Motivational interviewing in drug abuse services: A randomized trial.

Abstract

Motivational interviewing (MI) is a directive, client-centered brief intervention to elicit behavior change by helping clients explore and resolve ambivalence. In this clinical trial, 152 outpatients and 56 inpatients entering public agencies for treatment of drug problems were randomly assigned to receive or not receive a single session of manual-guided MI. Drug use was assessed by self-report, urine toxicology, and collateral reports from significant others at baseline, 3, 6, 9, and 12 months. Contrary to prior reports, MI showed no effect on drug use outcomes when added to inpatient or outpatient treatment, although both groups showed substantial increases in abstinence from illicit drugs and alcohol.

Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study

“…Given that MI was initially developed and validated as an intervention for alcohol use disorders, and that recent studies suggest that MI may be more effective among alcohol, rather than drug-using, populations (Miller et al, 2003), additional exploratory analyses were conducted to evaluate outcomes for the large subpopulation whose principal substance used was alcohol (n = 177). For this subgroup, those assigned to MI completed significantly more sessions in the 28 days following randomization compared with those assigned to the standard evaluation session (MI mean = 5.1 sessions (S.D.…”

“…First, although the bulk of studies evaluating MI with drug-using populations have suggested that MI is more effective than no treatment or comparison approaches (Burke et al, 2003;Dunn et al, 2001), several well-conducted studies evaluating MI with comparatively large samples of drug-using individuals have yielded few significant differences between MI and standard care comparison conditions (Miller et al, 2003;Donovan et al, 2001). Second, because the bulk of studies evaluating MI with drug users have evaluated the efficacy of adding an additional MI session to standard treatment, there are relatively few data on the effectiveness of MI under the conditions in which it is most likely to be applied in clinical practice, that is, integrating MI techniques into standard treatment approaches (Dunn et al, 2001).…”

“…Subsequent training trials have suggested a single workshop may be associated with some change in clinician behavior, but these changes may not be substantial enough to strongly affect patient response (Miller and Mount, 2001) and that coaching and feedback appear to be essential for effective implementation of MI (Miller et al, 2004). Finally, comparatively few studies have addressed critical internal validity issues in the effectiveness of training, such as providing data from adherence monitoring regarding whether MI was implemented with adequate fidelity and skill by clinicians and whether MI is discriminable from standard treatment (Miller et al, 2003;Burke et al, 2003).…”

La entrevista motivacional en el tratamiento del tabaquismo: una revisión

“…El planteamiento que formulan permite identificar diferentes niveles de predisposición (estadios de cambio) que puede mostrar una persona cuando se plantea modificar su conducta adictiva (DiClemente, Prochaska, Fairhurst, Velicer, Velásquez y Rossi, 1991;Miller, Yahne y Tonigan, 2003;Prochaska y DiClemente, 1992;Prochaska y Norcross, 2007). El nivel motivacional inferior se corresponde con el estadio en el cual no se tiene conciencia del problema y, por tanto, ninguna intención de modificar la conducta adictiva.…”

Efeitos da entrevista motivacional em adolescentes infratores

“…A EM tem se mostrado aplicável e efetiva (Dunn, Deroo & Rivara, 2001;Miller et al, 2003) em diversos comportamentos e na mudança dos estágios motivacionais (Heather, Rollnick, Bell & Richmond, 1995), na aderência ao processo terapêutico (Daley & Zuckoff, 1998;Lincourt, Kuettel & Bombardier, 2002), na adesão a dietas (Berg-Smith et al, 1999), na redução do uso de álcool (Borsari & Carey, 2000;Monti et al, 1999;Oliveira, 2001;Project Match Research Group, 1997), na redução do uso de maconha (Stephens, Roffman & Curtin, 2000;Stephens, Roffman, Fearer, Williams & Picciano, 2004), na redução do uso de cocaína (Donavan, Rosegren, Downey, Cox & Sloan, 2001), na redução do uso de anfetaminas (Baker, Boggs & Lewin, 2001), na cessação do uso de tabaco (Brown et al, 2003;Butler et al, 1999;Colby, 1998;Rodriguez, 2003;WHO 1996) e em pacientes com diabetes (Burke et al, 2002;Channon, Smith & Gregory, 2003). Comparada com o não-tratamento e com o uso de placebo, a EM foi superior em comportamentos envolvendo álcool, drogas, dietas e exercícios (Burke et al, 2003).…”