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Motivational Interviewing (motivational + interviewing)

Distribution by Scientific Domains

Medical Sciences	64%
Psychology	33%

Selected Abstracts

MOTIVATIONAL INTERVIEWING AS AN INTERVENTION FOR AT-RISK COUPLES

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 3 2001
James V. Cordova
First page of article [source]

A DISMANTLING TRIAL OF MOTIVATIONAL INTERVIEWING AND FEEDBACK AMONG HEAVY DRINKING COLLEGE STUDENTS

ALCOHOLISM, Issue 2008
ST Walters
Motivational Interviewing (MI) is a brief intervention that has been shown to reduce heavy drinking among college students. To date, all college studies of MI (and most adult studies) have used an intervention format that includes a feedback profile delivered in an MI style. This presentation will discuss the results of a dismantling trial of motivational interviewing, and feedback among heavy drinking college students. After an initial screen, 350 heavy drinking students were randomized to: (1) MI with feedback, (2) MI without feedback, (3) Web feedback only, (4) Assessment only, or (5) Delayed assessment only. At 6 months, only MI with feedback showed an effect over control in reducing drinks per week, peak BAC, and drinking related consequences. Neither MI nor feedback alone had an effect over assessment. Drinking severity moderated the effect of the interventions. [source]

Motivational Interviewing in Health Care: Helping Patients Change Behavior

DRUG AND ALCOHOL REVIEW, Issue 3 2009
Dana Wong
[source]

Development of a structured generic drug intervention model for public health purposes: a brief application of motivational interviewing with young people

DRUG AND ALCOHOL REVIEW, Issue 4 2003
JIM MCCAMBRIDGE
Abstract Brief applications of Motivational Interviewing (MI) emerged around 15 years ago to target problematic alcohol and other drug use. Interventions which specifically target illicit drug use, young people, or which are delivered in settings other than health-care services have, however, been relatively slow to develop. The needs of young people for interventions distinct from those offered to adults are considered, as a precursor to an outline of the structure of a newly adapted intervention targeting drug use in general among young people. Based upon earlier topic-based approaches developed by Rollnick et al. this intervention is innovative in simultaneously targeting a range of drugs in pursuit of secondary prevention objectives, while also seeking to manifest the spirit of MI. The intervention consists of a single-session face-to-face conversation of up to 60 minutes duration. Data are presented which describe the development and conduct of this intervention during the course of an efficacy trial, with promising efficacy data themselves reported elsewhere. Observations are made on intervention delivery and consideration is given to implications for further novel targeting of young people and within the field of addiction interventions more generally. [source]

Randomized controlled trial of a brief intervention for problematic prescription drug use in non-treatment-seeking patients

ADDICTION, Issue 1 2009
Anne Zahradnik
ABSTRACT Aims Dependence on or problematic use of prescription drugs (PD) is estimated to be between 1 and 2% in the general population. In contrast, the proportion of substance-specific treatment in PD use disorders at 0.5% is comparatively low. With an estimated prevalence of 4.7%, PD-specific disorders are widespread in general hospitals compared to the general population. Brief intervention delivered in general hospitals might be useful to promote discontinuation or reduction of problematic prescription drug use. Design A randomized, controlled clinical trial. Setting Internal, surgical and gynaecological wards of a general and a university hospital. Participants One hundred and twenty-six patients fulfilling criteria for either regular use of PD (more than 60 days within the last 3 months) or dependence on or abuse of PD, respectively, were allocated randomly to two conditions. Intervention Subjects received two counselling sessions based on Motivational Interviewing plus an individualized written feedback (intervention group, IG) or a booklet on health behaviour (control group, CG). Measurements The outcome was measured as reduction (>25%) and discontinuation of PD intake in terms of defined daily dosages (DDD). Findings After 3 months, more participants in the IG reduced their DDD compared to the participants in the CG (51.8% versus 30%; ,2 = 6.17; P = 0.017). In the IG 17.9%, in the CG 8.6% discontinued use of PD (,2 = 2.42; P = 0.17). Conclusions Brief intervention based on Motivational Interviewing is effective in reducing PD intake in non-treatment-seeking patients. [source]

