Do Young Problem Drinkers Respond to Motivational Interviewing?
Motivational interviewing is a counseling technique designed to (among other things) increase the willingness of people with significant alcohol problems to seek help for their excessive, dysfunctional alcohol intake. Current evidence supports the usefulness of this technique for adults affected by problematic drinking behaviors. In a study review published in August 2014 in The Cochrane Library, researchers from the United Kingdom’s Oxford Brookes University assessed the usefulness of motivational interviewing for teenagers and young adults who consume alcohol in dangerous ways. The researchers concluded that the technique may produce a substantially smaller benefit for people in these younger age groups.
Young People and Alcohol Problems
Two of the primary indicators of impending problems with diagnosable alcohol abuse and/or alcoholism are participation in a pattern of heavy alcohol intake and regular participation in binge drinking, an activity that produces rapid drunkenness. Heavy drinking occurs whenever an individual consumes alcohol above the daily or weekly limits for moderate intake at least once a month. Binge drinking typically involves the consumption of four drinks (for women) or five drinks (for men) in no more than two hours. Maintenance of a pattern of heavy drinking is one of the most clearly established risk factors for alcohol abuse/alcoholism (i.e., alcohol use disorder). Most people who binge drink with regularity also qualify as heavy drinkers, in addition to exposing themselves to alcohol poisoning, car wrecks and other severe consequences of excessive intoxication.
Young people between the ages of 21 and 34 are substantially more likely to binge drink than any other age group in the U.S., the federal Substance Abuse and Mental Health Services Administration reports. Binge drinking is also quite common in teens and younger adults between the ages of 18 and 20. The highest nationwide rates for heavy drinking occur in young people between the ages of 18 and 29; the peak rate for this dangerous practice appears in individuals between the ages of 21 and 25.
Motivational interviewing is also known as brief motivational interviewing or motivational enhancement therapy. The typical course of this form of counseling includes three to five sessions. The first session allows the professional conducting the therapy to assess his or her client/patient and understand the reasons this individual is hesitant to seek substance treatment. The individualized follow-up sessions give the counselor or therapist the opportunity to discuss treatment concerns and objections with the client/patient and use non-confrontational techniques to improve that individual’s positive outlook on treatment involvement. The specific approach used naturally varies from affected individual to affected individual. The National Institute on Drug Abuse notes the effectiveness of motivational interviewing in helping adults prepare for alcohol treatment and reduce their alcohol consumption.
Effectiveness in Younger Drinkers
In the study review published in The Cochrane Library, the Oxford Brookes University researchers used an analysis of 66 previous studies to assess the effectiveness of motivational interviewing in altering the alcohol-related behaviors of young people between the ages of 15 and 26 involved in problem drinking. A total of 17,901 people took part in these studies. Some of the studies under consideration included fairly long-term follow-up evaluations that allowed the current researchers to make comparisons to young people with drinking problems who did not take part in motivational interviewing.
After completing their analysis, the researchers concluded that, compared to young problem drinkers who don’t participate in motivational interviewing, young problem drinkers who do take part in this form of counseling consume smaller amounts of alcohol per week, drink alcohol on fewer days per week and have lower peak levels of alcohol circulating in their bloodstreams. However, the researchers also concluded that, for each of these outcomes, the differences found between the motivational interviewing participants and the non-participants were small and statistically insignificant.
Several factors may have influenced the researchers’ findings. First, most of the studies under consideration did not fully follow the guidelines for effective motivational interviewing outlined by the National Institute on Drug Abuse. Specifically, most of the participants in the reviewed studies only attended a single motivational interviewing session, not multiple sessions. In addition, several of the studies looked at motivational interviewing performed in a group setting, not in an individualized setting. Finally, in many cases, the young people enrolled in motivational interviewing were compelled to do so rather than participating voluntarily.