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Group First Step Brief Motivational Interviewing with Statistically High Risk Groups. Julie Lyzinski, M.Ed., L.P.C. Tamarah Smith-Dyer, M.S. Office of Alcohol and Other Drug Program Initiatives University of Pennsylvania. Background. Brief Motivational Interviewing (BMI)
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Group First StepBrief Motivational Interviewing with Statistically High Risk Groups Julie Lyzinski, M.Ed., L.P.C. Tamarah Smith-Dyer, M.S. Office of Alcohol and Other Drug Program Initiatives University of Pennsylvania
Background • Brief Motivational Interviewing (BMI) • B.A.S.I.C.S. model: Well Researched Effectiveness* • Based on: • Harm Reduction • Stages of Change Theory • Recommended: NIAAA (2002) tier 1 • Effective: With Individuals* • Efficient: Ideal for use in college settings (Dimeff, *(Dimeff, L. A. et al., 1999; Walters & Baer, 2006; NIAAA, 2002).
Why Cohort-Based Intervention? • Addresses the impact of group culture on high risk AOD behaviors • Peer influence is reported as: • The most common environmental risk factor for alcohol use in adolescence * • The single best predictor of young adult drinking* • Community normsare linked to drinking rates.** • Research of cohort BMI interventions is limited. *Jessor & Jessor (1977) and Kandel & Andrews (1987) **Walters & Baer (2006) (p. 5)
Why Cohort-Based Intervention? • Group First Step • Facilitates change within a specific group's culture • In turn, creates safer, healthier group environments • AND simultaneously impacts individuals' behavior within the group.
Background • BMI in a group setting • Strengths • Increases access/decrease resources • Addresses cultural/environmental contributors to high risk drinking -Group traditions (formal/informal) -Attitudes toward AOD use -Group expectations/Peer pressure • Impacts campus wide behaviors • Weakness • Limited research
Using BMI in a Group Intervention Components: • Pre-survey(online) • Individual feedback form(email) • Group feedback(verbally during meeting) • Group meeting(~2 hours): • Risk Behavior Continuum • Small/large group discussion • Group data feedback • Identify misperceptions/discrepancies • Education/information • Harm Reduction • Post-survey(online)
Using BMI in a Group Risk Behavior Continuum: • 12 realistic scenarios involving AOD • Break into groups of 4-5 • Students rate the scenarios (high, moderate or low risk) • Return to large group to discuss ratings: • Why? • If high risk, what would make the situation moderate or low risk? • If low risk, at what point would this become a high risk situation?
Using BMI in a Group Example: “A student smokes marijuana 3 or more times a week.” Common response: low to moderate risk *some will think it is high risk Discussion points: • How many of you have smoked pot in the past 2 months? • Challenge w/ survey data • What do you know about marijuana? • What level of use would make this scenario high risk? • Common response: daily or several times a day • What risks are involved with this level of use? • What risks are involved with your definition of “high” risk use? • Some key information • Does this change your perspective? If so, how?
Using BMI in a GroupPre- Post Assessment / Personalized Feedback Assessment: • Measure high risk behaviors • Measure negative consequences • Measure protective factors • Measure culture change
Using BMI in a GroupPre- Post Assessment / Personalized Feedback Feedback: • Individualized feedback on BAC levels: • last, highest & typical drinking occasion • based on students sex, weight, time, quantity provided in survey • Information about how to stay safe • Define “what is a drink”
Using BMI in a Group • Assessment and Feedback
NATIONAL DATA: Effectiveness of BMIIndividuals • Substantial amount of literature showing significant positive changes in drinking and related behaviors • See reference sheet
NATIONAL DATA: Effectiveness of BMIGroups- Unrelated students • Limited research • 1992 thru 2007: • Four studies (2 experimental/2 pre-post)* • Involved unrelated students • Significant decreases in • Alcohol consumption • BAC *see reference sheet
NATIONAL DATA: Effectiveness of BMIGroups- Related students • One study (2001) • Received both individual & group intervention • Significant decreases in • Alcohol consumption • BAC
PENN DATA: Effectiveness of BMIMeasures of High Risk Drinking • Measures included • BINGE DRINKING (4/5 drinks last 2 weeks) + BAC (>.08) • High risk drinking + FREQUENCY (4+ last 2 weeks) • Chronic high risk drinking
PENN DATA: Effectiveness of BMIIndividuals & Groups(combine data) • Population level assessment • Annual Alcohol, Other Drug & Wellness survey • Compared changes between ’05 and ’08 • Significant decreases • For entire population • Significantly greater decreases for FS participants
PENN DATA: Effectiveness of BMIIndividuals & Groups(combine data) First StepNo First Step N 1317 9517 Binge Drinking -10% -7% Chronic HR Drinking -14% -7% Negative Consequences -19% -16% Marijuana Use -20% -8% Cocaine Use -4% -2% Table 1. Decreases in AOD Use and Related Behaviors (AY 2004/05 – AY 2007/08)
PENN DATA: Effectiveness of BMIGroups of Fraternities & Sororities • Program Participant Assessment • Pre/Post surveys • Compared 2 weeks prior and 2 months post • Results • Reflective of program goals • HIGH RISK DRINKING: Decreased • PROTECTIVE FACTORS: Increased • NEGATIVE CONS.: Decreased