Clinician stance in the treatment of chronic eating disorders

EUROPEAN EATING DISORDERS REVIEW, Issue 6 2001
Josie Geller
Abstract Long-term outcome studies of anorexia nervosa have shown that a significant number of individuals do not fully recover from their eating disorder symptoms. Individuals who develop chronic eating disorders may express either strong ambivalence about symptom reduction or a complete lack of interest in change. As a result, clinicians can find this group particularly challenging. This report expands upon a treatment stance based on principles of Motivational Interviewing that addresses difficulties typically encountered in working with this population. The stance outlines a mission statement and specific clinician behaviours that promote engagement and alliance with this group, including the communication of beliefs that foster client self-acceptance, not making assumptions, being curious, active, and on the same side, and maximizing client responsibility for change. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review

ADDICTION, Issue 12 2001
Chris Dunn
Aims. To examine the effectiveness of brief behavioral interventions adapting the principles and techniques of Motivational Interviewing (MI) to four behavioral domains: substance abuse, smoking, HIV risk and diet/exercise. Design. We conducted a systematic review of 29 randomized trials of MI interventions. Data on methodological quality were extracted and tabulated. Between-group behavior change effect sizes and confidence intervals were calculated for each study. Findings. Due to varying intervention time lengths, targeted problem behaviors, settings and interventionists' backgrounds and skill levels, outcomes were not combined meta-analytically. Sixty per cent of the 29 studies yielded at least one significant behavior change effect size. No significant association between length of follow-up time and magnitude of effect sizes was found across studies. There was substantial evidence that MI is an effective substance abuse intervention method when used by clinicians who are non-specialists in substance abuse treatment, particularly when enhancing entry to and engagement in more intensive substance abuse treatment treatment-as-usual. Data were inadequate to judge the effect of MI in the other domains. Client attribute-treatment interactions were understudied and the sparse and inconsistent findings revealed little about the mechanism by which MI works or for whom it works best. Conclusion. To determine more effectively how well MI works in domains other than substance abuse and for whom it works best in all domains, researchers should study MI with risk behaviors other than substance abuse, while examining both interactions and the theoretical components of MI. [source]

Brief Motivational Interviewing for DWI Recidivists Who Abuse Alcohol and Are Not Participating in DWI Intervention: A Randomized Controlled Trial

ALCOHOLISM, Issue 2 2010
Thomas G. Brown
Background:, Driving while impaired (DWI) recidivists with unresolved alcohol use problems pose an ongoing risk for traffic safety. Following conviction, many do not participate in mandated alcohol evaluation and intervention programs, or continue to drink problematically after being relicensed. This study investigated if, in DWI recidivists with alcohol problems and not currently involved in DWI intervention, Brief Motivational Interviewing (BMI) produced greater reductions in risky drinking at 6- and 12-month follow-up compared to an information-advice control condition. Additional analyses explored whether BMI was associated with greater readiness to change, subsequent substance abuse treatment service utilization, and satisfaction compared to the control condition. Methods:, Male and female recidivists with drinking problems and not currently engaged in DWI intervention were recruited, evaluated, and then randomly assigned to receive 1 of 2 manualized interventions: 30-minute BMI session or information-advice. Participants, interviewers, researchers, and statisticians were blind to assignment. Outcomes were changed in: percent of risky drinking days (i.e., ,3 standard drinks/d for males; ,2 for females) in the previous 6 months derived from the Timeline Followback, biomarkers of alcohol abuse (GGT, AST, ALT, MCV) by blood assay, and alcohol abuse-related behaviors using the MMPI-Mac scale. Data from the Readiness to Change Questionnaire, a substance abuse service utilization questionnaire, and the Client Satisfaction Scale were also collected. Results:, Analyses revealed significant declines in risky drinking with both interventions. BMI (n = 92) resulted in a 25% reduction in risky drinking days at 12-month follow-up, which compared to the control intervention (n = 92) represented a significant decline from 6-month levels. Exposure to BMI also produced significantly greater improvement at 6-month follow-up in a biomarker of alcohol abuse and a behavioral measure related to recidivism risk. Exploration of readiness to change, substance abuse service utilization, and satisfaction with intervention indicated a perception of BMI being more useful in coping with problems. Conclusions:, Brief MI approaches warrant further implementation and effectiveness research as an opportunistic DWI intervention strategy to reduce risks associated with alcohol use outside of clinical and DWI relicensing settings. [source]

