Master of Science in Clinical Psychology

Clinical Psychology - Thesis Abstracts

"Using Screening and Brief Intervention to Examine Alcohol and Drug Use and Mental Health in College Students"

by Loretta Ransom (August, 2011)

The purpose of this study is to determine the relationship between drug and alcohol use behaviors and mental health within a sample of college students by using a screening and brief intervention (SBI) protocol. Screening, brief intervention, and referral to treatment (SBIRT) is an intervention model that identifies individuals who are problem substance users and provides them with a motivational intervention designed to promote appropriate steps to address the severity of the problem. For those with non dependent, problem substance use, a brief intervention can produce substantial reductions in alcohol and drug use. For those who have more serious substance abuse or dependence disorders, referral to appropriate treatment is warranted. This model represents a paradigm shift in how, when, and for whom substance use services are provided, with the focus on preventing further dependence as opposed than merely the treatment of the current dependencies. The SBIRT model utilizes screening tools to first identify persons at risk of developing substance use disorders, intervention techniques to assist individuals to reduce and or abstain from harmful alcohol and drug use, and referral to appropriate treatment programs for individuals who demonstrate a high risk of use.

There are many different types of screening tools utilized with SBIRT. One standardized, scripted screening tool, the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), has gained prominence and considerable usage, especially when used for screening for all substances (not just alcohol). This interview-guided screening tool was developed by the World Health Organization (WHO) and has been studied cross-culturally in eight countries. It provides a detailed assessment of both alcohol and illicit drug use (including injection drug use) and provides information on hazardous, harmful, or dependent use. It was originally developed for use in primary care settings but has been applied in other settings, such as trauma centers, mental health settings and college health centers.

SBIRT can be utilized in different types of settings where at-risk individuals may seek services, and by various professionals, who may or may not have prior substance use counseling experience. As such, one of the key benefits of utilizing SBIRT is increased organizational capacity to screen and deliver timely interventions for individuals at risk of substance use. Several studies have demonstrated long-term benefits of SBIRT, including decreases in the frequency and severity of drug and alcohol use, (Burke, Arkowitz, & Menchola, 2003), reduction in the risk of trauma associated with use (Gentilello et al. 1999; Fleming et al. (2002), increase in number of patients who enter long-term treatment, reduction in adverse effects of combining alcohol and other medications, and net health-care savings (Gentilello, Ebel, Wickizer, Salkever, & Rivara, 2005). While most of these outcomes have been well demonstrated among alcohol users interfacing with primary care settings, there have been promising approaches to the use of SBIRT with substance users in other settings.

Between 2006-2009 6,772 University students were pre-screened for drug and alcohol use with the Alcohol Use Disorders Test Consumption Questions (AUDIT-C) (Dawson, Grant, Stinson & Zhou, 2005) and students who screened positive were given a full-screen Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) (Henry-Edwards, Humeniuk, Ali, Poznyak, & Monteiro, 2003). Previous 30-day substance use and mental health data were extracted from the Government Performance and Results Act (GPRA) Client Outcome Measure (Center for Substance Abuse Treatment [CSAT] GPRA Client Outcome Measures, 2005) which was administered at baseline and at six month follow-up. Reductions in binge drinking, marijuana use, and days of depression and anxiety were found in male and female students. In addition, significant associations were found for binge drinking and anxiety at baseline. Screening and brief intervention procedures appear to be effective in aiding to reduce problematic drug and alcohol use within the college population and the GPRA client measure is effective in capturing clients' mental health outcomes at intake and follow-up. Used in conjunction, the screening tools and client outcome measure tool provided a practical motivational framework and specific intervention procedures for addressing substance abuse and mental health issues.

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