Motivational Interviewing Sessions Research Articles

Motivational interviewing targeting diet and physical activity improves adherence to paediatric obesity treatment: results from the MI Values randomized controlled trial.

Adherence is a challenge in obesity treatment. Motivational interviewing (MI) may promote patient adherence. MI Values is a randomized controlled trial of MI implemented as an adjunct to an adolescent obesity treatment [Teaching Encouragement Exercise Nutrition Support (T.E.E.N.S.)]. Assess effects of MI Values on T.E.E.N.S. attrition and adherence. Participants were randomized to MI (n = 58) or control (n = 41). At weeks 1 and 10, MI participants had brief MI sessions; controls viewed health education videos. All participants continued with T.E.E.N.S. (biweekly dietitian and behavioural support visits; 3 times per week supervised physical activity). Assessments were repeated at baseline, 3 and 6 months. T-tests and chi-square analyses examined T.E.E.N.S. attrition and adherence by group. Adolescents (N = 99) were primarily African-American (73%) females (74%); age = 13.8 ± 1.8 years, body mass index percentile = 98.0 ± 1.2. Compared with controls, MI participants had greater 3-month adherence overall (89.2% vs. 81.0%, P = 0.040), and to dietitian (91.3% vs. 84.0%; P = 0.046) and behavioural support (92.9% vs. 85.2%; P = 0.041) visits, and greater 6-month adherence overall (84.4% vs. 76.2%, P = 0.026) and to behavioural support visits (87.5% vs. 78.8%, P = 0.011). MI enhanced adherence to this obesity intervention. MI Values is the first study to examine the impact of MI on treatment adherence among obese, primarily African-American adolescents.

The Meanings of Family in Substance Users’ Change Talk During Motivational Interviewing: A Qualitative Study

Only a very small number of studies have examined the meaning of significant others in motivational interviewing (MI) sessions. The aim of this qualitative study is to provide insights into substance users’ experience of the meaning of family in the change process and to expand current understanding about the significance of family relationships in change talk during MI. The analyses are based on videotaped data consisting of 98 MI sessions in the Finnish Probation Service. The results show that family relationships are important and diverse factors that promote or hinder motivation to change in substance users’ change talk.

Using motivational interviewing for weight feedback to parents of young children

To determine whether a single session of motivational interviewing (MI) for feedback of a child's overweight status promotes engagement in treatment following screening. One thousand ninety-three children aged 4-8 years were recruited through primary and secondary care to attend health screening, including assessment of parenting practices and motivation (questionnaire). Families with normal-weight children were informed about their child's weight but had no further involvement. Parents of overweight (body mass index ≥ 85th percentile) children (n = 271) were randomised to receive weight feedback via MI or best practice care (BPC) using a traffic light concept to indicate degree of health risk. Follow-up interviews were held 2 weeks later to examine intervention uptake, changes to motivation and behaviour, and parental response to feedback. Recruitment into the intervention was high (76%) and not altered by feedback condition (percentage difference 6.6 (95% confidence interval -2.9, 16.0). High scores on the Health Care Climate Questionnaire (rating of the interviewer) indicated satisfaction with how the information was provided to parents. No differences were observed in multiple indicators of harm. However, self-determined motivation for healthy life-styles was significantly higher in the MI condition at follow-up (0.18: 0.00, 0.35), after only a single session of MI. MI and BPC were both successful in encouraging parents to participate in a family-based intervention, with MI offering little significant benefit over BPC. A traffic light approach to weight feedback is a suitable way of providing sensitive information to parents not expecting such news.