A DISMANTLING TRIAL OF MOTIVATIONAL INTERVIEWING AND FEEDBACK AMONG HEAVY DRINKING COLLEGE STUDENTS

A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drug

DRUG AND ALCOHOL REVIEW, Issue 3 2003
Dr ROBERT J. TAIT
Abstract The aim of this paper is to evaluate the effectiveness of brief interventions (BI) with adolescents (mean age < 20) in reducing alcohol, tobacco or other drug (ATOD) use by means of a systematic review of BI for adolescent substance use in the English language literature up to 2002. We identified 11 studies involving 3734 adolescents. Follow-up ranged from 6 weeks to 24 months. Motivational interviewing was the predominant approach, underpinning eight studies: the remaining three provided personalized health information. Seven papers reported outcomes for alcohol interventions and four involved other substances (including one with separate alcohol outcomes). The overall effect size was d= 0.126 with borderline homogeneity (Q = 14.9, df = 9, p = 0.09). The effect size from the eight alcohol interventions (n = 1075) was classified as significant but "small" (d = 0.275). The remaining non-alcohol studies were considered separately as interventions involving tobacco or multiple substance use. The two interventions with tobacco involved a substantial sample (n = 2626) but had a very small effect (d = 0.037), while the two interventions addressing multiple substances involved few participants (n = 110) but had a medium , large effect (d = 0.78). Across a diverse range of settings (dental clinic, schools, universities, substance treatment centres) and, therefore, probably diverse clients, BI conferred benefits to adolescent substance users. BI had a small effect on alcohol consumption and related measures. The data for tobacco interventions suggested a very small reduction, particularly with general community interventions. The effect of BI with multiple substances appears substantial but the small sample cautions against expansive generalization. [source]

Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence

ADDICTION, Issue 5 2009
Timothy R. Apodaca
ABSTRACT Aims Motivational interviewing (MI) is an efficacious treatment for substance use disorders. However, little is known about how MI exerts its therapeutic effects. This review is a first attempt to summarize and evaluate the evidence for purported within-session mechanisms of change. The primary question of interest was: which MI constructs and variables appear to be the most promising candidates for mechanisms of change? Methods Literature searches were conducted to identify studies delivering MI in an individual format for the treatment of substance use disorders. Our search identified a total of 152 studies for review; 19 studies met inclusion criteria by providing data on at least one link in the causal chain model under examination. Effect size estimates were calculated for every possible step in the causal model where sufficient data were provided by study authors. Results Four constructs of therapist behavior were evaluated: MI-Spirit, MI-Consistent behaviors, MI-Inconsistent behaviors and therapist use of specific techniques. Five constructs of client behavior were evaluated: change talk/intention, readiness to change, involvement/engagement, resistance and the client's experience of discrepancy. The absence of experimental and full mediation studies of mechanisms of change was notable. Effect sizes were generally mixed. Conclusions The most consistent evidence was found for three constructs: client change talk/intention (related to better outcomes); client experience of discrepancy (related to better outcomes); and therapist MI-Inconsistent behavior (related to worse outcomes). Regarding therapist use of specific techniques, use of a decisional balance exercise showed the strongest association to better outcomes. [source]

