Motivational Interviewing Approach Research Articles

Breaking Barriers in Behavioral Change: The Potential of Artificial Intelligence-Driven Motivational Interviewing.

Patient outcomes in ophthalmology are greatly influenced by adherence and patient participation, which can be particularly challenging in diseases like glaucoma, where medication regimens can be complex. A well-studied and evidence-based intervention for behavioral change is motivational interviewing (MI), a collaborative and patient-centered counseling approach that has been shown to improve medication adherence in glaucoma patients. However, there are many barriers to clinicians being able to provide motivational interviewing in-office, including short visit durations within high-volume ophthalmology clinics and inadequate billing structures for counseling. Recently, Large Language Models (LLMs), a type of artificial intelligence, have advanced such that they can follow instructions and carry coherent conversations, offering novel solutions to a wide range of clinical problems. In this paper, we discuss the potential of LLMs to provide chatbot-driven MI to improve adherence in glaucoma patients and provide an example conversation as a proof of concept. We discuss the advantages of AI-driven MI, such as demonstrated effectiveness, scalability, and accessibility. We also explore the risks and limitations, including issues of safety and privacy, as well as the factual inaccuracies and hallucinations to which LLMs are susceptible. Domain-specific training may be needed to ensure the accuracy and completeness of information provided in subspecialty areas such as glaucoma. Despite the current limitations, AI-driven motivational interviewing has the potential to offer significant improvements in adherence and should be further explored to maximally leverage the potential of artificial intelligence for our patients.

Motivational interviewing skills practice enhanced with artificial intelligence: ReadMI

BackgroundFinding time in the medical curriculum to focus on motivational interviewing (MI) training is a challenge in many medical schools. We developed a software-based training tool, “Real-time Assessment of Dialogue in Motivational Interviewing” (ReadMI), that aims to advance the skill acquisition of medical students as they learn the MI approach. This human-artificial intelligence teaming may help reduce the cognitive load on a training facilitator.MethodsDuring their Family Medicine clerkship, 125 third-year medical students were scheduled in pairs to participate in a 90-minute MI training session, with each student doing two role-plays as the physician. Intervention group students received both facilitator feedback and ReadMI metrics after their first role-play, while control group students received only facilitator feedback.ResultsWhile students in both conditions improved their MI approach from the first to the second role-play, those in the intervention condition used significantly more open-ended questions, fewer closed-ended questions, and had a higher ratio of open to closed questions.ConclusionMI skills practice can be gained with a relatively small investment of student time, and artificial intelligence can be utilized both for the measurement of MI skill acquisition and as an instructional aid.

Interface Between Motivational Interviewing and Burnout.

The contemporary challenges of improving patient engagement in chronic disease management and addressing the growing problem of physician burnout are commonly viewed as separate issues. However, there is extensive evidence that person-centered approaches to patient engagement, such as motivational interviewing (MI), are associated both with better outcomes for patients and improved well-being for clinicians. We conducted an exploratory survey study to ascertain whether resident physicians who perceive that they embrace and utilize the MI approach also report less burnout. A total of 318 residents in several specialties were invited via email to complete a 10-question survey about patient engagement and the experience of burnout. Frequencies and percentages were calculated for all categorical/ordinal variables to describe survey participants and question responses. Correlation coefficients were obtained to assess relationships between all burnout and engagement questions. A total of 79 residents completed the survey (response rate of 24.8%). There was broad agreement about the importance of patient engagement and the use of the MI approach, and approximately 60% of residents indicated that burnout was a problem. Two items related to residents' perceived use of MI were correlated with feeling a sense of personal accomplishment, one of the protective factors against burnout. Consistent with other studies indicating that person-centered approaches are associated both with better patient outcomes and provider wellbeing, our data suggest that residents' self-reported use of the MI approach in patient care may be related to less burnout. It appears that training in the MI approach in graduate medical education may be simultaneously good for patient outcomes and good for resident well-being.