Motivational interviewing with parents of overweight children: Study design and methods for the NOURISH + MI study

There is an urgent need for innovative approaches to pediatric obesity treatment. There is also a demand for targeted strategies that reduce attrition and improve treatment adherence. Intervening exclusively with parents of overweight children is a novel approach with demonstrated efficacy in reducing child body mass index (BMI) percentile. Motivational interviewing (MI), a brief communication style for exploring and resolving ambivalence about behavior change, might enhance treatment engagement when implemented as part of obesity interventions. The aim of this report is to provide the rationale and methods for a novel study of MI with parents in the treatment of their children's overweight. We designed and are currently implementing NOURISH+MI, a randomized controlled trial examining the feasibility and efficacy of an adjunct values-based MI intervention, implemented within a culturally-tailored parent intervention for overweight children ages 5–11years, NOURISH+ (Nourishing Our Understanding of Role modeling to Improve Support and Health). Specifically, we are randomly assigning 60 parents to this adjunctive treatment, and investigating if adding two MI sessions prior to the NOURISH+ group intervention will enhance treatment effects. We will be able to compare NOURISH+MI participants with those from the two NOURISH+ treatment conditions (NOURISH+ and control). We hypothesize that children whose parents participate in NOURISH+MI will demonstrate lower attrition and greater adherence with NOURISH+, ultimately leading to greater treatment effects, compared with children whose parents are randomized to NOURISH+ or a control group. Findings will contribute to the emerging literature examining the efficacy of MI within pediatric obesity interventions.

A randomised controlled trial and cost-effectiveness evaluation of ‘booster’ interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

More evidence is needed on the potential role of 'booster' interventions in the maintenance of increases in physical activity levels after a brief intervention in relatively sedentary populations. To determine whether objectively measured physical activity, 6 months after a brief intervention, is increased in those receiving physical activity 'booster' consultations delivered in a motivational interviewing (MI) style, either face to face or by telephone. Three-arm, parallel-group, pragmatic, superiority randomised controlled trial with nested qualitative research fidelity and geographical information systems and health economic substudies. Treatment allocation was carried out using a web-based simple randomisation procedure with equal allocation probabilities. Principal investigators and study statisticians were blinded to treatment allocation until after the final analysis only. Deprived areas of Sheffield, UK. Previously sedentary people, aged 40-64 years, living in deprived areas of Sheffield, UK, who had increased their physical activity levels after receiving a brief intervention. Participants were randomised to the control group (no further intervention) or to two sessions of MI, either face to face ('full booster') or by telephone ('mini booster'). Sessions were delivered 1 and 2 months post-randomisation. The primary outcome was total energy expenditure (TEE) per day in kcal from 7-day accelerometry, measured using an Actiheart device (CamNtech Ltd, Cambridge, UK). Independent evaluation of practitioner competence was carried out using the Motivational Interviewing Treatment Integrity assessment. An estimate of the per-participant intervention costs, resource use data collected by questionnaire and health-related quality of life data were analysed to produce a range of economic models from a short-term NHS perspective. An additional series of models were developed that used TEE values to estimate the long-term cost-effectiveness. In total, 282 people were randomised (control = 96; mini booster = 92, full booster = 94) of whom 160 had a minimum of 4 out of 7 days' accelerometry data at 3 months (control = 61, mini booster = 47, full booster = 52). The mean difference in TEE per day between baseline and 3 months favoured the control arm over the combined booster arm but this was not statistically significant (-39 kcal, 95% confidence interval -173 to 95, p = 0.57). The autonomy-enabled MI communication style was generally acceptable, although some participants wanted a more paternalistic approach and most expressed enthusiasm for monitoring and feedback components of the intervention and research. Full boosters were more popular than mini boosters. Practitioners achieved and maintained a consistent level of MI competence. Walking distance to the nearest municipal green space or leisure facilities was not associated with physical activity levels. Two alternative modelling approaches both suggested that neither intervention was likely to be cost-effective. Although some individuals do find a community-based, brief MI 'booster' intervention supportive, the low levels of recruitment and retention and the lack of impact on objectively measured physical activity levels in those with adequate outcome data suggest that it is unlikely to represent a clinically effective or cost-effective intervention for the maintenance of recently acquired physical activity increases in deprived middle-aged urban populations. Future research with middle-aged and relatively deprived populations should explore interventions to promote physical activity that require less proactive engagement from individuals, including environmental interventions. Current Controlled Trials ISRCTN56495859, ClinicalTrials.gov NCT00836459. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 13. See the NIHR Journals Library website for further project information.