Motivational interviewing and the incredible shrinking treatment effect

ADDICTION, Issue 4 2005
WILLIAM R. MILLER
No abstract is available for this article. [source]

Motivational interviewing with a depressed adolescent

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2009
Amanda E. Brody
Abstract Motivational interviewing (MI) is a potentially useful tool for clinicians who are exploring ways to improve treatment outcomes with depressed clients. MI techniques may be particularly appropriate with depressed adolescents, for whom motivation to engage in therapy is often a problem and who often experience ambivalence about life choices. The present article presents a case description of MI with a depressed adolescent who was ambivalent about what life change to pursue. MI was used to help the client identify conflicts between her values, learn how they were contributing to her distress, and move toward resolving them. Advantages and limitations of these techniques are discussed. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,12, 2009. [source]

Beyond behavior: eliciting broader change with motivational interviewing,

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2009
Christopher C. Wagner
Abstract Descriptions of Motivational interviewing (MI) usually focus on helping clients change a single problematic behavior. In contrast, the current case study shows that MI can serve as a more comprehensive psychotherapy, focused not only on multiple problem behaviors but also on broader change consistent with its roots in client-centered therapy. In this case, the therapist interwove a focus on several discrete behaviors with a focus on broader lifestyle change as well as increased clarity of client cognitions, values, and choices, resulting in several lasting changes. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1,15, 2009. [source]

Tailoring cognitive-behavioral therapy for chronic pain: A case example

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2006
Alicia A. Heapy
Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment for chronic pain. However, many patients who might benefit from this treatment either refuse treatment, fail to adhere to treatment recommendations, or drop out prematurely. Adherence to and engagement in CBT for chronic pain might be improved by tailoring a limited number of its components to individual preferences. Motivational interviewing, in which the therapist facilitates the patient's motivation for changing behavior, might also promote CBT engagement and adherence. We describe components of a tailored CBT treatment for chronic pain in the context of ongoing research and illustrate the process of tailoring CBT with a case study. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 1345,1354, 2006. [source]

How reliable is the current evidence looking at the efficacy of harm reduction and motivational interviewing interventions in the treatment of patients with a dual diagnosis?

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2007
C. J. LAKER ba bsc rmn
Current policy from the Department of Health advocates for an integrated approach to treating patients with a dual diagnosis. However, pragmatic and clinically effective brief interventions that can be delivered by nurses across mental health settings remain underdeveloped. Motivational interviewing has had some successful exposure in the field of dual diagnosis; however, harm reduction remains unexplored both conceptually and in terms of clinical intervention. This literature review examines the notion of harm reduction as a method of identifying and reducing the harm associated with the misuse of drugs and alcohol in relation to mental health problems. Currently there is a paucity of good quality evidence for integrated interventions in the treatment of dually diagnosed patients. Therefore, the papers are analysed in respect of their methodological quality and contribution to the evidence base to inform both future research and mental health nursing practice. [source]

Motivational interviewing in musculoskeletal care

MUSCULOSKELETAL CARE, Issue 4 2007
Robert Shannon BSc MSc
Abstract Motivational interviewing is a patient-centred counselling method designed to build motivation for behaviour change by resolving ambivalence. It was developed in the addictions field and has since been applied to medical and health promotion settings. This paper will provide a brief overview of the method and will discuss how it may be used in consultations for patients with musculoskeletal problems to increase engagement with treatment and to build motivation for helpful behaviour change. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Motivational interviewing for adherence problems in cystic fibrosis

PEDIATRIC PULMONOLOGY, Issue 3 2010
Alistair J.A. Duff
Abstract This review focuses on adherence in cystic fibrosis (CF), and the factors known to influence it. In particular, it discusses the importance of effective communication in clinical settings and considers the evidence for the effectiveness of motivational interviewing (MI), to increase adaptation and adherence in physical health and CF. The review also contains an overview of the key concepts of MI, its' practice in medical settings and recommendations on how to adopt MI techniques in the routine care of people with CF. Pediatr Pulmonol. 2010; 45:211,220. © 2010 Wiley-Liss, Inc. [source]

