Practice Profile: Targeted Brief Alcohol Interventions for Alcohol Use for Adolescents and Young Adults

This practice seeks to reduce alcohol use or alcohol-related problems for adolescents and young adults via a short-term intervention (one to five sessions). The practice is rated Effective for reducing alcohol consumption and alcohol-related problem outcomes for adolescents and young adults.

Practice Goals/Target Population

The goal of Brief Alcohol Interventions (BAIs) is to reduce participants’ alcohol use or alcohol-related problems via a short-term intervention. The target population for this practice includes adolescents, ages 11 to 17, and young adults, ages 18 to 30. BAIs can be delivered as universal, selective, or indicated prevention strategies (CSAT 1999).

Practice Theory

BAIs seek to motivate and provide resources to help participants moderate their drinking in the short term and seek more intensive treatment in the long term, if needed. This practice is based on elements from cognitive–behavioral therapy, motivational interviewing (Miller and Rollnick 1991), the transtheoretical model of behavior change (Prochaska and DiClemente 1984), or social norms theory (Berkowitz 2004). BAIs are designed to harness participants’ abilities, capabilities, and motivations to help them evaluate and regulate their drinking behaviors.

Services Provided

The defining characteristic of a brief intervention is the brief contact time (one to five sessions) with a health care provider (physician, nurse, psychologist, counselor) or other professional. The remaining components (length of session, duration of program, curriculum, theory, and philosophy) may vary by individual program (Heather 1995). For example, BAIs can be delivered in a variety of settings such as primary care/student health centers, schools/universities, and emergency rooms; for young adults, they can also be self-administered by participants. Intervention formats can include group or individual sessions, while interventions for adolescents can also include family components.

Most BAIs include at least one of the following components: a discussion of alcohol consumption, feedback on risk or levels of alcohol use, comparisons with local or national norms, information on potential harms, or coping strategies and goal-setting plans for dealing with drinking situations.

Specific types of BAIs include

• Therapy-based brief interventions such as motivational enhancement/motivational interviewing therapy (MET), psychoeducational therapy, cognitive–behavioral therapy (CBT), or a combination of CBT plus MET.
• Other brief interventions such as alcohol expectancy challenges for adolescents and young adults, or programs providing personalized feedback/information about drinking or a mailed 21st birthday informational card for young adults.

Tanner-Smith and Lipsey (2015) conducted moderator analyses on the studies included in their meta-analysis to explore when and for whom brief alcohol interventions (BAIs) were effective. In terms of intervention characteristics of BAIs, researchers found no statistically significant differences in effect sizes across intervention characteristics such as delivery site (i.e., school/university, primary health care clinics, or self-administered), format (i.e., self-administered/computerized, self-administered/not computerized, one-on-one sessions, or group sessions), or length (i.e., single session/less than 5 minutes, single session/5 to 15 minutes, single session/more than 15 minutes, or multi-session). These effects were similar for both adolescent and young adult populations. In terms of therapeutic components of BAIs, researchers found a statistically significant positive effect on reducing alcohol consumption for adolescent participants, compared with the control group, in studies that included decisional balance or goal-setting exercises as a part of the intervention. However, they did not find this effect for the young adult participants. 

Further, the authors examined whether the following characteristics of the participant samples were associated with the magnitude of effects: race composition, average age, gender composition, or whether samples were selected based on high-risk drinking at baseline screening. The researchers found that BAI were more effective in reducing alcohol consumption for adolescent samples with a greater proportion of minority participants. However, they did not find this effect for the young adult samples. Researchers also found that the age of the participants was not associated with the intervention effects for alcohol consumption outcomes; however, among adolescent samples, the effects on alcohol-related problems were significantly smaller in older samples. 

In regard to gender, the researchers found no evidence of association with was alcohol consumption or alcohol-related problems for adolescent and young adult populations. Finally, the researchers did find statistically significant reductions in alcohol-related problems for high-risk screened participants, compared with low-risk participants. This indicates that adolescents who already exhibit heavy alcohol consumption patterns may exhibit greater positive intervention effects, given that they have more room for improvement.

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

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

Berkowitz, Alan D. 2004. The Social Norms Approach: Theory, Research, and Annotated Bibliography. Traumansburg, NY: Independent Consultant.

CSAT [Center for Substance Abuse Treatment]. 1999. Brief Interventions and Brief Therapies for Substance Use. Treatment Improvement Protocol (TIP) Series 34. Rockville, Md.: 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.

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

Brief Alcohol Screening and Intervention of College Students (BASICS)

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