Motivational interviewing for substance abuse

Smedslund, Geir; Berg, Rigmor C.; Hammerstrøm, Karianne Thune; Steiro, Asbjørn; Leiknes, Kari Ann; Dahl, Helene; Karlsen, Kjetil

doi:10.1002/14651858.cd008063.pub2

Cited by 281 publications

(184 citation statements)

References 238 publications

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“…Moreover, the effect size from every meta‐analysis in this review favors MI, 19 of 34 (56%) effect sizes demonstrate statistically significant effects, and no studies reported harms for the intervention (see ‘Comparison 1’ in the review). Given the above, we were surprised by the review's strong conclusions unfavorable to MI, especially as the review authors noted that their conclusions differed from another Cochrane review on MI for drug use, even though the other review had similar effect sizes 41. Discrepancies in interpreting similar effect sizes for similar interventions indicate that MCIDs are not defined uniformly in this area, and the review authors’ conclusions represent a particular interpretation of effects (rather than the effects themselves) that differs from other review authors’ interpretations 1, 14, 15.…”

Section: Sustainability and Clinical Significance Of Intervention Effmentioning

confidence: 93%

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

et al. 2015

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BackgroundCochrane recently published a systematic review on motivational interviewing (MI) for alcohol misuse in young adults. The review authors concluded that ‘there are no substantive, meaningful benefits of MI interventions for the prevention of alcohol misuse’ (p. 2), as effect sizes were ‘small and unlikely to be of any meaningful benefit in practice’ (p. 27). As most of these interventions were quite brief, we wish to open a dialogue about interpreting effect sizes in this review and of (brief) alcohol interventions more generally.AnalysisWe analyze four methodological aspects of the review that likely influenced the author's conclusions about intervention effects: (1) risk of bias assessments, (2) search strategies, (3) assessing the quality of the body of evidence and (4) definitions of sustainability and clinical significance.ConclusionsWe interpret the effect sizes found in this review to indicate modest yet beneficial and potentially meaningful effects of these interventions, given their brevity and low cost. This interpretation is consistent with other reviews on brief, MI‐based interventions and brief interventions more generally. We therefore encourage the field to re‐open dialogue about the clinical importance of the effects of MI on alcohol misuse by young adults. Rather than dismissing interventions with small effects, we believe a more fruitful way forward for the field would be to catalogue effect sizes for various alcohol interventions. Such a catalogue would help stakeholders themselves to choose which interventions meet their minimum desired impact, and thus may be suitable given their targeted populations, setting and resources.

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Section: Sustainability and Clinical Significance Of Intervention Effmentioning

confidence: 93%

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

et al. 2015

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“…However, when the evidence for motivational interviewing is taken together, the results are somewhat mixed. For example, there are concerns about the staying power of motivational interviewing interventions, as effect sizes tend to diminish over time (Smedslund et al, 2011).…”

Section: Motivational Interviewingmentioning

confidence: 99%

Peer Network Counseling as Brief Treatment for Urban Adolescent Heavy Cannabis Users

Mason

Sabo

Zaharakis

2017

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: A small body of evidence supports targeting adolescents who are heavy users of cannabis with brief interventions, yet more research is needed to confirm the effectiveness of these studies. We conducted a secondary analysis of our Peer Network Counseling (PNC) study (Mason et al., 2015), focusing on 46 adolescents of the sample of 119 who reported heavy cannabis use at baseline. Method: Urban adolescents (91% African American) presenting for primary health care were randomized to intervention or control conditions and followed for 6 months. We selected cases (n = 46) to analyze based on heavy cannabis use reported at baseline ( 10 times in past month). The ordinal response data (cannabis use) were modeled using a mixed-effects proportional odds model, including fixed effects for treatment, time, and their interaction, and a subject-level random effect. Results: In the subsample of adolescents with heavy cannabis use, those assigned to PNC had a 35.9% probability of being abstinent at 6 months, compared with a 13.2% probability in the control condition. Adolescents in the PNC condition had a 16.6% probability of using cannabis 10 or more times per month, compared with a 38.1% probability in the control condition. This differs from results of the full sample (N = 119), where no significant effects on cannabis use were found. Conclusions: PNC increased the probability of abstinence and reduced heavy cannabis use. These results provide initial support for PNC as a model for brief treatment with non-treatmentseeking adolescents who are heavy users of cannabis. (J. Stud. Alcohol Drugs, 78, 152-157, 2017)

