The Professional Counselor | Volume 11, Issue 3 361 delivery and program facilitation were impacted by the personal style or characteristics unique to the instructor. These factors could be measured in future work. Lastly, we did not include a followup assessment that could speak to the robustness of our observed effects and longer term impact on substance use as students move through their high school years and beyond. Future Directions Research is needed to establish evidence to support school interventions such as the MCARR. Future research may support the efficacy of the MCARR through measures of substance use knowledge, risk assessment evaluation competencies, and attitudes about substance use. Longitudinal studies may explore how the MCARR impacts students’ future drug and alcohol use, and research should also explore the relevance of the MCARR for students of different ages, in a variety of school settings, across a diverse range of communities. Future research should focus on the feasibility of this curriculum in online learning environments, including possible delivery adaptations and content considerations. Collaboration with school staff, health educators, and other members of the school community could improve any impact offered by the MCARR. Using school counselors, the MCARR curriculum offers promise in mitigating drug and alcohol use, heading off problematic use, and encouraging students to intentionally reflect on their choices. For the longer term, we hope that a program such as the MCARR could be sustainable, drawing on the roles that counselors already fill within schools and with bridges to counselor education programs, where new school counselors enter the workforce with the MCARR program on board. Problematic substance use continues to plague our youth. We hope that the MCARR, realized through school counselors and other school professionals, can address an important gap via a systemic approach to mitigating youth substance use risk. For the future, we are planning a larger, multi-school study that addresses the limitations just noted and a deeper phenotyping of student characteristics and assessment of processes that may affect the potency of our program (e.g., student relationship with school, peer and parental attitudes about substance use). In conclusion, with MCARR we provide the profession with a promising primary preventive school-based approach for reducing adolescent substance use behaviors. MCARR is the first program designed specifically to harness the professional strengths of school counselors, with findings in an open trial suggesting impacts on student attitudes and knowledge related to substance use including perceived risk and readiness to change, but without appreciable increases in substance use during a high-risk period. Future work in a randomized trial and follow-up across the high school years will further evaluate MCARR impacts and sustainability in the school milieu. Conflict of Interest and Funding Disclosure The authors reported no conflict of interest or funding contributions for the development of this manuscript. References Alcohol Research Editorial Staff. (2018). Drinking patterns and their definitions. Alcohol Research, 39(1), 17–18. Ammerman, B. A., Steinberg, L., & McCloskey, M. S. (2018). Risk-taking behavior and suicidality: The unique role of adolescent drug use. Journal of Clinical Child & Adolescent Psychology, 47(1), 131–141. https://doi.org/10.1080/15374416.2016.1220313
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