A meta-analysis was conducted on controlled clinical trials investigating adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors. AMIs were equivalent to other active treatments and yielded moderate effects (from .25 to .57) compared with no treatment and/or placebo for problems involving alcohol, drugs, and diet and exercise. Results did not support the efficacy of AMIs for smoking or HIV-risk behaviors. AMIs showed clinical impact, with 51% improvement rates, a 56% reduction in client drinking, and moderate effect sizes on social impact measures (d ϭ 0.47). Potential moderators (comparative dose, AMI format, and problem area) were identified using both homogeneity analyses and exploratory multiple regression. Results are compared with other review results and suggestions for future research are offered.

A meta-analysis was conducted on empirical trials investigating the mortality salience (MS) hypothesis of terror management theory (TMT). TMT postulates that investment in cultural worldviews and self-esteem serves to buffer the potential for death anxiety; the MS hypothesis states that, as a consequence, accessibility of death-related thought (MS) should instigate increased worldview and self-esteem defense and striving. Overall, 164 articles with 277 experiments were included. MS yielded moderate effects (r = .35) on a range of worldview- and self-esteem-related dependent variables (DVs), with effects increased for experiments using (a) American participants, (b) college students, (c) a longer delay between MS and the DV, and (d) people-related attitudes as the DV. Gender and self-esteem may moderate MS effects differently than previously thought. Results are compared to other reviews and examined with regard to alternative explanations of TMT. Finally, suggestions for future research are offered.

Objective: The authors investigated the unique contribution motivational interviewing (MI) has on counseling outcomes and how MI compares with other interventions. Method: A total of 119 studies were subjected to a meta-analysis. Targeted outcomes included substance use (tobacco, alcohol, drugs, marijuana), health-related behaviors (diet, exercise, safe sex), gambling, and engagement in treatment variables. Results: Judged against weak comparison groups, MI produced statistically significant, durable results in the small effect range (average g = 0.28). Judged against specific treatments, MI produced nonsignificant results (average g = 0.09). MI was robust across many moderators, although feedback (Motivational Enhancement Therapy [MET]), delivery time, manualization, delivery mode (group vs. individual), and ethnicity moderated outcomes. Conclusions: MI contributes to counseling efforts, and results are influenced by participant and delivery factors.

No abstract

This article reviews the research support for Motivational interviewing (MI) so that practitioners can make informed decisions about the value and applicability of MI in their clinical work. We highlight the evidence from the three published meta-analyses of MI and a recent meta-analysis that we completed. MI is significantly (10%-20%) more effective than no treatment and generally equal to other viable treatments for a wide variety of problems ranging from substance use (alcohol, marijuana, tobacco, and other drugs) to reducing risky behaviors and increasing client engagement in treatment. Although most client-related variables are unrelated to outcomes (e.g., age, gender, severity), some decisions about treatment format (e.g., individual vs. group) are important. For example, relying solely on group-delivered MI appears to be less effective than one-on-one MI, whereas delivering MI with problem feedback is likely to generate better outcomes for some problems than MI alone.

Terror management theory posits that people are motivated to affirm cultural meaning systems, including political ideologies, to avoid the awareness of mortality. Accordingly, studies show that increasing mortality salience (MS) intensifies people's attitudes toward political issues and figures. However, whereas in some studies MS increases affirmation of preexisting political ideologies, be they liberal or conservative (supporting a “worldview‐defense hypothesis”), in other studies MS elicits a general shift toward conservatism, regardless of preexisting ideology (supporting a “conservative‐shift hypothesis”). The current study used meta‐analysis to assess the overall magnitude of MS effects on explicitly political attitudes and to clarify the nature of these effects by comparing effect sizes for these competing hypotheses. The overall effect of MS on political attitudes was large (r = .50). The effects of MS‐induced worldview defense (r = .35) and conservative shifting (r = .22) were significant and statistically equivalent. We discuss the conditions (e.g., contextual salience of political values) under which conservative shifting or worldview defense occurs.

Objective: The goal of this study was to assess the effects of training primary care providers (PCPs) to use Motivational Interviewing (MI) when treating depressed patients on providers' MI performance and patients' expressions of interest in depression treatment ("change talk") and short-term treatment adherence.Methods: This was a cluster randomized trial in urban primary care clinics (3 intervention, 4 control). We recruited 21 PCPs (10 intervention, 11 control) and 171 English-speaking patients with newly diagnosed depression (85 intervention, 86 control). MI training included a baseline and up to 2 refresher classroom trainings, along with feedback on audiotaped patient encounters. We report summary measures of technical (rate of MI-consistent statements per 10 minutes during encounters) and relational (global rating of "MI Spirit") MI performance, the association between MI performance and number of MI trainings attended (0, 1, 2, or 3), and rates of patient change talk regarding depression treatments (physical activity, antidepressant medication). We report PCP use of physical activity recommendations and antidepressant prescriptions and patients' short-term physical activity level and prescription fill rates.Results: Use of MI-consistent statements was 26% higher for MI-trained versus control PCPs (P ‫؍‬ .005). PCPs attending all 3 MI trainings (n ‫؍‬ 6) had 38% higher use of MI-consistent statements (P < .001) and were over 5 times more likely to show beginning proficiency in MI Spirit (P ‫؍‬ .036) relative to control PCPs. Although PCPs' use of physical activity recommendations and antidepressant prescriptions was not significantly different by randomization arm, patients seen by MI-trained PCPs had more frequent change talk (P ‫؍‬ .001). Patients of MI-trained PCPs also expressed change talk about physical activity 3 times more frequently (P ‫؍‬ .01) and reported more physical activity (3.05 vs 1.84 days in the week after the visit; P ‫؍‬ .007) than their counterparts visiting untrained PCPs. Change talk about antidepressant medication and fill rates were similar by randomization arm (P > .05 for both). Funding: Funding for this study was provided by the National Institute of Mental Health grant nos. K23MH0829972 and 3K23082997-S1; National Institutes of Health/National Center for Advancing Translational Sciences Colorado CTSI grant no. KL2 TR000156 (to CE).Conflict of interest: none declared. In this study we investigated whether a multifaceted MI training improved (1) PCPs' MI performance during index visits with patients with newly diagnosed depression; (2) subsequent outcomes related to patients' expressed interest ("change talk") in improving this condition; and (3) short-term adherence to treatment 5 (Figure 1). Depression is projected to become the leading cause of disability worldwide by 2030 6 and is often treated, at least in part, in primary care. 7,8 In general, poor depression outcomes in primary care 9 -11 are in part because of pervasive nonadherence to depression treatment, which is ...

No abstract