| For most students, college is a learning | | | | change counseling approach. This type of |
| experience that goes well beyond the | | | | counseling is based on motivational |
| classroom. More freedom and responsibility | | | | interviewing but requires less time to be |
| means more risk, which is borne out in the | | | | effective. Most students fall into the |
| statistics surroundings students' use of | | | | category of at-risk consumption, which brief |
| alcohol. According to the National Institute | | | | interventions are effective at tackling. |
| on Alcohol Abuse and Alcoholism (NIAAA), one | | | | According to Schaus, traditional, longer-term |
| in three 18 to 24 year olds admitted to the | | | | counseling is more appropriate for alcohol |
| emergency room is intoxicated, and about half | | | | use disorders, alcohol abuse or alcohol |
| of all fatal traffic crashes amongst this age | | | | dependency. However, usually only five to 10 |
| group involve alcohol. College health | | | | percent of college students fall into these |
| professionals are charged with a duty of care | | | | categories. The challenge, of course, is to |
| for students' health and wellbeing; the | | | | incorporate this into the schedule of a busy |
| somewhat daunting task of keeping them safe | | | | student health center. One tactic for doing |
| from alcohol-related injury and death can be | | | | this is known as the "teachable moment". |
| seen as part of that responsibility. The | | | | Schaus explains, "If a student presents with |
| question is, how can an already-stretched | | | | a sprained ankle because they fell over when |
| college health center best tackle the | | | | drunk, or if they're being tested for an STD |
| continuing problem of harm related to binge | | | | because they had a high-risk sexual encounter |
| drinking? An increasing number of health | | | | while intoxicated, you can use these |
| professionals, including Dr. James Schaus, | | | | incidents as a starting point to talk about |
| assistant director for clinical services at | | | | alcohol." Additionally, Schaus advises that |
| the University of Central Florida, and | | | | there should be a dedicated formal screen at |
| principal investigator in the NIAAA-funded | | | | initial patient registration at the health |
| study entititled "Alcohol Screening and | | | | center. Making sure that all students have |
| Intervention in a College Clinic", believe | | | | participated can be a simple process if your |
| the answer lies in a well-implemented program | | | | health center has a practice management |
| of alcohol screening followed by brief | | | | system such as Nuesoft Xpress (TM) . With the |
| interventions for high-risk students. The | | | | click of a button, a list can be compiled of |
| goal of a brief intervention is to reduce | | | | all students who have not yet been screened, |
| harm and effect a change in behavior. This is | | | | and a follow up letter sent to each one. |
| particularly important for this age group, | | | | Students can even schedule their own |
| explains Schaus. "Students are at a pivotal | | | | screenings via Nuesoft Xpress' student Web |
| time in their life," he said. "If you can | | | | portal. Schaus' screening and intervention |
| connect with a college student on the topic | | | | recommendations seem to be practical ones. |
| of alcohol and other social and preventative | | | | Yet a 2004 article by Foote in Journal of |
| health issues, and get them to recognize that | | | | American College Health indicated that only |
| there is a problem and maybe even do | | | | 32 percent of college health centers |
| something to change it, you're likely to be | | | | routinely screen and only 12 percent use a |
| affecting their behavior for life." The first | | | | standardized, approved screen. What's more, |
| step, however, is to screen students for | | | | says Schaus, the majority of these health |
| high-risk drinking. There are several ways to | | | | centers use the CAGE screen (so called |
| do this. The AUDIT or Alcohol Use Disorders | | | | because it is a mnemonic of the key words |
| Identification Test is a 10 question screen | | | | from each question) which is a screen |
| developed and validated by the World Health | | | | primarily used to detect alcohol dependency |
| Organization, but there are other, even | | | | rather than at-risk consumption. "Apart from |
| simpler screens also available. Schaus | | | | the lack of time and money, many college |
| recommends a single question screen that | | | | health centers feel their staff hasn't had |
| includes the "5/4" definition of high-risk | | | | adequate training to deliver an |
| drinking. "If the student is male, the | | | | intervention," says Schaus. "But only eight |
| question is 'In the last two weeks, have you | | | | hours of training are required for staff to |
| had five or more drinks in a row?' If the | | | | be able to deliver an effective brief |
| student is female, the figure changes to four | | | | intervention." Educational resources are |
| or more drinks in a row." Schaus believes | | | | accessible either through the BASICS program |
| that the key to successful screening is to | | | | or the College Drinking Prevention Curriculum |
| take a non-judgmental, student-centered | | | | developed by the NIAAA. This combination of |
| approach. "Alcohol can be a sensitive topic | | | | screening and brief interventions appears to |
| with students. If you ask them straight out | | | | be effective at identifying at-risk students |
| about their consumption of alcohol or drugs, | | | | and changing their behavior significantly. |
| you're not likely to get an honest answer," | | | | "At 12 months out from our initial study, |
| he said. "But if you use a motivational | | | | we're seeing a lasting effect," said Schaus. |
| interview style and approach the subject on | | | | Not only did the study show statistically |
| their terms, making sure you're | | | | significant reductions in all eight alcohol |
| non-judgmental in the way you deal with it, | | | | consumption outcomes (including peak blood |
| they feel more comfortable." This style of | | | | alcohol count and number of drinks consumed |
| interviewing can be applied to substance | | | | in one sitting); it also showed reductions in |
| abuse, eating disorders and a range of other | | | | alcohol related harms including driving after |
| problems. In fact, claims Schaus, when you | | | | three or more drinks, taking foolish risks |
| use this approach, you can often end up | | | | and physical injuries. Those college health |
| discussing other important problems that the | | | | centers with Nuesoft Xpress can use the |
| student didn't initially plan on broaching. | | | | clinical study feature to track the |
| If the student has a positive experience | | | | effectiveness of their own alcohol prevention |
| talking about these sensitive topics, it also | | | | program over time. As the results of studies |
| makes it more likely that they will return to | | | | such as Schaus' become publicized, more |
| the health center if they have a problem in | | | | college health centers will find a way to |
| the future. Once you've identified the | | | | implement these types of screenings and brief |
| high-risk students, the next step is to | | | | interventions, making high-risk drinking on |
| conduct a brief intervention. As the name | | | | campus less prevalent and helping to |
| suggests, it doesn't have to be time | | | | safeguard students. |
| consuming. There have been a number of | | | | |
| studies delivered by counselors suggesting | | | | Cassie Harman writes for NueMD ( ), a |
| that even very brief sessions - as little as | | | | provider of medical billing software. This |
| five minutes - can reduce harm. Schaus | | | | article previously appeared in the Nuesoft |
| suggests, if possible, scheduling two | | | | Xpress e-nues . |
| 20-minute sessions and using a behavioral | | | | |