Posted 02.21.2019 | by AMRA

Nearly half of all 15-19 year olds drink alcohol, at least on occasion, despite laws prohibiting its use by minors. Increased alcohol consumption by teenagers is linked to problems with attention, memory, and cognition. Impulsive teenagers are at higher risk for alcohol use, and interventions that reduce impulsivity may also reduce their likelihood of drinking. Public schools can serve as important venues for health programs aimed at lessening alcohol-related harm.

Patton et al. [Journal of Consulting and Clinical Psychology] tested whether including mindfulness meditation in a school-based cognitive behavioral therapy intervention adds to its effectiveness in decreasing teenage alcohol use.

The researchers randomly assigned 404 Australian 9th and 10th graders (62% female; average age = 15 years) to either a cognitive behavioral therapy intervention combined with mindful breathing (CBT+MM), a cognitive behavioral therapy intervention combined with progressive muscle relaxation (CBT+PMR), or an assessment-only control. The interventions were delivered in three group-based sessions lasting an average of 58 minutes each, and were taught by graduate-level psychology students.

Mindfulness training consisted of one session that included an introduction to mindfulness, a mindful eating exercise, and a mindfulness of the body and breath exercise, and a second session that included an exercise involving mindfulness of thoughts. Cognitive behavioral training consisted of one session that included an introduction to the cognitive model and identifying cognitive distortions, and a second session in which the cognitive model was applied to thoughts about alcohol.

All students were assessed before the intervention, at post-intervention, and at 3- and 6-month follow-up on self-report measures of alcohol use, impulsivity, mindfulness (using the Mindful Attention Awareness Scale), positive and negative beliefs about the effects of alcohol, and confidence in being able to refuse alcohol in a variety of circumstances.

Students in both active interventions reported significantly lower levels of increased drinking behavior over time compared to controls (Cohen’s d = -0.14). Intervention groups did not differ from one another in their drinking behavior. There were no differences between the three groups in terms of impulsivity, mindfulness, or confidence in being able to refuse alcohol. Students in the two active interventions had increased levels of both positive and negative beliefs about how alcohol might affect them compared to controls.

The results suggest that brief CBT-based interventions, including either mindfulness or progressive muscle relaxation, reduce the increase in student drinking behavior over the course of six months. It is not clear whether mindfulness or progressive muscle relaxation contributed to this effect. There is also no evidence that the CBT+MM intervention improved self-reported levels of mindfulness.

The main limitations of the study include the brevity of the intervention, the absence of a CBT-only control to determine if mindfulness and muscle relaxation contributed to the effect on alcohol, and its reliance on minimally-trained mindfulness instructors.

Reference:

Patton, K. A., Connor, J. P., Sheffield, J., Wood, A., & Gullo, M. J. (2019). Additive effectiveness of mindfulness meditation to a school-based brief cognitive-behavioral alcohol intervention for adolescents. Journal of Consulting and Clinical Psychology.

[Link to abstract]