Effectiveness of lifestyle intervention on prevention/management of antipsychotic-induced weight gain among persons with severe mental illness: A systematic review and meta-analysis.

Individualized lifestyle interventions using motivational interviewing (MI) approach are recommended for persons with severe mental illness (SMI) for effective weight management. The aim of this meta-analysis was to assess the effectiveness of various lifestyle interventions that addressed obesity among persons with SMI. Twelve RCTs were assessed by individual reviewers using revised cochrane risk-of-bias tool (RoB 2). The standardized mean difference (SMD) was calculated with a 95% CI. The age of participants was between 18 and 70 years. Waist circumference showed an SMD of -0.09 (-0.22, 0.03), weight -0.03 (-0.10, 0.15) and BMI -0.07 (-0.07, 0.22). The findings in this meta-analysis revealed that though lifestyle interventions were statistically insignificant in reducing antipsychotic induced weight gain among persons with SMI, they show changes in intervention group. Psychosocial management along with lifestyle interventions, and MI are effective in the management of antipsychotic induced weight gain.

Compassionate Curiosity: Mitigating the Effects of Bias Through Motivational Interviewing.

There is strong evidence that the implicit biases of health care professionals affect the treatment of patients, and that minority and other marginalized patients are disproportionately harmed. Assumptions made about patient knowledge or lack thereof function as judgments that are prone to bias, which then affect the education and advice imposed upon patients. We review how the motivational interviewing (MI) approach to patient engagement includes components of evidence-based bias-mitigating strategies, such as understanding circumstances from the patient's point of view, and therefore we propose that the MI approach can reduce the impact of bias in patient care.

A Motivational Interviewing Chatbot With Generative Reflections for Increasing Readiness to Quit Smoking: Iterative Development Study.

The motivational interviewing (MI) approach has been shown to help move ambivalent smokers toward the decision to quit smoking. There have been several attempts to broaden access to MI through text-based chatbots. These typically use scripted responses to client statements, but such nonspecific responses have been shown to reduce effectiveness. Recent advances in natural language processing provide a new way to create responses that are specific to a client's statements, using a generative language model. This study aimed to design, evolve, and measure the effectiveness of a chatbot system that can guide ambivalent people who smoke toward the decision to quit smoking with MI-style generative reflections. Over time, 4 different MI chatbot versions were evolved, and each version was tested with a separate group of ambivalent smokers. A total of 349 smokers were recruited through a web-based recruitment platform. The first chatbot version only asked questions without reflections on the answers. The second version asked the questions and provided reflections with an initial version of the reflection generator. The third version used an improved reflection generator, and the fourth version added extended interaction on some of the questions. Participants' readiness to quit was measured before the conversation and 1 week later using an 11-point scale that measured 3 attributes related to smoking cessation: readiness, confidence, and importance. The number of quit attempts made in the week before the conversation and the week after was surveyed; in addition, participants rated the perceived empathy of the chatbot. The main body of the conversation consists of 5 scripted questions, responses from participants, and (for 3 of the 4 versions) generated reflections. A pretrained transformer-based neural network was fine-tuned on examples of high-quality reflections to generate MI reflections. The increase in average confidence using the nongenerative version was 1.0 (SD 2.0; P=.001), whereas for the 3 generative versions, the increases ranged from 1.2 to 1.3 (SD 2.0-2.3; P<.001). The extended conversation with improved generative reflections was the only version associated with a significant increase in average importance (0.7, SD 2.0; P<.001) and readiness (0.4, SD 1.7; P=.01). The enhanced reflection and extended conversations exhibited significantly better perceived empathy than the nongenerative conversation (P=.02 and P=.004, respectively). The number of quit attempts did not significantly change between the week before the conversation and the week after across all 4 conversations. The results suggest that generative reflections increase the impact of a conversation on readiness to quit smoking 1 week later, although a significant portion of the impact seen so far can be achieved by only asking questions without the reflections. These results support further evolution of the chatbot conversation and can serve as a basis for comparison against more advanced versions.

