352 Louisa L. Foss-Kelly, Margaret M. Generali, Michael J. Crowley Making Choices and Reducing Risk (MCARR): School Counseling Primary Prevention of Substance Use The consequences of adolescent drug and alcohol use may be serious and far-reaching, forecasting problematic use or addictive behaviors into adulthood. School counselors are particularly well suited to understand the needs of the school community and to seamlessly deliver sustainable substance use prevention. This pilot study with 46 ninth-grade students investigates the impact of the Making Choices and Reducing Risk (MCARR) program, a drug and alcohol use prevention program for the school setting. The MCARR curriculum addresses general knowledge of substances and their related risks, methods for evaluating risk, and skills for avoiding or coping with drug and alcohol use. Using a motivational interviewing framework, MCARR empowers students to choose freely how they wish to behave in relation to drugs and alcohol and to contribute to the health of others in the school community. The authors hypothesized that the implementation of the MCARR curriculum would influence student attitudes, knowledge, and use of substances. Results suggest that the MCARR had a beneficial impact on student attitudes and knowledge. Further, no appreciable increases in substance use during the program were observed. Initial results point to the promise of program feasibility and further research with larger samples including assessment of longitudinal impact. Keywords: MCARR, school counselors, drug and alcohol use, substance use prevention, motivational interviewing Adolescent substance use continues to wreak havoc in the United States, resulting in tragic consequences for adolescents, their families, and communities. Although some substances of abuse and modes of delivery have faded in prominence, others have taken their place. For instance, data from the National Institute on Drug Abuse’s Monitoring the Future Survey reflect an alarming rise in e-cigarette use, which may predict an easier transition to combustible cigarettes and cause serious lung injuries (Johnston et al., 2020; Singh et al., 2020). Use of illicit drugs among adolescents is down, yet cannabis use has increased among younger adolescents to levels that the Food and Drug Administration has described as epidemic (Johnston et al., 2020; Yu et al., 2020). Reports have shown a rise in 30-day marijuana vaping, a common metric for assessing recent use, which has doubled or tripled among eighth, 10th, and 12th graders (Johnston et al., 2020). Concerns remain that early initiation of drug use may further fuel the United States’ ongoing opioid epidemic (D. A. Clark et al., 2020; D. J. Clark & Schumacher, 2017). Historically, alcohol has been the most prominent substance of abuse among adolescents (Substance Abuse and Mental Health Services Administration [SAMHSA], 2018); however, binge alcohol use, defined as more than five drinks on a single occasion, has been declining since the 1970s (Johnston et al., 2020). Regardless, alcohol use and its related risks, such as homicide, suicide, and motor vehicle crashes, continue to be a significant problem for youth (Hadland, 2019; Lee et al., 2018). Among adolescent risk-taking behaviors, substance use is particularly concerning because of potential impacts on the developing brain (Jordan &Andersen, 2017; Renard et al., 2016). Adolescence offers a The Professional Counselor™ Volume 11, Issue 3, Pages 352–369 http://tpcjournal.nbcc.org © 2021 NBCC, Inc. and Affiliates doi: 10.15241/llfk.11.3.352 Louisa L. Foss-Kelly, PhD, NCC, ACS, LPC, is a professor at Southern Connecticut State University. Margaret M. Generali, PhD, is a certified school counselor and a professor and department chair at Southern Connecticut State University. Michael J. Crowley, PhD, is a licensed psychologist and an associate professor at Yale University. Correspondence may be addressed to Louisa L. Foss-Kelly, Counseling and School Psychology, Southern Connecticut State University, 501 Crescent St., New Haven, CT 06515, fossl1@southernct.edu.
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