Program Goals
Research has found that adolescent alcohol use is associated with numerous negative outcomes such as decreased cognitive abilities, increased social problems, and high school noncompletion (Nguyen–Louie et al. 2015; Jennings et al. 2015; Kelly et al. 2015). Brief interventions that meet the unique needs of youth during adolescence have been developed to reduce these consequences. Cognitive Behavioral Therapy (CBT) Plus Mindfulness Meditation for Adolescent Alcohol Consumption was an in-school program that incorporated techniques from both approaches (CBT and mindfulness meditation) to target adolescents’ individual and general risk factors for alcohol use. The goal was to reduce the growth of alcohol consumption in adolescents.
Program Components/Target Population
Mindfulness meditation involves deliberate attention on the present with nonjudgmental acceptance of present-moment experiences (Papies, Barsalou, and Custers 2012). In the program, mindfulness techniques complemented a universal CBT program, which involved the cognitive model of the interplay between and among thoughts, emotions, and behaviors (Beck 1976) and techniques for students to address “unhelpful” cognitions.
The intervention was intended for students in 9th and 10th grades (around 13 to 15 years old) to reach this population before the average age of onset of alcohol use—15.7 years for Australian adolescents (Australian Institute of Health and Welfare 2014). It was designed to be a total of 110 minutes and was delivered over three sessions. The first session involved psychoeducation and an introduction to mindfulness as a technique to reduce inattention and to increase present-moment awareness, with content on mindful eating and mindfulness of the breath and body. The second session introduced students to the cognitive model of the interplay between and among thoughts, emotions, and behavior. Participants were taught techniques to identify, challenge, and change “unhelpful” cognitions, and they participated in Sitting Mindfulness of Thoughts practice. The first two sessions also involved home practice outside of school. The techniques were applied first to general stress and negative emotions. In the third session, they were applied specifically to alcohol use with a hypothetical party exercise.
Key Personnel
The program was delivered by one or two facilitators in class groups of from 8 to 23 students. The intervention was delivered by students completing master’s- or doctoral-level psychology programs who were trained in the intervention by a doctoral-level instructor (Patton et al. 2019).
Program Theory
The biosocial cognitive theory of substance use posits that elevated reward drive (also referred to as trait reward drive, approach motivation, or sensation seeking) may lead to positive alcohol expectancies (positive beliefs about the likely outcomes of alcohol consumption [Connor, Haber, and Hall 2016; Magill et al. 2015]), which leads to increases in alcohol use (Gullo et al. 2010). Further, high rash impulsivity (or trait rash impulsiveness, disinhibition, or lack of premeditation) undermines drinking-refusal self-efficacy (which refers to individuals’ belief in their ability to refuse alcohol), which may also lead to increased use (Gullo et al. 2010). CBT targets alcohol-related cognitions directly and may be able to interrupt the link between impulsivity and cognitions (Loree, Lundahl, and Ledgerwood 2015) and may also affect drinking-refusal self-efficacy through altering alcohol expectancies (Connor, Haber, and Hall 2016; Patton et al. 2019). The mindfulness meditation technique is theoretically consistent with managing rash, inattentive impulses (Papies, Barsalou, and Custers, 2012) and was added to the intervention to increase the efficacy of cognitive behavioral therapy.