Motivational interviewing for prevention in Swiss family medicine: Opportunities and challenges

Health promotion and primary prevention are a priority in a healthcare system characterised by a prevalence of chronic conditions. In this context, motivational interviewing (MI) as provided by family doctors (FDs) seems promising: influential health professionals motivate patients to adopt healthy lifestyles in a patient-centred style that promotes a balanced, horizontal doctor-patient relationship. Based on these assumptions, a pilot project called Girasole was implemented in Switzerland between 2016 and 2018 to train and support 19 FDs in implementing MI in their practices. This paper presents the analysis of implementation of the intervention with the aim of exploring the doctors’ experiences with MI through a qualitative research design. Data derive from focus groups and interviews with the participants, and from the observation of collective training sessions and follow-up meetings. A thematic analysis was conducted using the software Atlas.ti. Results show that there is great diversity in how FDs implement MI. FDs can be classified in four groups – convinced, interested, critical, and resistant – based on their adherence to the principles underlying the MI approach. This taxonomy highlights opportunities and challenges for family medicine: MI offers flexible tools and new ways of interacting with patients to meet the challenges of non-communicable and chronic diseases; at the same time, the issues associated with the medicalisation of human everyday problems, physicians’ status loss, and low cost-effectiveness should not be underestimated. Any further attempt to promote MI among FDs should take into account their individual attitudes and should establish tailored approaches and training methods.

Development of "LvL UP 1.0": a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders.

Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, "LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs. A multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development. Preliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a mobile device. The development process of LvL UP 1.0 led to an evidence-based and user-informed smartphone-based intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers.

Psycho-Educational Effect of Motivational Interviewing on School Burnout

School burnout is an important problem which should be understood in terms of the consequences it causes in the school environment. During school burnout cases, undesirable behaviors may be exhibited. For this reason, it is very important to understand school burnout to recognize and to intervene before causing negative results. The aim of this study is to reduce students' school burnout using the motivational interviewing approach. In this study, a psycho-education program which based on the basic principles of motivational interviewing was developed and applied to middle school 6th and 7th grade students. This study is an experimental study with pretest posttest follow-up test. According to the results of the post-test conducted after psycho-education applications, it was seen that this program decreased significantly students’ school burnout levels. In the follow-up test conducted later, it was observed that the decrease in the levels of school burnout showed stability. Based on these results, it can be said that motivational interviewing based psycho-education al interventions will be beneficial for students experiencing school burnout.

Motivational interviewing in child sexual abuse investigations: Approaches shown to increase suspect engagement and information gathering during police interviews

On average, more than 200 child sex offences were recorded by UK police every day in 2020, and investigations for offences including rape, online grooming and sexual assault against children in the United Kingdom (UK) increased by 57% from 2014/15 to 2019/20. The interview process is central to information gathering, but empirical research regarding the obtention of information through child sexual abuse (CSA) suspect interviewing is still limited. The current study analyses 45 hours of interviews with CSA suspects focusing on behaviours consistent (and inconsistent) with motivational interviewing (MI) using the Observing Rapport-Based Interpersonal Techniques coding manual. In line with previous research demonstrating the efficacy of MI with terrorist suspects, this article focuses on the same four key interviewer skills identified in the therapeutic literature (reflective listening, summarising, rolling with resistance and developing discrepancies). It looks at their effects on information yield (information of intelligence value) and suspect engagement. Results revealed that the four MI-consistent behaviours increased information gain. Also, approaches antithetical to MI (including assumptive questioning, judgemental summaries, fighting resistance and accusatory challenges) had a significant negative impact on suspect engagement and, by extension, reduced yield – potentially by creating suspect reactance (where the individual is motivated to regain a freedom they feel is being threatened). Hence, MI approaches are efficacious for information-gathering efforts, and using an approach antithetical to the spirit of motivational interviewing (like pressuring, confronting and judging) with CSA suspects will always make things worse.