Significant Others in Substance Abusers’ Change Talk During Motivational Interviewing Sessions in the Finnish Probation Service

AbstractAIMS – This article explores the meanings substance-abusing clients attach to family and friendships during motivational interviewing (MI) sessions in Probation Service. DATA – The analyses are based on videotaped and transcribed data consisting of 82 MI sessions. This database involves the first two counseling sessions of 41 client-counselor pairs. Sessions were videotaped in 12 Probation Service offices in Finland between 2007 and 2009. METHODS – The analysis relies on coding of client’s change talk utterances and qualitative semiotic framework. RESULTS – The meanings of the significant others were diverse from the point of view of the client’s motivation: family appeared as a support for change, an aspiration, a sufferer, or an obstacle to change; and friendship appeared as an obstacle to change, a surmounted obstacle, a cause to change, or a support to change. CONCLUSIONS - Significant others and their quality are important and diverse factors that promote or hinder change in substance abuser’ change talk. Thus, it is suggested that the meaning of significant others should not be overlooked in MI and other substance abuse treatment.

A randomized controlled trial utilizing motivational interviewing to reduce HIV risk and drug use in young gay and bisexual men.

Young gay and bisexual men (YGBM) are disproportionally at risk of HIV infection due to sexual risk behaviors, which are often exacerbated by recreational drug use. However, there have been no evidence-based interventions targeting substance-using YGBM. This study was designed to test a brief motivational interviewing (MI) intervention to reduce both risky sex and drug use among HIV-negative YGBM. A total of 143 non-treatment-seeking YGBM (ages 18-29 years) who reported recent unprotected anal intercourse (UAI) and recreational drug use were randomized to 4 sessions of MI or 4 sessions of content-matched education. Participants were followed every 3 months for 1 year, and behavior change was examined across conditions and time for aggregated and day-level drug use and UAI. Regardless of condition, participants reported significant reductions in UAI and substance use over time. However, YGBM in the MI condition were 18% less likely to use drugs and 24% less likely to engage in UAI than YGBM in the education condition. The results support the utility of MI, compared with a content-matched education condition, to significantly reduce both UAI and drug use among YGBM. Interventions may benefit from an emphasis on substance use reductions, which might indirectly lead to less frequent UAI. Future research efforts should examine whether this type of brief MI intervention is effective when delivered by clinic or community settings utilized by YGBM.

¿Mejora la entrevista motivacional la eficacia del tratamiento psicológico para dejar de fumar?

Several studies show that when using motivational interviewing (MI) added to standard treatment, in order to increase motivation, treatment outcomes improve. The aim of this study was to examine whether smokers who receive an intervention with MI before a cognitive-behavioral psychological treatment to quit smoking they improve adherence and treatment effectiveness, and they reduce the risk of relapse at follow-up compared with smokers who only receive cognitive-behavioral psychological treatment for smoking cessation. We compared the effectiveness of adding or not MI to a psychological treatment to quit smoking in a sample of 58 smokers (46.6% men and 53.4% women). The experimental group received 2 sessions of MI before the beginning of the 6 sessions of the psychological treatment, while the control group received only 6 sessions of treatment. The results showed no statistically significant differences between the two groups in adherence to treatment, and treatment outcomes at the end of treatment and at 6- and 12-month follow-ups. We conclude that intervention with MI does not produce better results compared to the application of cognitive-behavioral psychological treatment alone.

The association of therapist empathy and synchrony in vocally encoded arousal.

