The BASICS of Tackling Risky Drinking Behavior Among College Students

by Kaitlyn Hanisko on September 25, 2013

Photo credit: AnnieGreenSprings via wikimedia

Photo credit: AnnieGreenSprings via wikimedia

Risky drinking behavior among college students has been and continues to be a concern at most major universities across the US. According to the results from the 2011 National Survey on Drug Use and Health, young adults aged 18 to 22 enrolled full time in college were more likely than their peers who were not enrolled full time to use alcohol in the past month, binge drink, and drink heavily. 60.8% of full-time students reported they were current drinkers. 45% of undergraduates reported they engaged in binge drinking in the previous month. This pattern of higher rates of current alcohol use and binge drinking among college students compared to their peers not enrolled full time has remained consistent since 2002. On top of those concerns, according to a recent NPR article, in a poll of high school seniors, 20% said they’d binge drank in the past two weeks. This number highlights that students are coming into college with extreme binge drinking habits.

Universities are feeling the pressure to do something about their college students risky drinking behavior… But the question is what and how? It’s apparent that the alcohol education programs, such as Project DARE, that students receive in high school aren’t doing the job (Project D.A.R.E. has been declared ineffective). So what can on-campus alcohol and drug abuse education and prevention programs do differently to make an impact?

Back to the BASICS

It’s unrealistic to think that college students are going to just up and quit drinking because somebody told them not to. An interesting and somewhat new idea is to take a harm reduction approach, where the focus is on the prevention of harm from drinking alcohol versus the prevention of drinking alcohol. U of M’s Alcohol and Other Drug Department, along with 1,100 other colleges and universities, has put into place a program called Brief Alcohol Screening and Intervention of College Students (BASICS). BASICS aims to motivate students to reduce alcohol use in order to decrease the negative consequences of drinking. BASICS is designed to help students in examining their own drinking behavior in a judgment free environment. In a recent study done to determine the effectiveness of BASICS it was found that students who received BASICS had reported drinking alcohol much less after 1 year compared to those who hadn’t received BASICS. So what is it about BASICS that does the trick?

BASICS Broken Down

There are two important pieces to the BASICS program. First, is the use of brief motivational interviewing by the BASICS facilitator. Motivational interviewing is a kind of counseling that is delivered in an empathetic and non-confrontational way. During a BASICS session, various topics are covered with the student such as personal beliefs about alcohol use; drinking history; individual negative consequences and risk factors; and personal risk and benefits of drinking. The use of brief motivational interviewing in BASICS is intended to reveal discrepancy between the student’s risky drinking behavior and his or her goals and values in a nonjudgmental way. Additionally, by using motivational interviewing the BASICS facilitator doesn’t force change on the student but rather emphasizes that the choice is really up to the student if and how they want to make changes to their drinking behavior. Borsari et al. results showed that students who received brief motivational interviewing greatly reduced their number of alcohol-related problems compared to those who only received education at 3, 6, and 9 months of follow up. Motivational interviewing works through empowering the student. It also helps the student explore changing his or her behavior and works to help resolve any ambivalence they might have about making a change in their drinking behaviors.

The second important piece to the BASICS program is that it addresses social norms. Social norms are beliefs about what is acceptable in a social context and are addressed through personalized normative feedback (PNF). PNF approaches are designed to correct students’ misconceptions to reduce heavy drinking. For example, most students tend to think that their peers drink more often and more heavily than is really the case, PNF works to correct this idea. Three pieces of information are used when giving PNF: info about the student’s own drinking, info about the student’s perceptions of others drinking, and info about others actual drinking. By comparing the student’s actual drinking to others actual “normal” behavior their misconceptions are exposed. In a recent review of social norms interventions to reduce alcohol misuse in college students, it was reported that of the 476 participants who received PNF, 61% of them reported a reduction in the frequency of their drinking 4 to 16 months after and 60% reported a reduction in their binge drinking 3 months after. Lewis and Neighbors report that this is because college students have a strong influence on each others behavior.

The Answer is Pretty BASIC(S)

So, the key to tackling the issue of college students’ risky drinking behaviors is to work towards preventing the harm from drinking alcohol. BASICS really allows the student to take a 360 degree look at how alcohol fits into their life and in most cases enough discrepancy is created that they will want to do something about it.

SAA5of5 September 25, 2013 at 10:43 pm

This makes a lot of sense to me. When a young adult goes off to college they’re definitely ready to put aside a lot of “rules” they were made to hold to “at home.” Helping them recognize they are making firm decisions that may/may not match their own goals and objectives and concretely see the potential quite serious negative results would be more effective than, “because we said so.”

…Showing video of the behavior of those over-drinking could be chillingly effective!

Under, “social norms,” I thought the two misconceptions were fascinating: “First, that most students on their campus thought that the norms for both the frequency and the amount of drinking among their peers were higher than they actually were. Second, that students generally believed that their peers were more permissive in their personal attitudes about substance use than was in fact the case.”