Experience-based design: Empowering individuals while they wait for interprofessional chronic pain care

ObjectivesChronic pain is highly prevalent and a leading cause of disability. Long wait times for interprofessional care provide an opportunity to introduce web-based interventions that improve psychosocial function and patients’ readiness and ability to manage their condition. Here we describe the process of partnering with people with lived experience (PWLE) to develop an online self-management program enhanced by motivational interviewing. We also report the multiphase usability testing of the program. MethodsPWLE were included in all aspects of this project from program inception to content creation, module development, usability testing, and knowledge dissemination. Phase 1 included the development of the interactive, web-based modules. This process involved weekly meetings and asynchronous content creation with a core team of interprofessional pain experts, researchers, and PWLE. Phase 2 included usability testing by our PWLE and clinical expert advisory. Phase 3 included survey-based usability testing with a sample of 10 PWLE. ResultsWe created a chronic pain & motivational empowerment program includes a series of eight interactive educational web-based modules. Topics included: setting expectations, chronic pain explained, biopsychosocial factors, empowered management, self-awareness & compassion & acceptance, values, goal setting, and communication. The program is accompanied by a reflection journal and can be enhanced by one-on-one coaching sessions using a motivational interviewing approach. Phase two usability testing resulted in numerous content changes and the addition of accessibility features. Phase 3 usability testing with PWLE found the program highly accessible and easy to use. ConclusionsThe engagement of our PWLE team member and advisors made the online program more relevant, sensitive and helpful to the needs of people with pain. Practical valueThis PWLE-centric project sets the foundation for future work to examine the feasibility and effectiveness of the program for supporting individuals with chronic pain self-manage.

Teen and caregiver perspectives on success, clinician role, and family involvement in ACTION PAC, a weight management intervention trial.

Describe perspectives of teens and caregivers regarding motivations, successes, and challenges related to participation in ACTION PAC (ClinicalTrials.gov: NCT02502383), a two-year weight management trial. Intervention group participants received 16 short motivational interviewing (MI) sessions with school-based health center (SBHC) primary care clinicians over two years. Post-study, we conducted semi-structured interviews with purposefully sampled intervention group teens and their caregivers. Interviews were audio recorded, transcribed, and managed in NVivo 11. Three independent coders analyzed the data, developed a coding tree, examined how codes intersected and clarified relationships through memo writing. The clinician's role and use of motivational interviewing and family involvement in behavior changes were cited as critical to success. Some adolescents noted difficulty in sustaining behavior changes post-intervention and social and systemic barriers to behavior change. Future studies should identify strategies to sustain teen motivation, better involve families, and address systemic barriers. In this study, which simulated real-world SBHC conditions, adolescents appreciated the use of an MI approach and felt that was key to their success, indicating the potential to continue use of this approach to motivating behavior changes in SBHC settings.

Reducing Cannabis Use in Young Adults With Psychosis Using iCanChange, a Mobile Health App: Protocol for a Pilot Randomized Controlled Trial (ReCAP-iCC).

