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BASICS—Brief Alcohol Screening and Intervention of College Students: A Harm Reduction Approach—is a preventive intervention for college students 18 to 24 years old. It is aimed at students who drink alcohol heavily and have experienced or are at risk for alcohol-related problems such as poor class attendance, missed assignments, accidents, sexual assault, and violence.
Students often conform to patterns of heavy drinking they see as acceptable while holding false beliefs about alcohol’s effects or actual alcohol-use norms. BASICS is designed to help students make better alcohol-use decisions. The program’s style is empathic, rather than confrontational or judgmental. It 1) reduces alcohol consumption and its adverse consequences, 2) promotes healthier choices among young adults, and 3) provides important information and coping skills for risk reduction.
BASICS is conducted over the course of two 50-minute interviews. These brief, limited interventions prompt students to change their drinking patterns. Though research also shows that, over time, most students who drink heavily will reduce consumption without the intervention, BASICS speeds the process. Postintervention students often comment that they respond differently to friends as a result of participation. Thus, if implemented densely (e.g., in dormitory or other residential settings), BASICS may have a broader effect.
As a harm reduction approach, BASICS aims to motivate students to reduce risky behaviors instead of targeting a specific drinking goal such as abstinence or reduced drinking. Students can be identified through routine screening or through referral from medical, housing, or disciplinary services. Before or after the first interview, the student receives a self-report questionnaire to complete. From the questionnaire and the first interview, information is gathered about the student’s alcohol consumption pattern, personal beliefs about alcohol, understanding of social alcohol norms, and family history. The second interview, which occurs about 2 weeks after the initial interview, provides the student with personalized feedback on his or her patterns of drinking, typical and peak blood alcohol concentration, comparison of drinking patterns with other college students of the same age and gender, and level of family history of alcohol problems. Moreover, the program challenges inaccurate alcohol norms and myths about alcohol’s effects, highlights alcohol-related negative consequences, suggests ways to reduce future risks associated with alcohol use, and provides a menu of options to assist in making changes. Screening and referral for stepped-care treatment is also offered as needed.
BASICS has been evaluated with four randomized longitudinal designs. In these studies, student volunteers were recruited and assessed, then selected according to their drinking practices. In the most comprehensive follow-up study of the program, all students younger than 19 who had committed themselves to attending the University of Washington in fall 1990 (n=4,000) were mailed a questionnaire during the spring before matriculation. Of these individuals, 508 were identified as high risk—that is, drinking at least once a month and consuming five to six drinks on at least one occasion in the past month, or experiencing at least three negative consequences from drinking on three to five different occasions in the previous 3 years. The final sample of those identified as high risk was 348 students, who were randomized into either the intervention or the no-intervention control group. These high-risk students reported at baseline assessment, in the fall of their freshman year, on average, drinking more than 10 drinks per week (during, on average, fewer than two drinking occasions within that week), reaching a typical estimated peak blood alcohol level of 0.12 percent per drinking episode. The sample was 55 percent female and 84 percent white.
An additional normative comparison sample was selected randomly from the entire pool of respondents (n=151), including 33 persons who met high-risk criteria, to track the natural history of changes in drinking behavior within the cohort over time. The final normative comparison sample consisted of 113 students (54 percent female; 78 percent white) who reported drinking about 5½ drinks per week during one drinking occasion, reaching a typical estimated peak blood alcohol level of 0.08 percent.
Outcome measures included self-report 6-point scales, which rate the quantity, frequency, and peak occasions of drinking behavior. Students also completed the Daily Drinking Questionnaire, which asks the actual number of drinks for each day of a typical week, yielding drinking days per average week and average drinks per drinking day. Participants were also asked to complete the Rutgers Alcohol Problem Inventory, so researchers could assess negative drinking consequences and the Alcohol Dependency Scale. Follow-up assessments were completed by mail annually over 4 years.
It appears that brief individual preventive interventions for high-risk college drinkers can achieve long-term benefits, even in the context of maturational trends. Most students who drink heavily as freshmen tend to report few negative consequences over time, as the reasons for drinking diminish or change. However, those who received BASICS reported fewer consequences and more rapid change. Students receiving a brief individual preventive intervention had significantly greater reductions in negative consequences that persisted over a 4-year period than their control-group counterparts. Individual change analyses suggest that for those receiving the brief intervention, dependence symptoms are more likely to decrease and less likely to increase. Regarding drinking frequency, neither the high-risk group nor the normative sample changed drastically over the 4 years. Normative comparison participants representing the general student body reported slight increases in drinking frequency over time, particularly at the 3-year follow-up when many students had reached 21 years of age, while drinking frequency declined minimally over the 4-year period among high-risk students.
Baer, John S., Daniel R. Kivlahan, Arthur W. Blume, Patrick McKnight, and G. Alan Marlatt. 2001. “Brief Intervention for Heavy-Drinking College Students: 4-Year Follow-Up and Natural History.” American Journal of Public Health 91(8):1310–16.
Borsari, Brian, and Kate B. Carey. 2000. “Effects of a Brief Motivational Intervention With College Student Drinkers.” Journal of Consulting and Clinical Psychology 68(4):728–33.
Larimer, Mary E., A.P. Turner, B.K. Anderson, Jonathan S. Fader, J.R. Kilmer, R.S. Palmer, and Jessica M. Cronce. 2001. “Evaluating a Brief Alcohol Intervention With Fraternities.” Journal of Studies on Alcohol 62(3):370–80.
Marlatt, G. Alan, John S. Baer, Daniel R. Kivlahan, Linda A. Dimeff, Mary E. Larimer, Lori A. Quigley, Julian M. Somers, and Ellen Williams. 1998. “Screening and Brief Intervention for High-Risk College Student Drinkers: Results From a 2-Year Follow-Up Assessment.” Journal of Consulting and Clinical Psychology 66(4):604–15.
Murphy, James G., Jennifer J. Duchnick, Rudy E. Vuchinich, John W. Davison, Rhonda S. Karg, Amanda M. Olson, Anna F. Smith, and Timothy T. Coffey. 2001. “Relative Efficacy of a Brief Motivational Intervention for College Student Drinkers.” Psychology of Addictive Behaviors 15(4):373–79.
G. Alan Marlatt, Ph.D.
Addictive Behaviors Research Center, Department of Psychology
Box 351525
University of Washington
Seattle, WA 98195–1629
Phone: (206) 685-1395
Fax: (206) 685-1310
E-mail: marlatt@u.washington.edu
George A. Parks, Ph.D., Associate Director
Addictive Behaviors Research Center, Department of Psychology
University of Washington
Box 351629
Seattle, WA 98195–1629
Phone: (206) 685-7504
Fax: (206) 685-1310
E-mail: gparks@u.washington.edu
