Adapting a blended motivational interviewing and problem-solving intervention to address risky substance use amongst South Africans

Abstract

The purpose of this study was to examine the acceptability and initial substance use outcomes of a blended motivational interviewing (MI) and problem-solving therapy (PST) intervention, delivered by peer counsellors. Twenty people who scored at risk for substance use according to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) received a five session blended MI-PST intervention and were assessed at baseline and at three months. An open-ended semi-structured interview, designed to identify possible factors that may hinder or promote the acceptability of the intervention was also conducted. Fifteen participants completed the intervention and the three-month follow-up. According to ASSIST scores, participants significantly reduced their substance use (p > 0.001) at the three-month follow-up. Randomized controlled trials are needed to evaluate the effect of this intervention more rigorously.

The mental health experiences and needs of methamphetamine users in Cape Town: A mixed-methods study

“…Second, indicated prevention programmes for individuals who are using methamphetamine but are not yet dependent should include a focus on developing adaptive coping and problem-solving styles, particularly given emerging evidence that brief, problem-solving therapies are effective for reducing substance use involvement in high-risk South African populations. [15] Third, as mental health problems and problem-solving deficits are risk factors for poor treatment outcomes, [15] substance abuse services should screen all methamphetamine users for co-occurring mental health problems and provide patients with coping and problem-solving interventions to help them deal with life stressors. Finally, the low use of mental health services in this population indicates a need for improving community awareness of mental health problems and resources, which may hinder uptake and consistent use of available community-based services.…”

Screening and Brief Intervention for Substance Misuse: Does It Reduce Aggression and HIV-Related Risk Behaviours?

“…The possibilities of other interventions, such as brief motivational interviewing combined with problem-solving therapy (Sorsdahl et al, 2014), should also be explored; as should the question of whether interventions to reduce aggression and HIV risk behaviours must be integrated into substance abuse treatments in order to achieve reductions in those related risk behaviours as well as in substance misuse (Sorenson and Copeland, 2000;Prendergast et al, 2001;McCulloch and McMurran, 2008;Cunningham et al, 2010).…”

“…It may be that multiple session brief motivational interventions are needed to decrease substance misuse sufficiently to have an impact on HIV risk behaviours. Alternatively, other, only slightly more complex, interventions are being developed for precisely this context (Sorsdahl et al, 2014). Their promise to achieve reductions in substance misuse, and in other risk behaviours, must urgently be explored further.…”

Contingency management treatment for methamphetamine use disorder in South Africa

“…Treatment for MUD in South Africa has predominantly focused on cognitive behavioural therapy, motivational interviewing and problem‐solving skills . In response to the methamphetamine epidemic in 2007, the City of Cape Town introduced Matrix treatment centres, which use an evidence‐based treatment developed in the USA in the 1980s, at primary health‐care clinics .…”

“…Treatment for MUD in South Africa has predominantly focused on cognitive behavioural therapy, motivational interviewing and problem-solving skills [6][7][8].…”