Empathy is a critical ingredient in motivational interviewing (MI) and in psychotherapy generally. It is typically defined as the ability to experience and understand the feelings of another. Basic science indicates that empathy is related to the development of synchrony in dyads. However, in clinical research, empathy has proved difficult to operationalize and measure, and has mostly relied on the felt sense of observers, clients, or therapists. We extracted estimates of therapist and standardized patient (SP) vocally encoded arousal (mean fundamental frequency; mean f₀) in 89 MI sessions with high and low empathy ratings from independent observers. We hypothesized (a) therapist and SP mean f₀ would be correlated and (b) the correlation of therapist and SP mean f₀ would be greater in sessions with high empathy as compared with low. On the basis of a multivariate mixed model, the correlation between therapist and SP mean f₀ was large (r = .71) and close to 0 in randomly assigned therapist-SP dyads (r = -.08). The association was higher in sessions with high empathy ratings (r = .80) than in sessions with low ratings (r = .36). There was strong evidence for vocal synchrony in clinical dyads as well as for the association of synchrony with empathy ratings, illustrating the relevance of basic psychological processes to clinical interactions. These findings provide initial evidence for an objective and nonobtrusive method for assessing therapist performance. Novel indicators of therapist empathy may have implications for the study of MI process as well as the training of therapists generally. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Sustain talk predicts poorer outcomes among mandated college student drinkers receiving a brief motivational intervention.

Within-session client language that represents a movement toward behavior change (change talk) has been linked to better treatment outcomes in the literature on motivational interviewing (MI). There has been somewhat less study of the impact of client language against change (sustain talk) on outcomes following an MI session. This study examined the role of both client change talk and sustain talk, as well as therapist language, occurring during a brief motivational intervention (BMI) session with college students who had violated college alcohol policy (N = 92). Audiotapes of these sessions were coded using a therapy process coding system. A series of hierarchical regressions were used to examine the relationships among therapist MI-consistent and MI-inconsistent language, client change talk and sustain talk, as well as global measures of relational variables, and drinking outcomes. Contrary to prior research, sustain talk, but not change talk, predicted poorer alcohol use outcomes following the BMI at 3- and 12-month follow-up assessments. Higher levels of client self-exploration during the session also predicted improved drinking outcomes. Therapist measures of MI-consistent and MI-inconsistent language, and global measures of therapist acceptance and MI spirit were unrelated to client drinking outcomes. Results suggest that client sustain talk and self-exploration during the session play an important role in determining drinking outcomes among mandated college students receiving a BMI addressing alcohol use.

Alcohol Use Following an Alcohol Challenge and a Brief Intervention among Alcohol‐Dependent Individuals

The study examined the effects of an alcohol challenge on naturalistic drinking among alcohol-dependent individuals and explored brief motivational interviewing (MI) as a potential intervention for these participants. Alcohol-dependent individuals (n = 32, eight females) completed the intake assessment, alcohol challenge, one MI session, and 1-month follow-up (87.5% retention) where they completed measures of drinking and motivation for change. As expected, multilevel mixed models revealed that drinking did not increase post-alcohol challenge. Participants reported a reduction in ambivalence, drinking days, and a trend towards fewer total drinks between the MI and 1-month follow-up. Consistent with other studies, the alcohol challenge did not worsen alcohol use. Results support further investigation of brief MI for alcohol-dependent participants in alcohol challenges. Alcohol administration to alcohol-dependent participants appears to not exacerbate naturalistic drinking. MI may be a feasible intervention for non-treatment seeking alcohol-dependent participants in alcohol challenge studies.

