Computer-Based Therapy Helps College Students Drink Less

For college students who routinely go on binge drinking sprees, a new computerized interface may help curb the dangerous behavior.

Researchers from Brown University School of Public Health set out to reduce the incidence of harmful drinking and, in so doing, took a page from one of the classics.

“For this initial development, we chose to create a ‘Wizard of Oz’ computerized system where participants would speak directly to a computer screen and a human controller would select appropriate responses and follow-up questions from an onscreen menu,” report the study authors in JMIR Mental Health.

The computer-based counseling system is built on the tenets of motivational interviewing (MI), which previous research has shown is effective in changing unwanted or harmful behavior. Researchers found that, among 60 heavy-drinking college students whom they studied, the computer-driven counseling system significantly reduced dangerous drinking levels.

One of the most important elements of the system was the voice-based program, as opposed to a text-based program or strictly reading materials, note the researchers. As it turns out, the human connection was a key driver in change.

How the Study Worked

The Brown University researchers engineered a “voice-based computer-delivered intervention” that a human being operated behind the scenes – much like the fabled wizard. The software provided a degree of interactivity “that allowed participants to speak their responses to scripted prompts delivered by speech generation software.”

The researchers had half of the 60 students use the voice-based software, while the other half interacted with a text-based counseling program. After a month went by, the researchers checked in with the students in both groups to determine their progress.

“Participants reported that the voice-based computer-delivered intervention engaged positively with them in the session and delivered content in a manner consistent with motivational interviewing principles,” report the study authors.

Related: Even Casual Drinking May Lead to Dementia

At the one-month check-in, those using the voice-based program “reported significant decreases in quantity, frequency and problems associated with drinking and increased perceived importance of changing drinking behaviors.”

Also, in comparison to the text-based users, those communicating with the Oz-like program “reported significantly fewer alcohol-related problems at the one-month follow-up.”

The researchers believe with some tweaks to the software they can create a viable method of voice-based counseling. That could have tremendous public health benefits, as binge drinking racks up considerable health costs every year.

Yet the researchers note that some tweaks to the program may offer an even greater benefit.

“Future studies should examine enhancements that can increase the perceived warmth and empathy of voice-based computer-delivered intervention, possibly through greater personalization, improvements in the speech generation software, and embodying the computer-delivered intervention in a physical form,” they write.

Related: Binge Drinking Leads to Dangerous Heart Arrhythmias

But when it comes to the nuts and bolts of the system, the use of MI-based techniques is already proving its merit. MI focuses on a concept known as “change talk,” which the researchers describe as “verbal behavior that is supportive of behavior change.”

Giving students, and society at large, a platform to voice their concerns about a behavior as risky as binge drinking holds significant promise.

“This change talk is elicited in face-to-face MI interventions through open-ended questions and reflective listening techniques (including simple reflections, paraphrased reflections, double-sided reflections, and summarizations) that allow clients to hear their own change talk,” report the researchers.

Richard Scott

Richard Scott is a health care reporter focusing on health policy and public health. Richard keeps tabs on national health trends from his Philadelphia location and is an active member of the Association of Health Care Journalists.

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