keep the BMI concise and focused in order to maximize its impact on drinking outcomes.
The second research study by Borsari and colleagues examined whether or not BMIs are appropriate for all mandated students by looking at various profiles of student drinkers. Do you recognize your students in any of these profiles identified by the researchers?
- The “Bad incident” profile: these students were mandated for pretty serious alcohol-related incidents such as being medically evaluated or sent to the ER. These students reported the lowest past-month alcohol use and problems.
- The “So what?” profile: these students tended to be referred for alcohol possession or being drunk in public. These students reported the highest past-month alcohol use and problems.
- The “Why me?” profile: these students offenses were usually alcohol possession or being in the presence of alcohol These students reported low past-month alcohol use and related problems.
Students in the Bad Incident group were more likely to respond positively to a brief advice session, a 15-minute discussion with a trained peer which was mostly didactic but did solicit personal information from participants using open-ended questions and provided the opportunity to ask questions or discuss their personal alcohol use with the peer. These students were also more likely to report lower risk drinking after a brief advice session compared to students in the So What? and the Why Me? profiles. However, students in the Bad Incident group who still reported high-risk drinking 6 weeks later and went on to receive a more intensive 60-minute BMI actually had the greatest increase in heavy episodic drinking at 9-month follow-up.
So how does this research play out in the real world and how can you incorporate these findings into your work?
It appears that not all mandated students respond best to an intensive BMI. This research demonstrates that following up a brief intervention with a more intensive one for light drinkers may actually increase their drinking rates. Prevention professionals should think critically about which mandated students they provide with BMIs to reduce drinking because a subset of mandated students reduce their alcohol use on their own prior to receiving any intervention! In most cases, these students actually require very little additional intervention which would free up some resources for administrators to focus on more impactful efforts which can be found in EVERFI’s Alcohol Prevention Compass.