University of Michigan Depression on College Campuses Conference

Transcription

1 ALCOHOL SCREENING AND BRIEF INTERVENTION: EVIDENCE BASED STRATEGIES Presenter: Mary Jo Desprez Alcohol and Other Drug Prevention Program Health Promotion and Community Relations University Health Service Division of Student Affairs University of Michigan University of Michigan Depression on College Campuses Conference

2 Alcohol related incidents Can have: Legal/policy implications Health implications Community impact implications

3 Underreact Miss an opportunity to disrupt pattern Reinforce myth that it is just a normal part of college Overreact Reinforces a scare tactic script Promotes distrust

4 Screening Result Sweet Spot Educational Intervention

5

6

7 Screening and brief intervention efforts are intended to meet the public health goal of reducing the harms and societal costs associated with risky drinking and drug taking.

8 They are just college kids-doing what college kids do Research shows that risky drinking causes more total accidental harm than the heavy drinking of alcoholics. Though risky drinkers are individually less likely to cause alcohol-related problems, they make up a much greater portion of the general population than alcoholics, so the most significant amount of damage is caused by those who engage in risky drinking from time to time but are not dependent on alcohol.

9 There are many forms of excessive drinking that cause substantial risk or harm to the individual: high level drinking each day, repeated episodes of drinking to intoxication, drinking that is actually causing physical or mental harm drinking that has resulted in the person becoming dependent or addicted to alcohol. Alcohol-related problems represent a significant percentage of the harm on college campuses today (NIAAA).

10 A brief, non-judgmental intervention by a caring professional can have a positive, long term impact on risky alcohol use.

11 The AUDIT The Alcohol Use Disorders and Identification Test Developed by the World Health Organization A simple method of screening for excessive drinking and to assist in brief intervention. It is NOT a diagnostic tool. Evidence-based tool for identifying hazardous (or risky drinking) harmful drinking, or alcohol dependence.

12 Originally intended to be used in primary care settings but with suitable instructions it can be self-administered or used by non-health professionals World Health Organization, 2001

13 Checking your own baggage Our past experiences and current behavior can change the way we come to these interactions Reflect on your own behavior, your own bias and your own assumptions Suspend judgment Mindful that each situation is a new situation

14 Administering the AUDIT Consider the student rapport building is key non-judgmental, friendly and non-threatening (genuine concern for the student s well-being) confidential student is not intoxicated relevance to the student s health and safety even when heavy drinkers underestimate their consumption, they often qualify on the AUDIT scoring system as positive for alcohol risk

15 Options Oral Allows clarification of ambiguous answers May be more appropriate for low reading levels Allows seamless feedback to student and initiation of follow up recommendations Written Easy to administer May be more appropriate for introvert May produce more accurate answers

16

17 Interpreting the score with student 0-7 Low-risk 8-15 Risky or hazardous level Harmful level and probably high risk 20+ High-risk (Definite harm -strong indication for alcohol dependence) *Note about authenticity

18 Sharing the score with students Explain that it is a recognized tool that when scored gives us information about the role alcohol is currently playing in their life. Score and share the results with the student -- but before you say anything to the student-- ask for their reflection on the score and the category that it puts them listen and reflect Thank them for completing the screening and transition to next steps/follow up

19 0-7 Low-risk (Legal risk remains if under 21) Stay in the Blue (SIB) Information (BAC cards, etc.) and Strategies Sheet Choose to Be Safe and Legal Brochure AlcoholEdu for Sanctions Choices Booklet Especially appropriate if there is family history of alcohol and other drug issues, if student has experienced blackouts and/or age of first use is 17 or below.

20 8-15 Risky or hazardous level (Moderate risk of future harm, some students currently experiencing harm) Brief Alcohol Screening and Intervention for College Students (BASICS) is an appropriate referral which includes: - setting goals and limits - client-centered motivational enhancement - self-monitoring of drinking Assessment of Substance Abuse Patterns (ASAP).

21 16 19 Harmful level and probably high risk (Drinking that will eventually result in harm, if not already doing so. May be dependent) BASICS is recommended minimum requirement. ASAP is recommended and appropriate for more intensive intervention.

22 20+ High-Risk (Definite harm -strong indication for alcohol dependence) ASAP is a recommended minimum requirement Longer-term follow-up and support

23 RESOURCES/REFERRALS ONLINE ECHUG ALCOHOL EDU FOR SANCTIONS CHOICES BOOKLET SIB Tips BASICS ASAP UMATS/STUDENTS FOR RECOVERY MOTIVATIONAL INTERVEWING TRAINING CONSULTATIONS

24 UM offices that currently utilize alcohol screening Alcohol and Other Drug Prevention Program Office of Student Conflict Resolution (OSCR) Housing-Res Ed University Health Service **Developing pilot study (alcohol and depression screening)

25 Brief Interventions Brief Motivational Intervention Motivational Interviewing Brief Alcohol Screening and Intervention for College Students (BASICS) Motivational Interviewing Personalized Normative Feedback The Alcohol Skills Training Program: a group intervention for young adult drinkers ASTP

26 References The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care, 2 nd Edition. World Health Organization, Department of Mental Health and Substance Dependence, J. Baer, L. Dimeff, D. Kivlahan, and G.A. Marlatt. Brief Alcohol Screening and Intervention for College Students A Harm Reduction Approach, W. Miller and S. Rollnick. Motivational Interviewing Preparing People for Change, Baer, J.S., Marlatt, A., Kivlahan, D.R., Fromme, K., Larimer, M.E., and Williams, E. (1992). An experimental test of three methods of alcohol risk reduction with young adults. Journal of Consulting and Clinical Psychology, 60(6), Kivlahan, D.R., Marlatt, G.A., Fromme, K., Coppel, D.B., and Williams, E. (1990). Secondary prevention with college drinkers: Evaluation of an alcohol skills training program. Journal of Consulting and Clinical Psychology, 58(6),