Practitioner Review: When parent training doesn't work: theory-driven clinical strategies

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 12 2009
Stephen Scott
Improving the parent,child relationship by using strategies based on social learning theory has become the cornerstone for the treatment of conduct problems in children. Over the past 40 years, interventions have expanded greatly from small, experimental procedures to substantial, systematic programmes that provide clear guidelines in detailed manuals on how practitioners should implement the standardised treatments. They are now widely disseminated and there is a great deal of empirical support that they are very effective for the majority of cases. However, evaluations of even the best of these evidence-based programmes show that a quarter to a third of families and their children do not benefit. What does the practitioner then do, when a standard social learning approach, diligently applied, doesn't work? We argue that under these circumstances, some of the major theories of child development, family functioning and individual psychology can help the skilled practitioner think his or her way through complex clinical situations. This paper describes a set of practical strategies that can then be flexibly applied, based on a systematic theoretical analysis. We hold that social learning theory remains the core of effective parent training interventions, but that ideas from attachment theory, structural family systems theory, cognitive-attribution theory, and shared empowerment/motivational interviewing can each, according to the nature of the difficulty, greatly enrich the practitioner's ability to help bring about change in families who are stuck. We summarise each of these models and present practical examples of when and how they may help the clinician plan treatment. [source]

Postgraduate education for doctors in smoking cessation

DRUG AND ALCOHOL REVIEW, Issue 5 2009
NICHOLAS A. ZWAR
Abstract Introduction and Aims. Smoking cessation advice from doctors helps improve quit rates but the opportunity to provide this advice is often missed. Postgraduate education is one strategy to improve the amount and quality of cessation support provided. This paper describes a sample of postgraduate education programs for doctors in smoking cessation and suggests future directions to improve reach and quality. Design and Methods. Survey of key informants identified through tobacco control listserves supplemented by a review of the published literature on education programs since 2000. Programs and publications from Europe were not included as these are covered in another paper in this Special Issue. Results. Responses were received from only 21 key informants from eight countries. Two further training programs were identified from the literature review. The following components were present in the majority of programs: 5 As (Ask, Advise, Assess, Assist and Arrange) approach (72%), stage of change (64%), motivational interviewing (72%), pharmacotherapies (84%). Reference to clinical practice guidelines was very common (84%). The most common model of delivery of training was face to face. Lack of interest from doctors and lack of funding were identified as the main barriers to uptake and sustainability of training programs. Discussion and Conclusions. Identifying programs proved difficult and only a limited number were identified by the methods used. There was a high level of consistency in program content and a strong link to clinical practice guidelines. Key informants identified limited reach into the medical profession as an important issue. New approaches are needed to expand the availability and uptake of postgraduate education in smoking cessation.[Zwar NA, Richmond RL, Davidson D, Hasan I. Postgraduate education for doctors in smoking cessation. Drug Alcohol Rev 2009;28:466,473] [source]

Development of a structured generic drug intervention model for public health purposes: a brief application of motivational interviewing with young people

Results from two randomized clinical trials evaluating the impact of quarterly recovery management checkups with adult chronic substance users

