“…Although many studies have found that brief MI interventions to address substance use in primary care facilities have positive outcomes in the short-term (Kaner et al, 2009;Moyer, Finney, Swearingen, & Vergun, 2002;Vasilaki, Hosier, & Cox, 2006), these findings have not been replicated in a South African setting Pengpid, Peltzer, Skaal, & Van der Heever, 2013), possibly due to the difficulties in training non-speciality staff to conduct MI. Further, where these positive effects have been found, the magnitude of these effects diminishes over time (Havard, Shakeshaft, & Sanson-Fisher, 2008;Nilsen et al, 2008). This is probably because MI does not directly address the cognitive-behavioural factors that often lead to continued substance use or relapse to substance use, such as poor problem-solving ability (D'Zurilla et al, 2002).…”