Michael Smith is a 19 year-old student attending a large university in the Midwest. He is seen
at a local emergency department for an injury. Michael fell off a second floor balcony while
partying with his friends.
He had a fracture to his right wrist and a 3-inch laceration on his forehead. His blood alcohol
level was 0.16. His toxicology screen showed marijuana use. He reported having a few drinks but doesn't
remember how many. He parties most weekends with his friends and generally drinks 8-10 drinks at a
party.
He denies any prior problems with alcohol. He doesn't think he has an alcohol problem. He is
surprised that you are concerned about his drinking. He says he drinks less than his friends. He says
that his dad is an alcoholic and he knows all about alcohol problems.
We suggest that participants role play screening, assessment, brief intervention, and motivational
interviewing techniques. The participant playing the role of Michael Smith should add additional
information based on their own experiences with students. The patient is meant to have a moderate
amount of resistance.
Role-Play Case Scenario #2
Mary Jones is a 21 year-old senior at a small 4-year college in the Northeast. She is being seen at
the student health center for a urinary tract infection. The nurse practitioner seeing her is struck
by her affect and sadness. The provider begins to ask Mary questions about why she appears to be
depressed.
Patient reveals moderate to severe symptoms of depression. Patient also reveals having a number of
unpleasant sexual experiences over the past couple of years while partying. Further questions
reveal a history of sexual abuse by a family member when she was in middle school.
Mary reports using alcohol 3-4 times/week to relax and relieve stress. She parties 2-3 times a
month with friends and often becomes intoxicated. Patient is concerned about her drinking but doesn't
know what else to do about the stress and sadness in her life. She also begins to talk about chronic
headaches. She has a past history of suicidal thoughts but no current suicidal ideation.
Participants may want to do a more comprehensive assessment of Mary's alcohol and drug use. They
also may try to facilitate referral to a student health counselor.
Role-Play Case Scenario #3
Paul is a 25 year-old graduate student in biochemistry at a large southern university. He was told
by his senior professor to get some help with his drinking problem. Paul is coming into the student
health center for the first time. Paul's presenting illness is fatigue and not feeling well.
The physician who is seeing Paul begins to ask some questions about fatigue, depression and stress.
After some initial discussion, Paul tells the physician that he is really there to talk about a drinking
problem. Paul reports that he drinks alcohol most days. He drinks beer or scotch when he can afford it.
He usually drinks in the evening or in the early morning hours when he's trying to go to sleep. He
says he generally drinks alone and does not usually go to parties. He sometimes socializes with other
graduate students, but he spends most of the time working in his professor's research lab.
Paul has limited insurance and can't afford to take time off to go into an alcohol treatment
program. He is also not sure he wants to stop drinking because it helps him relax and sleep.
Participants may want to focus on office-based motivational interviewing with this case scenario.
Person playing the role of the patient should show mild to moderate resistance.