Recommendation ID

How effective and cost effective are individual, compared with group, education-based interventions for children and young people aged 11 to 18 in full-time education who are thought to be vulnerable to alcohol misuse?

Any explanatory notes
(if applicable)

Why the committee made the recommendations

Evidence suggests that targeted interventions for pupils who are vulnerable to alcohol misuse may be effective. These studies included individual or group brief interventions or counselling that are delivered over 1 to 5 sessions. The committee were unable to recommend specific details for these interventions because they thought the interventions would depend on the pupil's specific needs. For example, one pupil may benefit from a one-off session whereas another may need follow-up sessions or further support. It was not possible to determine the effectiveness of individual interventions compared with group interventions, and more research is needed on this (see research recommendations 2 and 4).

Although the published cost-effectiveness evidence was limited, it indicated that targeted interventions could be cost effective. The economic analysis showed the same. So the committee agreed that targeted interventions could be good value for money. However, they were mindful that cost effectiveness was closely related to the cost of the intervention. The interventions' benefits, measured as a reduction in the number of related crime and hospital events also had a significant impact on cost effectiveness because of their high associated costs.

The cost-effectiveness analysis showed that targeted interventions are more likely to be cost effective in the older age groups that might be drinking already, than in the younger ones that might not. The committee were concerned that this might lead to a focus on interventions for older children and young people. However, they did not think the evidence justified prioritising interventions for these groups because of limitations in study design. In addition, the studies used short follow-up, compared the interventions with usual education, and used outcomes such as problematic drinking (which is less common in younger age groups and unlikely to capture other benefits of alcohol education).

Experts told the committee that when planning an intervention it is important to consider any potential unintended consequences. This supported the committee's view that care should be taken to avoid 'labelling' or stigmatising pupils when selecting vulnerable pupils for a targeted intervention. For example, if a pupil needs to leave lessons for a counselling session, classmates or teachers might treat them differently, and they could be at increased risk of bullying. They may become withdrawn or defiant as a result, and increase the behaviour that the intervention is intended to prevent.

The committee were clear that seeking consent from the pupil or their guardian when offering any intervention is best practice. Also, for alcohol education to be successful the pupil must be a willing participant and seeking consent from them (or their families and carers) is an important part of following a whole-school approach.

How the recommendations might affect practice

The recommendations will reinforce best practice because they are based on existing processes and on guidance on individual sessions for vulnerable people. Using group, rather than one-to-one, interventions will potentially lead to savings but it is not clear how often these would be used.

Full details of the evidence and the committee's discussion are in evidence review B: targeted interventions.

Source guidance details

Comes from guidance
Alcohol interventions in secondary and further education
Date issued
August 2019

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/08/2019