Motivational interviewing as a smoking cessation strategy with nurses: An exploratory randomised controlled trial

BackgroundDespite the important role that health professionals have in reducing tobacco use, many have a smoking habit themselves. The prevalence of smoking is particularly high among nurses. ObjectiveTo test the efficacy, acceptability and feasibility of a motivational interviewing (MI) based smoking cessation intervention with nurses. DesignTwo group parallel experimental design with random allocation to groups. SettingA large teaching hospital in the North of Spain. ParticipantsNurses who smoked (n=30) were randomised into two groups: motivational interviewing based intervention (n=15) and usual care (n=15). MethodsMotivational interviewing based intervention consisted of four individual MI sessions. Usual care consisted of brief advice. Variables considered to assess efficacy were biochemically verified smoking cessation, mean cigarettes smoked, stages of change, self-efficacy and depression score. Variables to assess acceptability and feasibility included participant satisfaction, adherence to MI, and duration of sessions. Data were collected at: baseline, end of intervention and three months after the end of the intervention. ResultsAt three month follow up, compared with the control group, more nurses in the intervention group had quit (absolute difference 33.3%; 95% confidence interval [CI] 2.6–58.2). In the nurses who did not quit, there was no significant difference between the intervention and control groups in the number of cigarettes smoked per day, although progress in the stages of change was greater in the intervention group compared to the control group. Measures of acceptability and feasibility indicated good satisfaction with the intervention, with high levels of attendance and completion. ConclusionThis study found a beneficial effect of motivational interviewing on nurses’ smoking cessation. The intervention was acceptable for nurses and a number of aspects were identified that need to be considered prior to conducting a larger scale in order to optimise the intervention. Using MI might be a novel approach to the problem of health professionals who smoke.

From counselor skill to decreased marijuana use: Does change talk matter?

Client language about change, or change talk, is hypothesized to mediate the relationship between counselor fidelity in motivational interviewing (MI) and drug use outcomes. To investigate this causal chain, this study used data from an MI booster delivered to alternative high school students immediately after a universal classroom-based drug abuse prevention program. One hundred and seventy audio-recorded MI sessions about substance use were coded using the motivational interviewing skill code 2.5. Structural equation modeling showed that percentage of change talk on the part of the client mediated three of the four relationships between MI quality indicators and marijuana outcomes, while percentage of reflections of change talk showed a main effect of counselor skill on marijuana outcomes. Findings support change talk as an active ingredient of MI and provide new empirical support for the micro-skills of MI.

The Poetics of Therapeutic Practice: Motivational Interviewing and the Powers of Pause

Motivational interviewing (MI) is an increasingly prominent behavioral therapy that draws from and claims to synthesize two American therapeutic traditions long thought to be antithetical-"client-centered" and "directive" approaches. This paper proposes that MI achieves its hallmark "client-centered directiveness" through the aesthetic management of the therapeutic encounter, and more particularly, through MI practitioners' marked use of silence. Drawing on data collected during the ethnographic study of MI trainings and the formal analysis of video-recorded MI sessions that are commonly used as models in such trainings, we identify three patterns of pause that regularly fall at specific grammatical junctures within seasoned MI practitioners' turns-at-talk. We demonstrate how these pauses allow MI practitioners to subtly direct the conversation while simultaneously displaying unequivocal signs of client-centeredness. In other words, we show how and explain why the poetics of pause matter to MI. In presenting this case, we more generally highlight practice poetics-that is, the aesthetic management of the style and delivery of a professional message with a particular practical aim in mind-suggesting that this is a central if under-appreciated aspect of therapeutic practices.

Dosage effects of motivational interviewing on middle-school students' academic performance: randomized evaluation of one versus two sessions

Motivational interviewing (MI) is a brief client-centred intervention that increases intrinsic motivation for change. Little research has been conducted on MI to promote academic behaviours, but two studies found that one session of MI did improve middle-school students' math grades [Strait, G., Smith, B., McQuillin, S., Terry, J., Swan, S., & Malone, P. (2012). A randomized trial of motivational interviewing to improve middle school students' academic performance. Journal of Community Psychology, 40, 1032–1039; Terry, J., Strait, G., Smith, B., & McQuillin, S. (2013). Motivational interviewing to improve middle school students' academic performance: A replication study. Journal of Community Psychology, 41, 902–909]. This study examines dosage effects of MI by randomly assigning 42 middle-school students to either one or two sessions of MI (n = 21 per group). Significant dosage effects were found for math, science and history grades, with effect sizes of 0.55, 0.58 and 0.47, respectively. Considering that math effects were 0.47 and 0.37 in the prior studies, and math was the only significant change produced by one session of MI, these results strongly suggest that two sessions of MI are superior to one. Future studies should replicate these findings and explore if even higher doses produce stronger effects.

