Department of Veterans Affairs Medical Center, Providence, RI, USA.
J Consult Clin Psychol. 2012 Dec;80(6):1062-74. doi: 10.1037/a0029902. Epub 2012 Aug 27.
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.
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 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.
Stepped care is an efficient and cost-effective method to reduce harms associated with alcohol use by mandated students.
在过去的 20 年中，高校因违反酒精政策而被转介到行政部门的学生数量大幅增加。然而，相当一部分被强制要求的学生可能不需要广泛的治疗。阶梯式护理可以最大限度地提高治疗效率，并大大减少对校园酒精项目的需求。
研究参与者（N=598）是因校园饮酒罚单而被强制参加酒精项目的大学生。所有参与者都接受了第 1 步：15 分钟的简短咨询，其中包括提供一本包含减少饮酒建议的小册子。参与者在接受简短建议后 6 周进行评估，那些继续表现出危险饮酒行为的人（n=405）被随机分配到第 2 步，即 60-90 分钟的简短动机干预（n=211）或仅评估对照组（n=194）。在第 2 步后 3、6 和 9 个月进行随访评估。
结果表明，与仅接受评估的参与者相比，接受简短动机干预的参与者的酒精相关问题数量显著减少，尽管在饮酒方面没有显著的组间差异。此外，低风险饮酒者（n=102；在 6 周随访时报告低饮酒量和相关伤害，且未被随机分配到阶梯式护理）在整个随访期间表现出稳定的饮酒模式，表明他们不需要额外的干预。
阶梯式护理是一种有效且具有成本效益的方法，可以减少被强制要求的学生因饮酒而产生的危害。
