Influence of Counselor Characteristics and Behaviors on the Efficacy of a Brief Motivational Intervention for Heavy Drinking in Young Men-A Randomized Controlled Trial

Gaume, Jacques; Magill, Molly; Longabaugh, Richard; Bertholet, Nicolas; Gmel, Gerhard; Daeppen, Jean‐Bernard

doi:10.1111/acer.12469

Cited by 41 publications

(64 citation statements)

References 49 publications

(46 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These data are not necessarily in conflict with the view that MI skillfulness is an important component of BI, as greater use of these specific microskills may be indicative of lower overall skill. Together with results from the study by Gaume and colleagues (36), these findings highlight the key importance of competent reflective listening skills (i.e., the use of more complex reflections).…”

Section: Resultssupporting

confidence: 65%

“…(8, 14)] compared BI including MI skills to BI not including this approach. A recent study tried to address these limitations by designing a study including heterogeneous counselors (18 counselors ranging from beginners to MI experts) and comparing participants receiving a BMI with high level of MI skills to those receiving a BMI with low MI skill level and to a control group receiving no BMI (36). This study included non-treatment seeking young men (age 20) screened as hazardous drinkers and found that BMI where MI global ratings (acceptance, empathy, and MI spirit) were high, with no MI-inconsistent behaviors, and with a higher percentage of complex reflections, had better outcomes than those having had no intervention, whereas those with lower scores on these dimensions did not significantly differ from those in the non-intervention control group.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Mechanisms of Action of Brief Alcohol Interventions Remain Largely Unknown â€“ A Narrative Review

Gaume¹,

McCambridge

Bertholet³

et al. 2014

Front. Psychiatry

Self Cite

118

View full text Add to dashboard Cite

A growing body of evidence has shown the efficacy of brief intervention (BI) for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings and effectiveness when implemented at larger scale are disappointing. Indeed, BI comprises varying content; exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness. Medline and PsychInfo, as well as references of retrieved publications were searched for original research or review on active ingredients (components or mechanisms) of face-to-face BIs [and its subtypes, including brief advice and brief motivational interviewing (BMI)] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among patients in the emergency room, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such. Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.

show abstract

Section: Resultssupporting

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Mechanisms of Action of Brief Alcohol Interventions Remain Largely Unknown â€“ A Narrative Review

Gaume¹,

McCambridge

Bertholet³

et al. 2014

Front. Psychiatry

Self Cite

118

View full text Add to dashboard Cite

show abstract

“…On the other hand, brief interventions providing mainly mere information are considered to be effective (Bertholet, Daeppen, Wietlisbach, Fleming, & Burnand, 2005). C-SURF revealed a significant but small effect in reducing alcohol use in the intervention group compared with the control group in an embedded brief-intervention controlled trial (Gaume et al, 2014). The peculiarity of the study was that 18 counselors delivered the intervention, and their motivational skills were measured.…”

Section: Discussionmentioning

confidence: 99%

The Swiss Cohort Study on Substance Use Risk Factors – Findings of two Waves

Gmel

Akré

Astudillo

et al. 2015

SUCHT

Self Cite

View full text Add to dashboard Cite

Abstract. Aim: To summarize published findings in peer-reviewed journals of the first two waves of the Swiss Cohort Study on Substance Use Risk Factors (C-SURF), a longitudinal study assessing risk and protective factors of 5,987 young men during the phase of emerging adulthood (20 years at baseline, followed-up 15 months later). Methods: Included were 33 studies published until November 2014 focusing on substance use. Results: Substance use in early adulthood is a prevalent and stable behavior. The 12-month prevalence of nonmedical use of prescription drugs (10.6 %) lies between that of cannabis (36.4 %) and other illicit drugs such as ecstasy (3.7 %) and cocaine (3.2 %). Although peer pressure in the form of misconduct is associated with increased substance use, other aspects such as peer involvement in social activities may have beneficial effects. Regular sport activities are associated with reduced substance use, with the exception of alcohol use. Young men are susceptible to structural conditions such as the price of alcohol beverages or the density of on-premise alcohol outlets. Particularly alcohol use in public settings such as bars, discos or in parks (compared with private settings such as the home) is associated with alcohol-related harm, including injuries or violence. Being a single parent versus nuclear family has no effect on alcohol use, but active parenting does. Besides parenting, religiousness is an important protective factor for both legal and illegal substance use. Merely informing young men about the risks of substance use may not be an effective preventive measure. At-risk users of licit and illicit substances are more health literate, e. g., for example, they seek out more information on the internet than non-at-risk-users or abstainers. Discussion: There are a number of risk and protective substance use factors, but their associations with substance use do not necessarily agree with those found outside Europe. In the United States, for example, heavy alcohol use in this age group commonly takes place in private settings, whereas in Switzerland it more often takes place in public settings. Other behaviors, such as the nonmedical use of prescription drugs, appear to be similar to those found overseas, which may show the need for targeted preventive actions. C-SURF findings point to the necessity of establishing European studies to identify factors for designing specific preventive actions.

