Using Motivational Interviewing to Address College Client Alcohol Abuse

Motivational Interviewing (MI; W. R. Miller & S. Rollnick, 2002) is presented as a potentially effective counseling strategy for assisting traditionally aged college students in reducing their problematic, heavy alcohol use. MI's congruence with two developmental theories--Self-Determination Theory (R. M. Ryan & E. L. Deci, 2000) and SevenVector Model (A.W. Chickering & L. Reisser, 1993)--is explored. In addition to presenting a case illustration, recommendations, advantages, and limitations are discussed. ********** Alcohol abuse is a common student concern addressed by college counseling professionals. For example, researchers have reported binge drinking behavior among 23% (Wechsler, Lee, Kuo, & Lee, 2000) to approximately 40% of undergraduate university and college students (Johnston, O'Malley, & Bachman, 2001a, 2001b; O'Malley & Johnston, 2002). Furthermore, in a survey study consisting of 14,000 participants, 6% of undergraduates reported recently engaging in behaviors meeting the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for a diagnosis of alcohol dependence, and 31% reported recently engaging in behaviors meeting the criteria for a diagnosis of alcohol abuse (Knight et al., 2002). Alcohol abuse is problematic not only because abuse behaviors may sometimes graduate toward dependence, but also because alcohol abuse has been associated with such problems as academic difficulties, sexual assaults, physical fights, homicidal behaviors, suicidal thoughts and behaviors, and driving while intoxicated (Hingson, Heeren, Winter, & Wechsler, 2005; Wechsler, Lee, et al., 2000). In the social context, peers of alcohol abusing college students report such undesirable effects as interrupted sleep, unwanted sexual advances, and property damage (Gintner & Choate, 2003). Consequently, many colleges and universities devote resources to the prevention and reduction of alcohol abuse (Wechsler, Kelley, Weitzman, San Giovanni, & Seibring, 2000). Despite the priority often placed on addressing alcohol abuse, student binge drinking seems to have increased over the past 20 years (Substance Abuse and Mental Health Services Administration, 2007; Wechsler, Lee, et al., 2000). One inherent difficulty in effectively treating alcohol abuse on campuses may be related to the college years representing a transitional period of exploration for traditional-age students that is characterized, in part, by increased risk-taking behavior such as drug and alcohol use. To effectively treat college students' alcohol abuse, counselors must understand the problem in the context of the person's developmental process (Baer & Peterson, 2002). Arnett (2000) described a transitional period of emerging adulthood between adolescence and adulthood, which corresponds to traditional college age. According to the model (Arnett, 2000), emerging adulthood is characterized by high levels of risk-taking behavior, including use of substances, as young adults seek to explore various aspects of their identities (e.g., love, work). Participation in novel, intense, or risky behaviors such as alcohol misuse is commonly facilitated by independent living arrangements and peer norms supporting risk taking. The characteristics of this developmental process also include factors that may pose special challenges for college counselors. First, students who abuse alcohol frequently do not view themselves as having a problem (Baer & Peterson, 2002). Second, students who abuse alcohol commonly perceive drinking behavior as rewarding and are consequently ambivalent about changing their behavior (Gintner & Choate, 2003; Vik, Culbertson, & Sellers, 2000). Third, some researchers have suggested that college students who abuse alcohol frequently are also struggling to establish autonomy from families in which they have experienced unusually high parental control (Baer & Peterson, 2002). …