Practice Profile: Nontargeted Brief Alcohol Interventions for Substance Use for Juveniles

The practice is aimed at reducing substance use (alcohol and other hard drugs) by providing motivations and/or skills to promote behavior change in a relatively brief time, typically between one to five sessions. The target population are juveniles and young adults ages 11 to 30. This practice is rated Effective for reducing illicit substance use, marijuana use, and alcohol use. The practice is rated Promising for reducing the use of other hard substances.

Practice Goals/Target Population

Brief alcohol interventions are designed to reduce alcohol use, and other risky substance use behavior, among participants by providing skills and bolstering motivations to change risky behaviors. Brief alcohol interventions that are “nontargeted” are not exclusively focused on reducing alcohol use; they also concentrate on other substance use. In contrast, brief alcohol interventions that are “targeted” focus only on reducing alcohol use. The target population are juveniles and young adults ages 11 to 30 (CSAT 1999).

Practice Theory

Brief interventions are most commonly based on cognitive–behavioral therapy, motivational enhancement therapy (Miller and Rollnick 1991), and transtheoretical model of behavior change (Prochaska and DiClemente 1984). These theories emphasize the importance of stimulating participants’ abilities, capabilities, and motivations to self-evaluate and self-regulate their behaviors. While brief alcohol interventions are aimed primarily at reducing alcohol consumption, they also can affect other risky substance use behaviors (e.g., marijuana or other illicit substance use). This means that participants receiving brief alcohol interventions might generalize skills and behavior change techniques to other co-occurring risk behaviors.

Services Provided

Brief interventions can be used as universal, selective, or indicated prevention (CSAT 1999). Brief interventions vary in terms of structure, delivery, communication, underpinning theory, and intervention philosophy (Heather 1995). They typically consist of one to five sessions, usually last about 1 hour, and can be delivered by a physician, nurse, or psychologist (CSAT 1999). Interventions can be conducted in high school or university settings, primary care provider offices, and emergency rooms. Common intervention methods include motivational interviewing/motivational enhancement therapy (MET), a combination of MET and cognitive–behavioral therapy, feedback only, or generic psychoeducation therapy.

Brief alcohol interventions include multiple therapeutic components that provide skills or enhance motivations for behavior change. This includes various combinations of components such as baseline assessments used to personalize feedback on substance use levels, generic information about substance use, local/national norm referring of substance use levels, goal-setting exercises (e.g., setting target consumption levels), decisional balance exercises (e.g., listing pros and cons of substance use), identifying high-risk situations, information on the consequences of heavy substance use, risk factors for substance use disorder or related consequences, discussion of moderation strategies (e.g., tips for alternating alcoholic drinks with water), and basic provision of information (e.g., how to calculate blood–alcohol concentration, money spent on substances).

Additional Information

This practice included nontargeted brief interventions that focused on substance use beyond alcohol use. Other similar practices on CrimeSolutions, such as Targeted Brief Alcohol Interventions for Alcohol Use for Adolescents and Young Adults and Computerized Brief Interventions for Youth Alcohol Use, include targeted brief interventions that focused solely on reducing alcohol use.

Tanner–Smith and colleagues (2015) conducted moderator analyses to determine whether the presence or absence of certain alcohol- or substance-related therapeutic components, intervention duration (in minutes), or follow-up timing (length between intervention end and posttest measurement, in weeks) had an effect on participants’ substance and alcohol use. Therapeutic components included in the moderator analysis were decisional balance exercise, generic education/information about substance use, goal-setting/contracting exercise, identifying high-risk situations, information on consequences of heavy substance use, information about risk factors for substance use disorders or related consequences, moderation strategies discussion, local/national norm referencing of substance use levels, and personalized feedback on substance use levels.

The meta-analysis authors found that alcohol-focused interventions that used identification of high-risk drinking situations and those that provided information about the consequences of heavy drinking showed larger statistically significant effects on subsequent illicit substance use. Single-substance-focused interventions that used discussion of substance moderation strategies showed larger statistically significant effects on subsequent illicit substance use. No statistically significant moderating effects were found for intervention duration or follow-up timing.

These sources were used in the development of the practice profile:

These sources were used in the development of the practice profile:

(CSAT) Center for Substance Abuse Treatment. 1999. Brief Interventions and Brief Therapies for Substance Use. Treatment Improvement Protocol (TIP) Series 34. Rockville, Md.: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. DHHS Publication No. SMA 99–3353.

Heather, Nick. 1995. “Interpreting the Evidence on Brief Interventions for Excessive Drinkers: The Need for Caution.” Alcohol and Alcoholism 30:287–96.

Miller, William R., and Stephen Rollnick. 1991. Motivational Interviewing: Preparing People to Change Addictive Behavior. New York, N.Y.: Guilford Press.

Prochaska, James O., and Carlo C. DiClemente. 1984. The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy. Homewood, Ill.: Dow Jones–Irwin.

Tanner–Smith, Emily E., and Mark W. Lipsey. 2015. “Brief Alcohol Interventions for Adolescents and Young Adults: A Systematic Review and Meta-Analysis." Journal of Substance Abuse Treatment 51:1–18.

Following are CrimeSolutions-rated programs that are related to this practice:

Brief Alcohol Screening and Intervention of College Students (BASICS)

Stepped Collaborative Care for Adolescents (Washington State)

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?