Addressing alcohol use and problems in mandated college students: a randomized clinical trial using stepped care

J Consult Clin Psychol. 2012 Dec;80(6):1062-74. doi: 10.1037/a0029902. Epub 2012 Aug 27.


Objective: Over the past 2 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-min brief advice session that included the provision of a booklet containing advice to reduce drinking. Participants were assessed 6 weeks after receiving the brief advice, and those who continued to exhibit risky alcohol use (n = 405) were randomized to Step 2, a 60- to 90-min brief motivational intervention (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 brief motivational intervention showed a significantly reduced 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Alcohol-Related Disorders / psychology
  • Alcohol-Related Disorders / therapy*
  • Humans
  • Mandatory Programs
  • Motivational Interviewing*
  • Patient Education as Topic*
  • Psychotherapy, Brief*
  • Students / psychology*
  • Treatment Outcome
  • Universities
  • Young Adult