Wednesday 05 October 2011, 11:43AM
PEARLS 323, August 2011, written by Brian R
How effective is motivational interviewing for reducing substance
People who received motivational interviewing reduced their use of
substances more than people who had not received any treat.ment.
However, other active treatments, treatment as usual, and being
assessed and receiving feedback were as effective as motivational
interviewing. There was not enough data to form conclusions about
the effects of motivational interviewing on re.tention in
treatment, readiness to change, or repeat convictions.
The evidence was mostly of low quality. Motivational interviewing
is a brief intervention. Given it involves only 1 to 4 sessions,
one should not expect too much regarding changes in drug abuse
outcomes. Motivational interviewing and other interventions share a
number of non-specific therapeutic factors, such as attention and
therapeutic alliance. These factors may have a much greater
influence on outcome than the contribution made by
approach-specific theory and technique. In an early review of
empirical studies cited,common therapeutic factors accounted for
30% of the therapeutic effect, technique 15%, expectancy (placebo
effect) 15%, and spontaneous remission 40%.1
There are 76.3 million people with alcohol use disorders
world.wide and 15.3 million with drug use disorders. Motivational
interviewing is a client-centred, semi-directive method for
enhanc.ing intrinsic motivation to change by exploring and
resolving ambivalence. The client and counsellor typically meet
between 1 and 4 times for about 1 hour each time. The intervention
is used widely, so, therefore, it is important to determine whether
it helps, harms or is ineffective.
Cochrane Systematic Review
Smedslund G, et al. Motivational interviewing for substance abuse.
Cochrane Reviews, 2011, Issue 5. Article No. CD008063. DOI:
10.1002/14651858.CD008063.pub2. This review contains 59 studies
involving 13,342 participants.
Further references 1. Lambert, M. Handbook of Eclectic
Psychotherapy. New York: Brunner Mazel; 1986:436Ð62.