Stepped Care for Mandated College Students

Colleges and universities have seen a large increase in the number of students referred to
the administration for the violation of alcohol policies. However, research indicates that
the majority of mandated students may not require extensive treatment. Stepped care assigns
individuals to different levels of care according to their response to treatment.
Encouraging research indicates that minimal interventions and BMIs may reduce heavy drinking
in mandated college students. Thus, implementing stepped care using these interventions
could maximize treatment efficiency and reduce the demands on campus alcohol programs.

Participants will be students mandated to attend an alcohol program at a northeastern
private university. All participants will receive Step 1, a 15-minute minimal intervention
including a discussion of the referral incident and the provision of a booklet containing
advice to reduce drinking. Participants will be assessed six weeks later, and those
continuing to exhibit risky alcohol use will receive Step 2, randomization to: (a) a 60-90
minute brief motivational intervention (BMI) or (b) an assessment-only control. All students
will complete 3, 6, and 9 month follow-up assessments. The three groups will be compared on
two outcome measures: frequency of binge drinking episodes and alcohol-related problems in
the past 30 days. Predictors of treatment response (readiness to change, alcohol
expectancies, age of first drink, sensation seeking, descriptive norms, and reaction to the
referral) will also be evaluated for both steps of the intervention. Research findings will
assist college alcohol programs in determining the most effective and efficient allocation
of their limited resources in treating mandated students. The long-term objectives of this
research are to inform preventive intervention research about the utility and
cost-effectiveness of stepped-care approaches and to identify individual and situational
factors that qualify these effects.