Cannabis use is the most prevalent among adolescents and young adults; frequent consumption is associated with cannabis use disorder (CUD) and psychosis, with a high prevalence (up to 50%) of CUD in individuals with first-episode psychosis (FEP). Early Intervention Services (EIS) for psychosis include face-to-face psychosocial interventions for CUD, because reducing or discontinuing cannabis use improves clinical and health care service use outcomes. However, multiple barriers (eg, staff availability and limited access to treatment) can hinder the implementation of these interventions. Mobile health (mHealth) interventions may help circumvent some of these barriers; however, to date, no study has evaluated the effects of mHealth psychological interventions for CUD in individuals with FEP. This study describes the protocol for a pilot randomized controlled trial using a novel mHealth psychological intervention (iCanChange [iCC]) to address CUD in young adults with FEP. iCC was developed based on clinical evidence showing that in individuals without psychosis, integrating the principles of cognitive behavioral therapy, motivational interviewing, and behavioral self-management approaches are effective in improving cannabis use-related outcomes. Consenting individuals (n=100) meeting the inclusion criteria (eg, aged 18-35 years with FEP and CUD) will be randomly allocated in a 1:1 ratio to the intervention (iCC+modified EIS) or control (EIS) group. The iCC is fully automatized and contains 21 modules that are completed over a 12-week period and 3 booster modules available during the 3-month follow-up period. Validated self-report measures will be taken via in-person assessments at baseline and at 6, 12 (end point), and 24 weeks (end of trial); iCC use data will be collected directly from the mobile app. Primary outcomes are intervention completion and trial retention rates, and secondary outcomes are cannabis use quantity, participant satisfaction, app use, and trial recruiting parameters. Exploratory outcomes include severity of psychotic symptoms and CUD severity. For primary outcomes, we will use the chi-square test using data collected at week 12. We will consider participation in iCC acceptable if ≥50% of the participants complete at least 11 out of 21 intervention modules and the trial feasible if attrition does not reach 50%. We will use analysis of covariance and mixed-effects models for secondary outcomes and generalized estimating equation multivariable analyses for exploratory outcomes. Recruitment began in July 2022, and data collection is anticipated to be completed in July 2024. The main results are expected to be submitted for publication in 2024. We will engage patient partners and other stakeholders in creating a multifaceted knowledge translation plan to reach a diverse audience. If feasible, this study will provide essential data for a larger-scale efficacy trial of iCC on cannabis use outcomes in individuals with FEP and CUD. ClinicalTrials.gov NCT05310981; https://www.clinicaltrials.gov/ct2/show/NCT05310981. PRR1-10.2196/40817.

THE USE OF MOTIVATIONAL INTERVIEW IN EDUCATIONS TO PROVIDE PROFESSIONAL NURSING CARE OF STUDENTS

The nursing process includes the development of comprehensive knowledge, skills and attitudes. Ensuring this development and gaining professional values is very important in maintaining professional life. During nursing education, the emotions experienced by student nurses while providing professional care and the meaning they give to education and profession may differ. In the presentation of the nursing profession, which has quite complex and comprehensive knowledge and theoretical background concepts, it is very important for students to be motivated, internalize nursing concepts and develop their own nursing perspectives, believe in the usefulness of their practices, manage possible sudden changes, and make the right decision and practice between ethical dilemmas. In this context, depending on individual differences, the motivation and willingness of nursing students may differ. The use of motivational interviewing approach may be beneficial for people who are needed in their preparation for the profession and in providing professional care. Motivational interviewing is defined as “a client-centered approach that provides behavior change by helping the client discover and analyze the ambivalence they experience, and makes use of directives for this”. It has many uses such as addiction treatment, healthy behavior acquisition, mental problems, diet and nutritional habits, sports gains, drug compliance. Other areas of uses that are not frequently mentioned are education and business life. Therefore, for the purpose of this review is to examine the training and practice motivations of student nurses, who are expected to gain professional care skills, from the perspective of motivational interviewing.

Best shot: A motivational interviewing approach to address vaccine hesitancy in pediatric outpatient settings