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“…Dentro de las estrategias terapéuticas conductuales se encuentran la realización de terapias cognitivoconductual, entrevistas de motivación y terapias grupales (NIDA, 2008(NIDA, , 2010Engle, 2011;Smedslund et al, 2011).…”

Section: Estrategias Terapéuticasunclassified

“…El consejero tiene un rol activo guiando al sujeto en objetivos a corto y largo plazo y evaluando constantemente su acción sobre estos (Engle, 2011;Smedslund et al, 2011). Adicionalmente, el consejero debe desarrollar empatía con el sujeto para comprender su punto de vista y llevarlo a que perciba la discrepancia entre lo que se es y lo que se quiere ser.…”

Section: Estrategias Terapéuticasunclassified

“…Adicionalmente, el consejero debe desarrollar empatía con el sujeto para comprender su punto de vista y llevarlo a que perciba la discrepancia entre lo que se es y lo que se quiere ser. Cabe destacar que en este tipo de terapia de motivación el sujeto debe mostrar disposición a la salida de su problema de abuso y adicción de sustancias (Apodaca & Longabaugh, 2009;Smedslund et al, 2011).…”

Section: Estrategias Terapéuticasunclassified

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Abuso de Drogas: Generalidades Neurobiológicas y Terapéuticas

Velásquez-Martinez

Ortíz

2014

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Resumen. El abuso de drogas es una enfermedad caracterizada por la urgencia de obtener y consumir una sustancia determinada independientemente de sus consecuencias negativas. Existen factores biológicos, sociales y psicológicos que predisponen a un individuo al abuso de drogas los adolescentes son los más vulnerables porque su cerebro no ha madurado completamente y están bajo presiones tanto sociales como psicológicas. Es por esto último que la prevención es aún más efectiva a esta edad. Las drogas de abuso alteran principalmente el sistema mesocorticolimbico; la dopamina y el glutamato desempeñan un papel importante en este circuito que normalmente median comportamientos de motivación. Se cree que las sustancias de abuso modifican este circuito usando mecanismos similares al aprendizaje normal resultando en aprendizaje disfuncional. Dichos cambios son a largo plazo y pueden ser evocados por eventos que recuerden la droga, en la ausencia de la misma. Un manejo multidisciplinario es necesario ya que el abuso de drogas tiene componentes biológicos, sociales y psicológicos. Las terapias cognitivas y comportamentales son comúnmente complementadas con agentes farmacológicos con los que se manejan los síntomas específicos de retirada y abstinencia.Palabras clave. Adicción, sistema mesocorticolimbico, dopamina, generalidades terapéuticas.Abstract. Drug abuse is an illness characterized by the urge to obtain and consume a given substance regardless of the negative consequences. There are biological, social and psychological factors that predispose an individual to abuse drugs. Adolescents are most vulnerable because their brain has not fully matured yet and there are strong social and psychological pressures. Thus, prevention is most effective at this age. Most abused drugs target the brain's mesocorticolimbic system. Dopamine and glutamate play a major role in this circuit that normally mediates motivated behaviors. It is thought that adicctive substances modify this circuit using mechanisms similar to normal learning resulting in dysfunctional learning. Such changes are very long lasting and can be evoked by events reminiscent of the drug abuse, in the absence of the drug. A multidisciplinary approach is needed because drug abuse has biological, social and psychological components. Cognitive and behavioral therapies are often paired with pharmacological agents that address specific drug withdrawal and abstinence symptoms.

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Motivational interviewing for substance abuse

Cited by 281 publications

References 238 publications

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

Peer Network Counseling as Brief Treatment for Urban Adolescent Heavy Cannabis Users

Abuso de Drogas: Generalidades Neurobiológicas y Terapéuticas

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