Kaitlyn Hanisko September 26, 2013 at 9:17 am

Hi! Thank you for your comment. I’m glad to hear that this approach makes sense to you. I’m actually a BASICS facilitator here at U of M and it’s quite amazing to see the effectiveness first hand. It’s really rewarding too, to see students recognize their risky drinking behaviors and to help guide them towards making safer decisions. You’re right though about the social norms, it’s quite surprising that students can be so far off, but to be honest I think the general population has kind of a misconception about the amount that the average college student drinks.

Kevin Boehnke September 26, 2013 at 10:11 am

The BASICs strategy seems like a good way to tackle college binge drinking. Something else that I’ve noticed (anecdotally of course) is that people who are not allowed to drink before college more often end up going buck-wild with alcohol during their first encounters. It seems like this is due to a fewfactors: 1) finally being able to do that “adult thing”, 2) being in a situation that allows and often encourages that behavior, 3) not understanding personal consumption limits. I wonder if lowering the drinking age (or removing it altogether) and introducing people to alcohol (in moderation of course) at a younger age would de-mystify alcohol binging to an extent and thus affect the behaviors that surround alcohol use in college.

Kaitlyn Hanisko September 26, 2013 at 11:44 am

Kevin – You’re right in noticing the factors that contribute to how some college students approach drinking if they haven’t drank before college. However, a lot of times we hear from those who did drink prior to college as feeling that they are “experienced”…

And that is the great debate… should we lower the drinking age, would that make a difference? It’s a tough call. We see other countries that have lower drinking ages seem to have less drinking problems but I think a lot of other factors play into it too. Here’s a good website that discusses the pros and cons of doing so http://drinkingage.procon.org/.

Lindsay September 26, 2013 at 10:49 am

Great job, Kate!

Megan September 26, 2013 at 11:06 am

Great resource! Well done!

Sharon September 26, 2013 at 11:43 am

Great job Katie!! This is awesome. Sooo proud of you and all you do!

Kaitlyn Hanisko September 26, 2013 at 11:45 am

Thank you, all. I’m glad you found it interesting.

Blake Miner September 26, 2013 at 1:56 pm

Excellent Article! We have a great platform to administer BASICS. BASICS feedback provides Personalized Feedback Reports (PFRs), to help prepare counselors for Motivational Interviewing (MI).

Our platform also helps keep students informed with a Class Scheduling Feature (Counseling Sessions), and provides tools to organize and prepare the counselor for the counseling experience.

Please feel free to contact me @ (360) 527-9111 ext. 117.
If you would like to learn more about out Software as a Service, or visit our website @ http://www.basicsfeedback.com

Kaitlyn Hanisko September 26, 2013 at 7:17 pm

Hi Blake – Thank you! BASICS is a great program. I will share your information with my supervisor.

George A. Parks, Ph.D. September 26, 2013 at 8:38 pm

Kaitlyn has captured the essence of BASICS in this thoughtful and well-written blog. She is part of the excellent team led by Marsha Benz at the University of Michigan with one of the nation’s longest running BASICS implementations.

I am a member of the team of clinicians and researchers who developed the BASICS Program under the leadership of Dr. Alan Marlatt and a research team led by Dr. John Baer. For the the past 15 years I have conducted training to prepare colleges to deliver and implement both the BASICS Program and its companion group modality based on the Alcohol Skills Training Program, CHOICES About Alcohol. The feedback application that Blake describes above is one of several alternatives used to structure the second session of BASICS, but has the distinction of having a very effective scheduling modules. However, staff training and a protocol to deliver BASICS as well as Motivational Interviewing proficiency are what actualizes the impact of BASICS on a student drinker.

Colleges and University seeking to implement BASICS would benefit from staff training beginning with reading the book titled “BASICS” published by Guilford Press (1999) authored by Linda A. Dimeff, John S. Baer, Daniel R. Kivlahan and G. Alan Marlatt.

I have written BASICS Facilitator Guides that supplement this key resource by giving BASICS Providers a manual to deliver the program using a particular assessment and feedback application as providing a structure for the first session of BASICS. I also provide training and consultation on delivering and implementing BASICS, CHOICES About Alcohol (published by The Change Companies) and other Brief Motivational Interventions that can be used by health and student services staff to address alcohol, marijuana and other behavioral health issues.

BASICS is listed on NREPP, SAMHSA’S National Registry of Evidence-based Programs and Practices at http://www.nrepp.samhas.gov. I also have resources on BASICS research and would be happy to provide assistant to those interested in starting a BASICS Program on their campus.

Please feel free to contact me via phone at 206.930.1949 or send me an email at geoaparks@earthlink.net.

Reducing the threat that episodic heavy drinking poses to the safety, health and success of college students, other young adults and teenagers is critical our collective future and can be accomplished with programs like BASICS and CHOICES About Alcohol delivered by well-trained and dedicated college and community professionals.

Blake Miner October 7, 2013 at 5:08 pm

Good point George,

BASICS feedback has custom survey building features that could potentially utilize Research Based Protocols to help with other areas of counseling and interviewing. I have included some scholarly article links on the effectiveness of web-based intervention.

http://www.ncbi.nlm.nih.gov/pubmed/15279527/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2459313/

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