ADDICTION, Issue 6 2009
Christy K Scott
ABSTRACT Aims Post-discharge monitoring and early reintervention have become standard practice when managing numerous chronic conditions. These two experiments tested the effectiveness of recovery management checkup (RMC) protocols for adult chronic substance users. Intervention RMC included quarterly monitoring; motivational interviewing to provide personalized feedback and to resolve ambivalence about substance use; treatment linkage, engagement and retention protocols to increase the amount of treatment received. Participants and setting Recruited from sequential addiction treatment admissions, participants in the two experiments were, on average, 36 and 38 years of age, mainly female (59% versus 46%), African American (85% versus 80%) and met past-year criteria for dependence (87% versus 76%). Design Participants in both experiments were assigned randomly to the RMC or control condition and interviewed quarterly for 2 years. Measurement The Global Appraisal of Individual Needs (GAIN) was the main assessment instrument. Findings RMC participant outcomes were better than control participants in both experiments. Effect sizes were larger in the second experiment in terms of reducing days to readmission (Cohen's d = 0.41 versus d = 0.22), successive quarters in the community using substances (d = ,0.32 versus ,0.19), past-month symptoms of abuse/dependence (d = ,0.23 versus ,0.02) and increasing the days of abstinence over 2 years (d = +0.29 versus 0.04). Conclusion RMC, which provided ongoing monitoring and linkage, is feasible to conduct and is effective for adults with chronic substance dependence. [source]

Mechanisms of change in motivational interviewing: a review and preliminary evaluation of the evidence

Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: a randomized controlled trial of clinical efficacy

ADDICTION, Issue 3 2009
Frances J. Kay-Lambkin
ABSTRACT Aims To evaluate computer- versus therapist-delivered psychological treatment for people with comorbid depression and alcohol/cannabis use problems. Design Randomized controlled trial. Setting Community-based participants in the Hunter Region of New South Wales, Australia. Participants Ninety-seven people with comorbid major depression and alcohol/cannabis misuse. Intervention All participants received a brief intervention (BI) for depressive symptoms and substance misuse, followed by random assignment to: no further treatment (BI alone); or nine sessions of motivational interviewing and cognitive behaviour therapy (intensive MI/CBT). Participants allocated to the intensive MI/CBT condition were selected at random to receive their treatment ,live' (i.e. delivered by a psychologist) or via a computer-based program (with brief weekly input from a psychologist). Measurements Depression, alcohol/cannabis use and hazardous substance use index scores measured at baseline, and 3, 6 and 12 months post-baseline assessment. Findings (i) Depression responded better to intensive MI/CBT compared to BI alone, with ,live' treatment demonstrating a strong short-term beneficial effect which was matched by computer-based treatment at 12-month follow-up; (ii) problematic alcohol use responded well to BI alone and even better to the intensive MI/CBT intervention; (iii) intensive MI/CBT was significantly better than BI alone in reducing cannabis use and hazardous substance use, with computer-based therapy showing the largest treatment effect. Conclusions Computer-based treatment, targeting both depression and substance use simultaneously, results in at least equivalent 12-month outcomes relative to a ,live' intervention. For clinicians treating people with comorbid depression and alcohol problems, BIs addressing both issues appear to be an appropriate and efficacious treatment option. Primary care of those with comorbid depression and cannabis use problems could involve computer-based integrated interventions for depression and cannabis use, with brief regular contact with the clinician to check on progress. [source]

What is this thing called motivational interviewing?

ADDICTION, Issue 3 2007
STEVE ALLSOP
No abstract is available for this article. [source]

When smokers are resistant to change: experimental analysis of the effect of patient resistance on practitioner behaviour

ADDICTION, Issue 8 2005
Nick Francis
ABSTRACT Aims In the field of motivational interviewing, practitioner confrontational behaviour has been associated with lower levels of patient behaviour change. We set out to explore whether resistance to change among smokers affects practitioner confrontational and other behaviours. Design Experimental manipulation of levels of patient resistance in a role play. Setting The study was conducted at the start of a 2-day health behaviour change workshop. Participants Thirty-two practitioners who had registered for the workshop. Intervention The practitioners were assigned randomly to interview a standardized patient (actor) who portrayed a smoker who had been briefed to display either high or low levels of resistance to change. Measurements Interviews were audiotaped and transcribed. Practitioners and standardized patients completed interview ratings at the end of each interview. After listening to each taped interview practitioners were assigned a global score for confrontation, empathy and expert instructional style. Interviews were then submitted to a qualitative analysis. Findings Higher levels of practitioner confrontational behaviour were observed in the high resistance group. This was evident both from the global scores (median 2 versus 0, P = 0.001) and the qualitative analysis. Global scores for empathy and expert instruction were not significantly different. Qualitative analysis also suggests a pervasive negative impact on other practitioner behaviours. Conclusions Higher patient resistance probably leads to an increase in confrontational and other negative behaviours in health professionals attempting to promote behaviour change. This challenges important assumptions about the influence of practitioner behaviour on patient behaviour and subsequent health-related outcomes. [source]

