Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness.

Abstract

Motivation is a well-established predictor of recovery for addictive behaviors. Treatments aimed at changing substance use and gambling frequently employ motivational enhancing strategies, based in the principles of Motivational Interviewing (MI). Evidence for these approaches across addictive behaviors does not always paint a clear picture. The purpose of this review was to examine existing reviews of motivational-based interventions for various substances of abuse and gambling in the last decade to gain a deeper understanding of the current evidence and implications for future research and clinical practice. Literature searches were conducted to identify review articles from January 1, 2007 to January 30, 2017 for motivational enhancing interventions for alcohol, tobacco, drugs, marijuana, cocaine, opioids, methamphetamines, and gambling. Of the 144 articles assessed we included a total of 34 review articles in our review, including 6 Cochrane reviews. This review supports use of motivationally enhancing interventions across addictive behaviors with strongest evidence supporting use in alcohol and tobacco, with brief interventions showing strong efficacy. There is strong support for MI with marijuana and some support for gambling. Insufficient evidence is available for methamphetamine or opiate use. There are important caveats. In most cases, MI is more effective than no treatment and as effective (but not necessarily more effective) than other active treatments. Findings for effectiveness of more intensive motivational interventions or combinations are mixed. Treatment fidelity assessments, limited subpopulation analyses, and differences in dose, outcomes, and protocol specification continue to pose significant problems for reviews. (PsycINFO Database Record

Association Between Gabapentin Receipt for Any Indication and Alcohol Use Disorders Identification Test—Consumption Scores Among Clinical Subpopulations With and Without Alcohol Use Disorder

“…We addressed methodological challenges inherent to observational study designs by using uniform exclusion criteria for exposed and unexposed patients, evaluating incident exposures, setting an index date for exposed and unexposed patients, and using propensity score matching to account for confounding by indication. Second, previous studies have shown that motivation to receive treatment for AUD can impact treatment outcomes (Diclemente et al., , ; Field et al., ). Given that patients in our sample were prescribed gabapentin from nonsubstance use treatment providers, it is likely that patients were not receiving gabapentin to address their alcohol use.…”

Rumo aos 40 anos de entrevista motivacional: evolução da abordagem

“…De maneira geral, a EM tem se mostrado efetiva para promover a mudança de comportamento. Uma revisão recente com 34 ensaios clínicos realizados nos últimos 10 anos apontou resultados positivos da EM quando aplicada ao tratamento dos transtornos por uso de substâncias (DiClemente, Corno, Graydon, Wiprovnick, & Knoblach, 2017), enquanto que no Brasil, uma revisão realizada não foi conclusiva com relação aos efeitos da EM, principalmente por esta forma de tratamento estar muito associada a outras abordagens (Andretta, Meyer, Kuhn, & Rigon 2014). Variações entre os resultados são justificadas principalmente nas variações metodológicas, como número variado de sessões e amostras diversas, além da qualidade da intervenção (Andretta, Meyer, Kuhn & Rigon, 2014;Romano & Peters, 2016;Magill, Apodaca, Borsari, Gaume, Hoadley, Gordon, Tonigan, & Moyers, 2018).…”

The Development and Evaluation of a Statewide Training Center for Home Visitors and Supervisors

“…On the basis of this process, we identified the following six possible training content areas: (a) motivational communication, (b) parenting and child development, (c) healthy partner/family relationships, (d) mental health, (e) substance use, and (f) cultural sensitivity. We conceptualized motivational communication as the foundation for all training content, given its extensive research base in promoting relationships, retention in services, and behavior change (DiClemente et al., ). Training content would include principles of motivational communication and the Transtheoretical Model of Change.…”

“…Training content would include principles of motivational communication and the Transtheoretical Model of Change. The Transtheoretical Model of Change delineates an individual's “stages of behavior change” for a target behavior (e.g., smoking cessation) and helps a professional determine how they might meet and most effectively interact with the individual at different points in the behavior change process (DiClemente et al., ; Prochaska & DiClemente, ). All subsequent training content would emphasize and extend the focus on readiness and the relational and communication skills developed in the motivational communication training.…”