title: Addressing alcohol use and problems in mandated college students: a randomized clinical trial using stepped care.
abstract: OBJECTIVE
  Over the past 2 decades, colleges and universities have seen a large increase in the number of students referred to the administration for alcohol policies violations. However, a substantial portion of mandated students may not require extensive treatment. Stepped care may maximize treatment efficiency and greatly reduce the demands on campus alcohol programs.
  
  
  METHODS
  Participants in the study (N = 598) were college students mandated to attend an alcohol program following a campus-based alcohol citation. All participants received Step 1: a 15-min brief advice session that included the provision of a booklet containing advice to reduce drinking. Participants were assessed 6 weeks after receiving the brief advice, and those who continued to exhibit risky alcohol use (n = 405) were randomized to Step 2, a 60- to 90-min brief motivational intervention (n = 211), or an assessment-only control (n = 194). Follow-up assessments were conducted 3, 6, and 9 months after Step 2.
  
  
  RESULTS
  Results indicated that the participants who received a brief motivational intervention showed a significantly reduced number of alcohol-related problems compared to those who received assessment only, despite no significant group differences in alcohol use. In addition, low-risk drinkers (n = 102; who reported low alcohol use and related harms at 6-week follow-up and were not randomized to stepped care) showed a stable alcohol use pattern throughout the follow-up period, indicating they required no additional intervention.
  
  
  CONCLUSIONS
  Stepped care is an efficient and cost-effective method to reduce harms associated with alcohol use by mandated students.
authors.affiliation: Department of Veterans Affairs Medical Center, Providence, RI, USA. Brian_Borsari@brown.edu
authors.forename: Brian
authors.initials: B
authors.lastname: Borsari
authors.forename: John T P
authors.initials: JT
authors.lastname: Hustad
authors.forename: Nadine R
authors.initials: NR
authors.lastname: Mastroleo
authors.forename: Tracy O'Leary
authors.initials: TO
authors.lastname: Tevyaw
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Barnett
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kahler
authors.forename: Erica Eaton
authors.initials: EE
authors.lastname: Short
authors.forename: Peter M
authors.initials: PM
authors.lastname: Monti
mesh_terms: D000293:Adolescent; D019973:Alcohol-Related Disorders / Q000523:psychology / Q000628:therapy*; D006801:Humans; D037141:Mandatory Programs; D062405:Motivational Interviewing; D010353:Patient Education as Topic; D011614:Psychotherapy, Brief; D013334:Students / Q000523:psychology*; D016896:Treatment Outcome; D014495:Universities; D055815:Young Adult