Collaborative care between professionals and non-professionals in the management of eating disorders: a description of workshops focussed on interpersonal maintaining factors

EUROPEAN EATING DISORDERS REVIEW, Issue 1 2007
J. Treasure
Abstract The aim of this paper is to describe the content and processes involved in a series of workshops for carers of people with an eating disorder. These workshops were designed to equip carers with the skills and knowledge needed to be a ,coach' and help the person with an eating disorder break free from the traps that block recovery. The first hurdle is to overcome the unhelpful patterns of interpersonal processes between the person with an eating disorder and their carers. In both naturalistic studies and randomised controlled trials (RCT), family factors have been implicated either as moderators or mediators of outcome. High levels of expressed emotion (EE), misattributions about the illness or unhelpful methods of engaging with the eating disorder symptoms contribute to this effect. These workshops aim to reduce EE such as over protection. Carers are introduced to the transtheoretical model of change and the principles of motivational interviewing so that they can help rather than hinder change. They learn how to use reflective listening to reduce confrontation and how to sidestep resistance. Carers learn what is needed to help their daughter change by reflecting on the processes involved in changing their own behaviours in relationship with the person with eating disorders. Once they recognise that they may need to change then they can use their skills, information and insight to help change eating disorder symptoms. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review

Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review

JOURNAL OF ADVANCED NURSING, Issue 2 2009
Michelle Cleary
Abstract Title.,Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review. Aim., This study is a report of a systematic review to assess current evidence for the efficacy of psychosocial interventions for reducing substance use, as well as improving mental state and encouraging treatment retention, among people with dual diagnosis. Background., Substance misuse by people with a severe mental illness is common and of concern because of its many adverse consequences and lack of evidence for effective psychosocial interventions. Data sources., Several electronic databases were searched to identify studies published between January 1990 and February 2008. Additional searches were conducted by means of reference lists and contact with authors. Review methods., Results from studies using meta-analysis, randomized and non-randomized trials assessing any psychosocial intervention for people with a severe mental illness and substance misuse were included. Results., Fifty-four studies were included: one systematic review with meta-analysis, 30 randomized controlled trials and 23 non-experimental studies. Although some inconsistencies were apparent, results showed that motivational interviewing had the most quality evidence for reducing substance use over the short term and, when combined with cognitive behavioural therapy, improvements in mental state were also apparent. Cognitive behavioural therapy alone showed little consistent support. Support was found for long-term integrated residential programmes; however, the evidence is of lesser quality. Contingency management shows promise, but there were few studies assessing this intervention. Conclusion., These results indicate the importance of motivational interviewing in psychiatric settings for the reduction of substance use, at least in the short term. Further quality research should target particular diagnoses and substance use, as some interventions may work better for some subgroups. [source]

Therapist empathy and client anxiety reduction in motivational interviewing: "She carries with me, the experience"

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2009
Lynne E. Angus
Abstract In this article, we examine the use of motivational interviewing (MI) to treat generalized anxiety disorder (GAD) by means of case illustration that focuses on four categories drawn from the client's experience of the key ingredients in MI therapy. The case illustration, drawn from the York study on combining MI and cognitive behavior therapy in the treatment of GAD (uses the client's pre- and post-therapy narrative interviews) to arrive at categories representative of the client's experience of MI therapy. The results of the qualitative analysis highlight the key contributions to positive client outcomes and readiness for change in brief MI therapy for GAD. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,12, 2009. [source]