Lack of effect for decisional balance as a brief motivational intervention for at-risk college drinkers

This study examined the effects of written and in-person decisional balance exercises on measures of risky drinking. College students determined to be at-risk for alcohol-related problems (N=131) were randomly assigned to an in-person decisional balance (IDB), a written decisional balance (WDB), or an assessment-only control (C) group. IDB participants met with an interventionist for individual 30-min discussions of the pros and cons of maintaining versus changing their drinking behavior, whereas WDB participants completed written decisional balance exercises. All participants completed alcohol-use assessments at baseline, 2-week posttest, and 6-month follow-up. Process analyses indicated that IDB participants generated more cons of current drinking and more pros of cutting down than WDB participants. Further, the proportion of pros to cons for cutting down predicted IDB but not WDB group drinking change. On the other hand, analyses of covariance indicated no significant differences among the groups on 2-week alcohol consumption, heavy-drinking episodes, alcohol consumption during peak drinking occasions, and alcohol-related problems. This study did not provide support for decisional balance as a stand-alone brief motivational intervention for at-risk college drinkers.