354 The Professional Counselor | Volume 11, Issue 3 The Role of School Counselors As stable members of the school community, school counselors hold knowledge of their students and the culture of the school and surrounding community, allowing for a seamless response to student needs. The schoolwide multi-tiered system of supports (MTSS) model used to prevent and respond to academic and behavioral difficulties in children provides a structure for delivering prevention in comprehensive school counseling services (Pullen et al., 2019). MTSS utilizes student assessment for the development of tiers of intervention or support to address identified student needs in comprehensive school counseling services (Ziomek-Daigle, 2016). MTSS defines a Tier 1 intervention as primary prevention and includes evidence-based programming for all students. These interventions are used to support student knowledge, skill acquisition, and healthy decision-making and are appropriate for addressing conflict resolution, nutrition and health, and substance use. The comprehensive school counseling model provides a sound means for delivering substance use prevention interventions. Classroom guidance education, a key responsibility of school counselors, provides an ideal opportunity to implement primary prevention of substance use for all students. However, to date no comprehensive substance use prevention program has focused specifically on delivery by school counselors. The MCARR Program Making Choices and Reducing Risk (MCARR) is a school counseling–based program for addressing substance use among adolescents. MCARR utilizes a structured classroom educational program. The program is implemented throughout the academic year as a Tier 1 schoolwide approach with ninth graders in a classroom setting (Ziomek-Daigle, 2016). The program involves meeting once per month to deliver psychoeducation and to engage in reflective and team-oriented learning experiences as part of a health education or related class. MCARR is a naturally sustainable intervention based on school community concepts and highly effective adolescent counseling interventions, described below. Motivational Interviewing The MCARR is based on motivational interviewing (MI) and risk reduction principles, both of which are well-established approaches in clinical settings (e.g., Cushing et al., 2014; DiClemente et al., 2017) and in schools (Rollnick et al., 2016). MI focuses primarily on the decision-making process, including resolving ambivalence about change and respecting the client’s autonomy to make their own choices (Miller & Rollnick, 2013). MI has been described as more of a philosophy or method of communication rather than a set of specific techniques. Alongside the Rogerian value of respect, MI offers a form of freedom by providing a validating, encouraging, and safe space to explore one’s identity and learn to make adaptive life choices. Other MI concepts include developing and amplifying discrepancies between one’s current behavior and desired behavior. MI also calls counselors to “roll with resistance” when clients verbalize a lack of desire to change or refusal to change or make healthy choices (Miller & Rollnick, 2013). Rolling with resistance is particularly helpful for adults working with adolescents familiar with authority figure conflict. These adults may quickly slide into an authoritarian tug-of-war to win the adolescent over to behaving in a certain way, inadvertently causing even more resistance. MI may be ideal for supporting adolescents who yearn for personal freedom and the right to make their own choices (Naar-King & Suarez, 2011). Risk Reduction Risk reduction is a widely used public health concept in drug and alcohol treatment, especially in terms of relapse prevention (Hendershot et al., 2011). Risk reduction is not directed at abstinence— rather it aims to help those who use alcohol or drugs to engage in use at a lower risk level. The concept
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