Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study
Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study
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DOI：
10.1016/j.drugalcdep.2005.08.002
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发表时间：
2006-02-28
影响因子：
4.2
通讯作者：
Woody, GE
中科院分区：
文献类型：
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作者：
Carroll, KM;Ball, SA;Woody, GE
尽管近期强调将经实证验证的治疗方法纳入临床实践，但关于手册引导的行为疗法能否在标准临床实践中实施，以及采用此类技术是否与改善治疗效果相关，数据甚少。在一项多地点随机临床试验中，对将动机性访谈（MI）技术融入初次接触和评估环节的有效性进行了评估。参与者是423名在五个社区治疗机构接受门诊治疗的物质使用者，他们被随机分配，在每个地点要么接受标准的接诊/评估环节，要么接受融入了MI技术和策略的相同环节。临床医生来自参与项目的工作人员，他们也被随机分配，要么学习并实施MI，要么进行标准的接诊/评估环节。对315份环节录音带的独立分析表明，这两种治疗形式具有高度的可区分性，而且接受过MI实施培训的临床医生往往技能评分更高。关于治疗结果，就整个样本而言，被分配到MI组的参与者在28天的随访中留存率明显高于被分配到标准干预组的参与者。在28天或84天的随访中，MI对物质使用结果没有显著影响。结果表明，社区临床医生在接受培训和监督的情况下能够有效地实施MI，并且在治疗的最早阶段融入MI技术可能对治疗初期的留存率有积极影响。（c）2005爱思唯尔爱尔兰有限公司。保留所有权利。
Despite recent emphasis on integrating empirically validated treatment into clinical practice, there are little data on whether manual-guided behavioral therapies can be implemented in standard clinical practice and whether incorporation of such techniques is associated with improved outcomes. The effectiveness of integrating motivational interviewing (MI) techniques into the initial contact and evaluation session was evaluated in a multisite randomized clinical trial. Participants were 423 substance users entering outpatient treatment in five community-based treatment settings, who were randomized to receive either the standard intake/evaluation session at each site or the same session in which MI techniques and strategies were integrated. Clinicians were drawn from the staff of the participating programs and were randomized either to learn and implement MI or to deliver the standard intake/evaluation session. Independent analyses of 315 session audiotapes suggested the two forms of treatment were highly discriminable and that clinicians trained to implement MI tended to have higher skill ratings. Regarding outcomes, for the sample as a whole, participants assigned to MI had significantly better retention through the 28-day follow-up than those assigned to the standard intervention. There were no significant effects of MI on substance use outcomes at either the 28-day or 84-day follow-up. Results suggest that community-based clinicians can effectively implement MI when provided training and supervision, and that integrating MI techniques in the earliest phases of treatment may have positive effects on retention early in the course of treatment. (c) 2005 Elsevier Ireland Ltd. All rights reserved.