BackgroundVaccine hesitancy in parents and childhood vaccine refusal is increasing. A standard of care to address this problem has not been identified. PurposeTo identify if the use of motivational interviewing by pediatric providers during routine well child visits, when compared to standard of care, would increase vaccine rates in children 0–12 months of age. Factors associated with vaccine hesitancy were also investigated. MethodsA quasi-experimental study was completed on a convenience sample of pediatric providers (N = 6) and caregivers of children 0–12 months of age (N = 66). Four providers were trained to use motivational interviewing. During the well child visit the Parent Attitudes About Childhood Vaccines survey was completed, and the motivational interviewing intervention was implemented. Clinic's data were compared with other clinic data of non-trained providers. FindingsVaccine refusal/delays rate was 11.4% among caregivers. Vaccine refusal rate decreased after the intervention (9.00% pre-intervention and 6.40% post-intervention). An ordinal regression identified caregivers with higher vaccine hesitancy scores and more children were more likely to delay or refuse vaccines, while caregivers ≥30 years or with high income were less likely to delay/refuse vaccines. A difference in difference analysis identified that an additional 2.6% of children received vaccines when seen by trained providers compared to non-trained (β = −0.330, OR = 0.719, p = 0.470). DiscussionFindings indicate a condensed motivational interviewing education session may be clinically significant in decreasing vaccine hesitancy among this population. Applications to practiceA more robust study to confirm these findings is recommended prior to practice implementation.

THE COMPARISON OF EFFECT OF MOTIVATIONAL INTERVIEWING AND DENTAL HEALTH EDUCATION ON ORAL HEALTHCARE KNOWLEDGE, ATTITUDES AND BEHAVIOUR OF PARENTS AND CAREGIVERS OF PRESCHOOL CHILDREN

ntroduction- Motivational Interviewing (MI) has been used in healthcare and has shown reduction in the prevalence of early childhood caries (ECC) in preschool children. The aim of this study was to assess the effect of an MI approach delivered in an individual-setting as part of the regular dental appointment, on parent /caregiver oral health knowledge and attitudes toward the oral health of their children, in contrast with traditional dental health education (DHE), in an exploratory community-based study. The design of this study included 60 parents and caregiversMethod- visiting People's university (Bhopal) and were randomly assigned to Motivational interviewing(MI) group or Dental health education(DHE) group(30 in each group). Parents and caregivers in the MI-group (n = 30) received a talk on dental health using an MI approach and the DHE-group (n = 30) received a talk using traditional DHE. Both groups received additional, written dental health information and also received two telephone call follow-ups as part of the protocol at 3 months and 6 months. Both groups were given questionnaires before the talks and 3 months and 6 months later. Question items included oral health knowledge, attitudes, brushing behaviour, and a specic instrument to asses 'readiness for change', the Readiness Assessment of Parents Concerning Infant Dental Decay (RAPIDD). Both the groups were equally effective in raising theResult- awareness amongst the parents of the children seeking dental care. Intra-group comparison scores of individual items revealed that the scores obtained by participants belonging to group A and group B did not differ signicantly between the visits. Motivational interviewingConclusion- and Dental Health Education have similar effects when used as a part of regular dental appointment.

Addressing Methamphetamine Use in Primary Care: Provider Perspectives.

The opioid epidemic has evolved into a combined stimulant epidemic, with escalating stimulant and fentanyl-related overdose deaths. Primary care providers are on the frontlines grappling with patients' methamphetamine use. Although effective models exist for treating opioid use disorder in primary care, little is known about current clinical practices for methamphetamine use. Six semistructured group interviews were conducted with 38 primary care providers. Interviews focused on provider perceptions of patients with methamphetamine use problems and their care. Data were analyzed using inductive and thematic analysis and summarized along the following dimensions: (1) problem identification, (2) clinical management, (3) barriers and facilitators to care, and (4) perceived needs to improve services. Primary care providers varied in their approach to identifying and treating patient methamphetamine use. Unlike opioid use disorders, providers reported lacking standardized screening measures and evidence-based treatments, particularly medications, to address methamphetamine use. They seek more standardized screening tools, Food and Drug Administration-approved medications, reliable connections to addiction medicine specialists, and more training. Interest in novel behavioral health interventions suitable for primary care settings was also noteworthy. The findings from this qualitative analysis revealed that primary care providers are using a wide range of tools to screen and treat methamphetamine use, but with little perceived effectiveness. Primary care faces multiple challenges in effectively addressing methamphetamine use among patients singularly or comorbid with opioid use disorders, including the lack of Food and Drug Administration-approved medications, limited patient retention, referral opportunities, funding, and training for methamphetamine use. Focusing on patients' medical issues using a harm reduction, motivational interviewing approach, and linkage with addiction medicine specialists may be the most reasonable options to support primary care in compassionately and effectively managing patients who use methamphetamines.

