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Motivational Interview (motivational + interview)
Selected AbstractsA Brief Motivational Interview in a Pediatric Emergency Department, Plus 10-day Telephone Follow-up, Increases Attempts to Quit Drinking Among Youth and Young Adults Who Screen Positive for Problematic DrinkingACADEMIC EMERGENCY MEDICINE, Issue 8 2010Judith Bernstein RNC ACADEMIC EMERGENCY MEDICINE 2010; 17:890,902 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, Adolescents in their late teens and early 20s have the highest alcohol consumption in the United States; binge drinking peaks at age 21-25 years. Underage drinking is associated with many negative consequences, including academic problems and risk of intentional and unintentional injuries. This study tested the effectiveness of pediatric emergency department (PED) screening and brief intervention to reduce alcohol consumption and associated risks. Methods:, A three-group randomized assignment trial was structured to test differences between intervention (I) and standard assessed control (AC) groups in alcohol consumption and alcohol-related behaviors from baseline to 12 months and to compare the AC group with a minimally assessed control (MAC) group to adjust for the effect of assessment reactivity on control group behavior. Patients aged 14,21 years were eligible if they screened positive on the Alcohol Use Disorders Identification Test (AUDIT) or for binge drinking or high-risk behaviors. The MAC group received a resource handout, written advice about alcohol-related risks, and a 12-month follow-up appointment. Patients in the AC group were assessed using standardized instruments in addition to the MAC protocol. The I group received a peer-conducted motivational intervention, referral to community resources and treatment if indicated, and a 10-day booster in addition to assessment. Measurements included 30-day self-report of alcohol consumption and alcohol-related behaviors, screens for depression and posttraumatic stress disorder, and self-report of attempts to quit, cut back, or change conditions of use, all repeated at follow-up. Motor vehicle records and medical records were also analyzed for changes from baseline to 1-year follow-up. Results:, Among 7,807 PED patients screened, 1,202 were eligible; 853 enrolled (I, n = 283; AC, n = 284; MAC, n = 286), with a 12-month follow-up rate of 72%. At 12 months, more than half of enrollees in Reaching Adolescents for Prevention (RAP) attempted to cut back on drinking, and over a third tried to quit. A significantly larger proportion of the I group made efforts to quit drinking and to be careful about situations when drinking compared to AC enrollees, and there was a numerically but not significantly greater likelihood (p = 0.065) among the I group for efforts to cut back on drinking. At 3 months, the likelihood of the I group making attempts to cut back was almost triple that of ACs. For efforts to quit, it was double, and for trying to be careful about situations when drinking, there was a 72% increase in the odds ratio (OR) for the I group. Three-month results for attempts were sustained at 12 months for quit attempts and efforts to be careful. Consumption declined in both groups from baseline to 3 months to 12 months, but there were no significant between-group differences in alcohol-related consequences at 12 months or in alcohol-related risk behaviors. We found a pattern suggestive of assessment reactivity in only one variable at 12 months: the attempt to cut back (73.3% for the I group vs. 64.9% among the AC group and 54.8% among the MAC group). Conclusions:, Brief motivational intervention resulted in significant efforts to change behavior (quit drinking and be careful about situations while drinking) but did not alter between-group consumption or consequences. [source] Six-month outcomes associated with a brief alcohol intervention for adult in-patients with psychiatric disordersDRUG AND ALCOHOL REVIEW, Issue 2 2002GARY K. HULSE Abstract The objective of this study was to evaluate the 6-month outcomes of a brief intervention to reduce alcohol consumption by psychiatric in-patients in the general hospital setting and following resolution of psychiatric morbidity. Patients from the psychiatric wards of three general hospitals were screened using the Alcohol Use Disorders Identification Test. Of 144 people approached who matched the study criteria, 120 (83%) people aged 18,64 years (mean 31.7) were recruited. Participants were randomized to either a brief motivational interview or an information package to reduce alcohol consumption. Alcohol consumption was assessed as total weekly consumption and categorized on Australian National Health and Medical Research