show abstract

“…As noted by Feldstein Ewing et al [7], abstraction relies heavily on prefrontal cortex, and self-reflection depends upon parietal cortex, precuneus and posterior cingulate. Protracted development of prefrontal and parietal cortices throughout adolescence is well documented [8]. One testable prediction is that an adolescent's stage of neurocognitive development, as reflected in neuropsychological performance and brain function, morphology and microstructure, would moderate response to MI.…”

Section: Ambivalence and Motivational Interviewing With Adolescents: mentioning

confidence: 99%

“…An alcoholism treatment study found positive behaviour outcomes varying from 25 to 100%, depending on the counsellors' interpersonal functioning [7]. Recently Gaume and colleagues [8] found similar variability across 18 counsellors in a standardized brief MI efficacy study in young men, also supporting the influential role of relational factors in MI. These results may reflect the relative importance of relational factors compared to specific ingredients on the efficacy of MI.…”

mentioning

confidence: 90%

Should we measure ambivalence to change?

Daeppen¹

2016

Addiction

Self Cite

View full text Add to dashboard Cite

SHOULD WE MEASURE AMBIVALENCE TO CHANGE?Substantial doubts exist about the added value of measuring ambivalence to change in motivational interviewing (MI) efficacy research. It is extremely challenging to assess ambivalence to change accurately, and its relative importance as a mechanism of MI efficacy is probably very marginal compared to the contribution of relational factors.In this issue of Addiction, Sarah Feldstein Ewing and colleagues [1] address the importance of ambivalence as a determinant of motivational interviewing (MI) efficacy in adolescents. They underline the need to deconstruct the concept of ambivalence to improve its measurement. Should we measure ambivalence more accurately when exploring MI efficacy?Ambivalence to change is a simple and didactic concept that changed the paradigm of substance abuse treatment, helping clinicians to accept patients' hesitations and relapses, and acknowledge that behaviour change takes time. The resolution of ambivalence is a central concept in MI: 'MI helps people to keep moving forward through the natural process of resolving ambivalence' ([2], p. 167). This hypothesis is based on the fairly straightforward observation that: 'most people who smoke, drink too much, or exercise too little are aware of the downside of their behavior' ([2], p. 6). Another general observation is that most individuals with a history of substance use disorder are no longer ambivalent to change once they are stabilized in abstinence. Despite data supporting the efficacy of MI in reducing the consumption of alcohol and other drugs, including among adolescents [3], there is no evidence that the resolution of ambivalence is a causal pathway in MI efficacy. There are data suggesting that change discussion, particularly the production of change talk, is associated with outcome [4], but this does not imply that the resolution of ambivalence is a mediator in the MI change process.Another concern is that the measurement of ambivalence to change is challenging, as it results from the encounter of several layers of subjects' dynamic and fluid internal, external, conscious and unconscious factors. Finally, even though the resolution of ambivalence is a critical ingredient of MI, its association with MI efficacy might, in the best case, be marginal. A recent meta-analysis of 59 psychotherapy efficacy studies [5] found minimal differences between the total treatment with and without one or more critical ingredients (effect size, d = 0.01), while relational factors such as empathy had a much larger effect size (d = 0.63). In addiction treatment, a large body of literature indicates that patients' outcomes are influenced mainly by relational factors rather than by critical ingredients, even when counsellors apply standardized treatment accurately [6]. An alcoholism treatment study found positive behaviour outcomes varying from 25 to 100%, depending on the counsellors' interpersonal functioning [7]. Recently Gaume and colleagues [8] found similar variability across 18 counsellors in a standardized ...

show abstract

Influence of Counselor Characteristics and Behaviors on the Efficacy of a Brief Motivational Intervention for Heavy Drinking in Young Men-A Randomized Controlled Trial

Cited by 41 publications

References 49 publications

Mechanisms of Action of Brief Alcohol Interventions Remain Largely Unknown â€“ A Narrative Review

Mechanisms of Action of Brief Alcohol Interventions Remain Largely Unknown â€“ A Narrative Review

The Swiss Cohort Study on Substance Use Risk Factors – Findings of two Waves

Should we measure ambivalence to change?

Contact Info

Product

Resources

About