Readiness to Change, Social Norms, and Alcohol Involvement among College Students

Beginning of article

The author explored the impact that readiness to change variables have on dimensions of alcohol involvement and how the explanatory power of the variables compares with social norms among college students. Canonical analysis suggested that alcohol intensity and drinking consequences were best explained by the norms for closest friends and contemplation about one's drinking.

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In the United States, alcohol abuse on college campuses has come under increasing attack (Thombs & Briddick, 2000). The growing concern about this issue can be gauged by the national news media coverage of heavy episodic drinking, property destruction and vandalism, and alcohol-related fatalities (e.g., Rivera, 2000 ["Smashed: Kids and Alcohol"]). Recent developments in government, higher education, and the public health community have led to greater public awareness and policies to address the problem (Thombs & Biddick, 2000). For example, in 1998 the U.S. Congress passed legislation that gives universities and colleges the jurisdiction to notify parents when students under the age of 21 have violated policies related to substance use (Center for Science in the Public Interest, 1998). Additionally, the National Institute of Alcohol Abuse and Alcoholism (NIAAA) responded to the issue by creating a task force calling for action to change the culture of drinking at U.S. colleges and universities (Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism, 2002). The NIAAA also responded by identifying college student alcohol abuse as a tremendous societal burden, prompting government officials to form coalitions to thoroughly assess the scope of the problem (Kington, 2002).

It is somewhat surprising that alcohol abuse on university campuses is receiving more attention today than it has in the past, given its long history and prevalence (e.g., see Straus & Bacon, 1953). The rates of consumption appear to be relatively stable but high (Thombs & Briddick, 2000). In a nationwide analysis of the problem, Wechsler, Dowdall, Maenner, Gledhill-Hoyt, and Lee (1998) found that from 1993 to 1997, there was little change in drinking rates, with 42.6% of college students classified as "binge drinkers" and 20.7% classified as "frequent binge drinkers." In a more recent nationwide survey, Wechsler et al. (2002) found "heavy, episodic alcohol use" (i.e., binge drinking) among 44% of the sample. Although controversial, Wechsler et al. (1998, 2002) defined binge drinking as consuming five (four for women) or more drinks in a row in one sitting within the previous 2 weeks.

For decades, the cornerstones of alcohol abuse prevention on America's college and university campuses have been policy development and the enforcement of institutional regulations and state law (Eigen, 1995; Schuh & Shore, 1997). Most campuses establish alcohol policies that regulate the times and places of drinking. Somewhat less common are policies that regulate the sponsorship and marketing of campus events, the methods of dispensing alcohol, the application of sanctions for off-campus alcohol-related misbehavior, and the notification of parents following an alcohol-related emergency (Lewis & Thombs, 2005). Thus, most colleges and universities have responded in a typical fashion: by forming coalitions that promote, create, and enforce drinking regulations and establish psycho-education and counseling as mandatory activities for alcohol-related misbehavior (Gadaleto & Anderson, 1986; Thombs & Briddick, 2000).

Typically, students' readiness to change is not considered in the development of such interventions (Thombs & Briddick, 2000). Considering the motivational aspects of students' drinking, it may be that most moderate to heavy drinkers actually have a social investment in their alcohol use (W. R. Miller & Rollnick, 2002). Thombs and Briddick (2000) summarized the questionable assumptions that conventional alcohol prevention and intervention approaches may rest upon: (a) college students cannot manage the risks associated with drinking alcohol; (b) social conditions (i.e., interventions and campus environment) cannot influence readiness to change because it is an internal trait; (c) even if strategies do not deter students from heavy drinking, at least something was done; and (d) student compliance with alcohol prevention and intervention programs is evidence of their effectiveness. Thus, campus officials may need to reexamine the assumptions of traditional approaches to combat alcohol abuse and consider implementing programs that are based on a different set of assumptions about students' motivation to use alcohol (Thombs & Briddick, 2000).

The Stages of Change Model

University personnel and campus counselors who experience poor outcomes related to alcohol prevention and intervention programs may do so because they incorrectly assume that students are ready to take action to change unwanted behaviors (W. R. Miller & Rollnick, 2002). As Prochaska (1999) noted, people who are unwilling to change cannot be counseled in the same manner as those who have made a decision to change. College students, who are already struggling with their own developmental issues, identity exploration, and independence, may be a particularly difficult group to counsel toward changing behavior, especially in permissive environments that discourage change (Thombs & Briddick, 2000).

Prochaska, DiClemente, and Norcross (1992) developed a transtheoretical stage model (i.e., the Stages of Change model) to explain how individuals engage in the change process, either with or without the help of professional counseling. According to this model, individuals on the path of change progress through a series of identifiable stages, ranging from little awareness to a problem behavior, to recognition of a problem, to taking active steps to eliminate the bad habit from their lives. In particular, the Stages of Change model provides practitioners with a perspective on an individual's readiness to confront and deal with problems; the model has also been useful for clinicians because they can tailor interventions to match a client's stage of change. Indeed, one of the major factors in a client's resistance to counseling is a mismatch between a client's stage of change and counselor interventions (W. R. Miller & Rollnick, 2002).

The Stages of Change model describes five stages: (a) precontemplation, (b) contemplation, (c) preparation, (d) action, and (e) maintenance (Prochaska et al., 1992). It should not be assumed that individuals pass through stages in a linear fashion. Clients can and do vacillate between stages (Prochaska et al., 1992). That is, an individual who is in the action stage may, upon encountering a setback, move back to the precontemplation stage, only to move through the remaining stages again.

In the precontemplation stage, individuals have difficulty identifying their alcohol use as problematic. Generally, they have no intention of changing the behavior in the near future (Thombs & Briddick, 2000). People may be in this stage because they are uninformed about the consequences of their behavior or they may be defensive, denying that there is a problem (Prochaska, 1999). This pattern of motivation may be quite common among college students who use alcohol excessively. Thus, in the current study, it was expected that precontemplative students would engage in higher levels of alcohol use and related consequences.

In the contemplation stage, individuals consider the possibility of change but make no commitment or take no action toward change. Those in contemplation usually manifest strong ambivalence toward changing (W. R. Miller & Rollnick, 1991). Unlike the precontemplator, the contemplator is willing to consider change and may even acknowledge that change would be beneficial. College students who abuse alcohol may be a particularly …