Motivational Interviewing, Enhancement, and Brief Interventions Over the Last Decade: A Review of Reviews of Efficacy and Effectiveness
Motivational Interviewing, Enhancement, and Brief Interventions Over the Last Decade: A Review of Reviews of Efficacy and Effectiveness
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DOI：
10.1037/adb0000318
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发表时间：
2017-12-01
影响因子：
3.4
通讯作者：
Knoblach, Daniel J.
中科院分区：
文献类型：
--
作者：
DiClemente, Carlo C.;Corno, Catherine M.;Knoblach, Daniel J.
动机是成瘾行为恢复的良好预测因素。旨在改变药物使用和赌博的治疗经常采用基于动机访谈（MI）原则的动机增强策略。这些方法在成瘾行为中的证据并不总是描绘出一幅清晰的画面。本综述的目的是检查过去十年中对各种滥用和赌博物质的基于动机的干预措施的现有综述，以更深入地了解当前证据及其对未来研究和临床实践的影响。进行了文献检索，以识别2007年1月1日至2017年1月30日期间关于酒精、烟草、毒品、大麻、可卡因、阿片类药物、甲基苯丙胺和赌博的动机增强干预的综述文章。在评估的144篇文章中，我们共纳入了34篇综述文章，包括6篇科克伦综述。这篇综述支持在成瘾行为中使用动机增强干预措施，最有力的证据支持在酒精和烟草中使用，简短的干预措施显示出很强的疗效。有强烈的支持MI与大麻和一些支持赌博。使用甲基苯丙胺或阿片剂的证据不足。有一些重要的警告。在大多数情况下，MI比不治疗更有效，并且与其他积极治疗一样有效（但不一定更有效）。更密集的动机干预或组合的有效性的调查结果是喜忧参半。治疗保真度评估、有限的亚群分析以及剂量、结局和方案规范的差异继续给审查带来重大问题。
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.