Telephone-Based Motivational Interviewing to Promote Physical Activity and Stage of Change Progression in Older Adults

This study examined the efficacy of motivational interviewing (MI) for increasing physical activity in aging adults. Eighty-six participants aged 55 years and older were randomly assigned to receive either four weekly sessions of telephone-based MI for increasing physical activity, or a healthy activity living guide (information only control). Changes from baseline weekly caloric expenditure from physical activity, self-efficacy for physical activity, and stage of change for physical activity were compared across groups at posttreatment and six months follow-up. Results indicated that MI participants had higher weekly caloric expenditures from physical activity at posttreatment, but not at six months follow-up; higher self-efficacy for physical activity at six months follow-up; and demonstrated greater stage of change progression across assessments. These findings support the use of telephone-based MI for increasing physical activity in older adults in the short-term. Future studies will need to determine if follow-up booster sessions increase long-term efficacy.

Intensive Motivational Interviewing for women with concurrent alcohol problems and methamphetamine dependence

Motivational interviewing (MI) for the treatment of alcohol and drug problems is typically conducted over 1 to 3 sessions. The current work evaluates an intensive 9-session version of MI (Intensive MI) compared to a standard single MI session (Standard MI) using 163 methamphetamine (MA) dependent individuals. The primary purpose of this paper is to report the unexpected finding that women with co-occurring alcohol problems in the Intensive MI condition reduced the severity of their alcohol problems significantly more than women in the Standard MI condition at the 6-month follow-up. Stronger perceived alliance with the therapist was inversely associated with alcohol problem severity scores. Findings indicate that Intensive MI is a beneficial treatment for alcohol problems among women with MA dependence.

Innovative Interventions in Pediatric Obesity: Commentary and Future Directions

As described in the manuscripts in this special issue, pediatric obesity is an epidemic that challenges the health of children in the United States and globally, and places considerable burden on all levels of our health care system. During the past decade, pediatric psychologists have actively pursued an understanding of the psychosocial correlates of pediatric obesity and developed effective interventions based on this knowledge. This special issue is a reflection of the considerable progress that has been made in this arena, while simultaneously paving the way for the work that remains to be done. Treatment Models Several of the manuscripts in this special issue outline novel approaches for intervening with obese children and adolescents. Overweight/obese adolescents present a particular challenge for intervention stemming from developmentally normative striving for autonomy, the ambiguous role of parents in initiating and supporting weight control, and decreased body satisfaction (Jelalian et al., 2010). Walpole, Dettmer, Morrongiello, McCrindle, and Hamilton (2013) randomized youth with a mean age of 13.9 years to six sessions of motivational interviewing (MI) or social skills training combined with standard care. There was no advantage to MI over social skills training with regard to change in body mass index z-score (zBMI) or self-efficacy. When groups were combined, adolescents demonstrated significant increases in self-efficacy related to weight-control behaviors and a trend toward decrease in weight status. Of interest, attendance at MI sessions was superior to that for social skills sessions, suggesting that MI may be an effective strategy for engaging adolescents. MI may serve as an initial engagement strategy or an adjunctive treatment to support weight control in adolescents. In a study with adults (West, DiLillo, Bursac, Gore, & Greene, 2007), participants randomized to standard group-based behavioral obesity treatment combined with adjunctive motivational sessions demonstrated superior weight loss compared with those randomized to behavioral weight loss treatment and attention control sessions. In the area of weight control for adolescents, we may need to combine MI with more intensive lifestyle interventions to see incremental benefits in body mass index (BMI) decrease. A second strategy for enhancing motivation to facilitate weight change is seen in the study by Saelens, Lozano, and Scholz (2013). This study, which was conducted with school-age children rather than adolescents, presents another model for incorporating motivational factors into intervention development. These investigators randomized children between the ages of 7 and 11 years to a 20-week behavioral weight-control intervention with a standard untailored prescription of weekly goals by the interventionist or a ‘‘self-directed’’ approach in which parent–child dyads were encouraged to increase autonomy in selection of weekly goals based on their own motivation. Interestingly, children and parents in both treatment conditions showed significant reductions in zBMI and BMI, respectively, with no added benefit associated with the enhanced motivational approach. As noted by the authors, there may be alternative models for more explicitly enhancing motivation that would result in stronger outcomes for

