Do Brief Alcohol Motivational Interventions Work Like We Think They Do?

Bertholet, Nicolas; Palfai, Tibor P.; Gaume, Jacques; Daeppen, Jean‐Bernard; Saitz, Richard

doi:10.1111/acer.12274

Cited by 46 publications

(48 citation statements)

References 37 publications

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“…The notable exceptions were the therapist global ratings in study 1, which were in the “poor” (ICCs < .40) to “fair” range (ICC's from .40 to .50). That said, other studies that have coded therapist globals (Apodaca, Magill, Longabaugh, Jackson, & Monti, 2013; Bertholet et al, 2014; Gaume et al, 2008; Moyers et al, 2005; Vader et al, 2010) have obtained similar interrater reliabilities (.20 - .62 for acceptance, .22 – .53 for empathy, and .45 - .67 for MI Spirit). Therefore, we decided to retain these global ratings in subsequent analyses.…”

Section: Methodsmentioning

confidence: 72%

In-session processes of brief motivational interventions in two trials with mandated college students.

Borsari¹,

Apodaca

Jackson

et al. 2015

Journal of Consulting and Clinical Psychology

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Objective Each year, thousands of college students receive mandated intervention as a sanction for alcohol use or alcohol-related behavior. For these mandated students, Brief Motivational Interventions (BMIs) are currently the most efficacious individual intervention. However, little is known about how the technical (therapist behaviors) and relational (e.g., global ratings of therapist empathy) components of BMIs influence client language as well as subsequent change in alcohol use and consequences in mandated students. Method This study used the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003) to code BMI sessions from two randomized clinical trials that facilitated significant reductions in alcohol use (Study 1, n = 91) and alcohol-related consequences (Study 2, n = 158) in mandated students. Results There were significant relationships among therapist behaviors, global scores, and client language both for and against change, yet there were no links between in-session client language and subsequent changes in alcohol use or problems. In contrast, relational aspects of MI (global ratings of therapist MI Spirit and client self-exploration) were most predictive of post-session alcohol use. Mediation models incorporating both technical and relational components revealed that higher levels of client self-exploration mediated the relationship between higher therapist ratings of MI Spirit and improved drinking at follow-up. Conclusions Findings highlight the importance of considering how both technical and relational components of MI may influence alcohol use in mandated college students, and also suggest more exact analyses to better understand this complex relationship.

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Section: Methodsmentioning

confidence: 72%

In-session processes of brief motivational interventions in two trials with mandated college students.

Borsari¹,

Apodaca

Jackson

et al. 2015

Journal of Consulting and Clinical Psychology

View full text Add to dashboard Cite

show abstract

“…Alternatively, greater elaboration of causal chains, focusing on therapy-specific micro-processes, may reveal subtle differences in the time course of intervention effects (i.e., rapidity of treatment response) or the pathways through which a particular sequence or combination of therapy-specific active ingredients may have an effect on outcome 50,54 . Emerging findings suggest that failure to confirm hypothesized treatment-specific causal chains may be due to imprecise definition and/or measurement of key constructs, the need to identify relevant parameters of change (e.g., rapidity and durability of effects), and the need for greater specificity of the causal chains to be tested 31, 55 .…”

Section: Reviewmentioning

confidence: 99%

Mechanisms of Change in Adolescent Substance Use Treatment: How Does Treatment Work?

Black

Chung

2014

Substance Abuse

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Background Adolescent substance use treatment outcome research generally shows small to moderate effects in reducing substance use, with no specific “brand” of treatment emerging as clearly superior to any other, and treatment gains that fade over time. The relatively weak and temporary effects of treatment call for improving the potency and durability of intervention effects. In response to this call, this critical narrative review summarizes research on mechanisms of change for both adults and adolescents in substance use treatment, with a particular focus on reviewing what is known regarding “how” adolescent substance use treatment works. Methods A comprehensive review of the adolescent (ages 11–18) substance use treatment literature was conducted to identify empirical studies that examined mediators of intervention effects. Relevant databases (e.g., PsychINFO, Medline) were searched using key words (e.g., “mediator”), and relevant articles from reference sections of identified studies and review papers were considered. Results Studies of mechanisms of psychotherapy change are rare in the adult, and particularly adolescent, substance use treatment outcome literature. The four adolescent studies that examined substance use treatment mechanisms found that positive social support, motivation to abstain, and positive parenting behaviors mediated treatment effects. To date, research has not supported therapy-specific mechanisms of change, finding instead that “common” processes of change largely account for improvements in outcome across distinct “brands” of treatment. Conclusions The lack of empirical support for treatment-specific mechanisms of change may be due to the need for greater precision in defining and measuring treatment-specific causal chains. Future directions include neuroscience approaches to examining changes in brain functioning that are associated with treatment response and recovery and examining mechanisms in adaptive treatment designs, which can accommodate individual differences in targets for intervention and response to treatment.

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“…This study suggests that the VA's nationwide effort to implement population-based brief interventions for patients with moderate to severe alcohol misuse was associated with an increase in rates over time of patient-reported alcohol-related advice-a key component of evidence-based brief interventions (Bertholet et al, 2014;Kaner et al, 2007;Whitlock et al, 2004). From the year before the VA's implementation of brief interventions (FY 2007) to the third year after implementation (FY 2010), report of FIGURE 3.…”

Section: Discussionmentioning

confidence: 91%

Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions

Chavez

Williams

Lapham

et al. 2016

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. Method: This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP;-2011 who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C 5) was estimated for each year. Results: Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. Conclusions: The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation. (J. Stud. Alcohol Drugs, 77, 500-508, 2016)

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Do Brief Alcohol Motivational Interventions Work Like We Think They Do?

Cited by 46 publications

References 37 publications

In-session processes of brief motivational interventions in two trials with mandated college students.

In-session processes of brief motivational interventions in two trials with mandated college students.

Mechanisms of Change in Adolescent Substance Use Treatment: How Does Treatment Work?

Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions

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