The Effect of Couple's Motivational Interviewing on Exposure to Secondhand Smoke Among Pregnant Women at Home.

Objective: Secondhand smoke (SHS) during pregnancy is associated with many maternal-fetal complications. Iran has a high male smoking prevalence rate. This study aimed to determine the effect of motivational interviewing with couples on exposure to SHS at home in pregnant women referring to health centers in Urmia in 2019. Materials and methods : A randomized control trial was performed on 112 non-smoking pregnant women with smoking husbands, randomly allocated into two groups (each with 56 members). The participants were asked to specify the daily average times and duration of exposure during the last week. Five motivational interviewing sessions were held for the members of the intervention group. Each session lasted90 minutes and two sessions were held per week. The data were collected before and four weeks after the intervention. The data were analyzed using the repeated-measures analysis of variance (ANOVA) by SPSS-20 at a significance level of 0.05. Results: Of 112 couples who were randomized, 102 (91.07%) completed the trial. There was a significant reduction in terms of the daily frequency and duration of SHS exposure of the husband one week and one month after the intervention in the intervention group. The daily frequency and duration of SHS exposure of people other than the spouse at home did not decrease over time. Conclusion: Following the results of the study, the couple-based motivational interviewing approach can be used to reduce SHS exposure in women at home.

Exploring the Effectiveness of Counseling Intervention on Sedative Drug Addiction at Penjara Kajang

The COVID-19 pandemic which strike Malaysia and worldwide is a nightmare for most individuals. It brought various implications that in turn change the pattern of human’s life. There are some individuals who fail to adapt causing them to experience emotional disturbances that contribute to mental health problems. It also contributes to various social problems including drug abuse, domestic violence, divorce and others. Hence, this study was conducted to identify the causes and effects of sedative drug abuse as well as to examine the level of effectiveness of counseling interventions and coping strategies in solving this problem. This study was conducted qualitatively involving interview sessions and individual counseling sessions to one of the detainees in Kajang Prison who was involved in sedative drug abuse. The implementation of counseling sessions through Motivational Interviewing (MI) approach and Reality Therapy were conducted. The use of Motivational Interviewing in the initial session is seen to be effective in increasing client motivation. While the use of reality theory is seen to help clients in making decisions, plan and taking action. In conclusion, the right and proper counselling approach can help clients in the issue of drug addiction as well as the selection of coping strategies in dealing with the problems faced.

Counselling Intervention for Tobacco and Methamphetamine Addiction (Dual Users)

&#x0D; &#x0D; &#x0D; &#x0D; ABSTRACT&#x0D; Statistics released by the National Anti-Drug Agency showed that drug addiction activities are still vigorous. Therefore, this study was done to look at the effectiveness of counselling intervention, specifically involving dual users’ addiction. The subject involved in this case study is a client who is a 30-year-old lady which involved in dual drug use (tobacco and methamphetamine). She is currently under rehabilitation program with Agensi Anti Dadah Kebangsaan (AADK) Daerah Kinta. Due to the addiction to smoking and substance, it has affected the client in committing responsibilities as mother to her child. Client also experiences emotional stress in view of her husband often forces her to take methamphetamine. Three individual counselling session are conducted. The counseling process has been handled using the Motivational Interviewing (MI) and Cognitive Behavior Therapy (CBT) approaches. Findings from the intervention session showed that the frequency of smoking was reduced. While the findings on the use of methamphetamine show that the client is determined to quit in the third session, there is no case of relapse. Counseling intervention is effective in helping clients to fight with tobacco and drug addiction. Indirectly, it is also helpful in managing other issues involving mental health of the client.&#x0D; &#x0D; &#x0D; &#x0D;