The impact of motivational interviewing to reduce alcohol use among adults in treatment for depression

This study examined the effectiveness of Motivational Interviewing (MI) to reduce hazardous drinking among patients in treatment for depression. The sample consisted of 307 participants ages 18 and over in depression treatment in Kaiser Permanente outpatient psychiatry who reported hazardous drinking, illegal drug use or misuse of prescription drugs in the prior 30 days, and who scored ≥ 5 on the Patient Health Questionnaire (PHQ-9). Participants were randomized to receive either 3 sessions of MI or printed literature about alcohol and drug use risks, as an adjunct to usual outpatient depression care. Preliminary analyses examined baseline group differences and outcomes among the 264 participants who completed 3- month follow-up to date. In the 3 month follow-up sample, both groups showed reduction in hazardous drinking and depression. Among participants reporting any hazardous drinking at the 4+/5+ level at baseline (N=154), MI-treated participants were less likely than controls to report hazardous drinking at 3 months, at a level approaching statistical significance (44.9% vs. 59.2%, p = .075). No group differences in cannabis use reduction or depression reduction were observed. This study examined preliminary data regarding the efficacy of MI (intervention) versus printed literature on alcohol use risks (control) among depression patients in a clinical setting as a supplement to usual care in psychiatry. Initial findings indicate that both groups reduced hazardous drinking at 3 months, but that MI may be somewhat more effective among participants drinking at a 4+/5+ level. The investigators are in process of completing 3-, 6- and 12-month follow up. Further analyses will examine long term outcomes, outcomes among subgroups based on drinking and psychiatric severity, predictors of hazardous drinking reduction in the sample as a whole, initiation with specialty alcohol and drug treatment among dependent participants, and cost effectiveness of the intervention.

A preliminary study of motivational interviewing as a prelude to intensive treatment for an eating disorder.

BackgroundEngaging patients with an eating disorder in change is difficult and intensive treatment programs have high drop-out rates. The purpose of the study was to determine whether Motivational Interviewing (MI) in the form of a brief, pre-treatment intervention would be associated with higher completion rates in subsequent intensive treatment for an eating disorder.Thirty-two participants diagnosed with an eating disorder participated in the study. All participants were on the waitlist for admission to an intensive, hospital-based treatment program. Sixteen participants were randomly assigned to four individual sessions of MI that began prior to entrance into the treatment program (MI condition) and 16 participants were assigned to treatment as usual (control condition). The main outcome was completion of the intensive treatment program. Participants also completed self-report measures of motivation to change.ResultsParticipants in the MI condition were significantly more likely to complete intensive treatment (69% completion rate) than were those in the control condition (31%).ConclusionsMI can be a useful intervention to engage individuals with severe eating disorders prior to participation in intensive treatment. MI as a brief prelude to hospital-based treatment for an eating disorder may help to improve completion rates in such programs. Further research is required to determine the precise therapeutic mechanisms of change in MI.