Council (NH&MRC) criteria. We delivered 62 motivational interviews and 58 information packages. At the 6-month follow-up 83 (69%), participants were reassessed. Both groups had significantly reduced alcohol consumption. However, the motivation group had a significantly greater reduction in weekly consumption than the information group (F = 6.8, (1,65) p < 0.025) after controlling for age, sex, SCL-90-R GSI and alcohol dependence (and baseline alcohol consumption). A greater proportion of the motivation group compared to the information group also ,improved' in their classification on NH&MRC criteria (,2 = 7.3, df 1, p < 0.01). Brief interventions, especially motivational interviews, are effective in reducing alcohol use in persons with psychiatric disorders. They are effective across the mid-range of GSI severity scores for in-patients. Screening and brief interventions can and should be incorporated into the routine assessment and management in psychiatric units. [source] Moderators and mediators of two brief interventions for alcohol in the emergency departmentADDICTION, Issue 3 2010Nancy P. Barnett ABSTRACT Objective To evaluate moderators and mediators of brief alcohol interventions conducted in the emergency department. Methods Patients (18,24 years; n = 172) in an emergency department received a motivational interview with personalized feedback (MI) or feedback only (FO), with 1- and 3-month booster sessions and 6- and 12-month follow-ups. Gender, alcohol status/severity group [ALC+ only, Alcohol Use Disorders Identification Test (AUDIT+) only, ALC+/AUDIT+], attribution of alcohol in the medical event, aversiveness of the event, perceived seriousness of the event and baseline readiness to change alcohol use were evaluated as moderators of intervention efficacy. Readiness to change also was evaluated as a mediator of intervention efficacy, as were perceived risks/benefits of alcohol use, self-efficacy and alcohol treatment seeking. Results Alcohol status, attribution and readiness moderated intervention effects such that patients who had not been drinking prior to their medical event, those who had low or medium attribution for alcohol in the event and those who had low or medium readiness to change showed lower alcohol use 12 months after receiving MI compared to FO. In the AUDIT+ only group those who received MI showed lower rates of alcohol-related injury at follow-up than those who received FO. Patients who had been drinking prior to their precipitating event did not show different outcomes in the two interventions, regardless of AUDIT status. Gender did not moderate intervention efficacy and no significant mediation was found. Conclusions Findings may help practitioners target patients for whom brief interventions will be most effective. More research is needed to understand how brief interventions transmit their effects. [source] Six-month outcomes associated with a brief alcohol intervention for adult in-patients with psychiatric disordersDRUG AND ALCOHOL REVIEW, Issue 2 2002GARY K. HULSE Abstract The objective of this study was to evaluate the 6-month outcomes of a brief intervention to reduce alcohol consumption by psychiatric in-patients in the general hospital setting and following resolution of psychiatric morbidity. Patients from the psychiatric wards of three general hospitals were screened using the Alcohol Use Disorders Identification Test. Of 144 people approached who matched the study criteria, 120 (83%) people aged 18,64 years (mean 31.7) were recruited. Participants were randomized to either a brief motivational interview or an information package to reduce alcohol consumption. Alcohol consumption was assessed as total weekly consumption and categorized on Australian National Health and Medical Research Council (NH&MRC) criteria. We delivered 62 motivational interviews and 58 information packages. At the 6-month follow-up 83 (69%), participants were reassessed. Both groups had significantly reduced alcohol consumption. However, the motivation group had a significantly greater reduction in weekly consumption than the information group (F = 6.8, (1,65) p < 0.025) after controlling for age, sex, SCL-90-R GSI and alcohol dependence (and baseline alcohol consumption). A greater proportion of the motivation group compared to the information group also ,improved' in their classification on NH&MRC criteria (,2 = 7.3, df 1, p < 0.01). Brief interventions, especially motivational interviews, are effective in reducing alcohol use in persons with psychiatric disorders. They are effective across the mid-range of GSI severity scores for in-patients. Screening and brief interventions can and should be incorporated into the routine assessment and management in psychiatric units. [source] |