MODELING AND MODIFYING MOTIVATION FOR CHANGE

治疗药物依赖的一个普遍认识到的障碍是明显缺乏 客户改变的动机。然而，目前还没有达成共识 关于如何最好地衡量和修改这种动机。这个项目 目的是阐明药物改变动机的结构 滥用/依赖，同时测试一种有前途的 增强动机的治疗方法。该项目还 代表了临床研究和基础科学的一种新的结合， 承诺的心理语言学，侧重于口头互动， 客户和治疗师。一系列的四项研究建议与客户 因药物问题接受门诊或住院治疗。的 前三个是动机增强疗法的随机试验 (MET)，这一程序在一系列先前的试验中显示是有效的， 减少酒精的使用和问题，当给药之前或代替 治疗这三项试验的目标人群均为女性 接受药物滥用治疗的门诊病人和住院病人 UNM-CASAA或阿尔伯克基退伍军人管理局的项目。医学中心科目 将随机接受或不接受MET干预， 进入治疗。第四项研究将审查 具有潜在成本效益的MET组形式。通过使用 广泛的常见预处理评估组合，这些样品还可以 结合因素和聚类分析， 结构。心理语言学分析将进行与自然 受试者关于药物使用的语言使用和改变的愿望， 根据先前关于语言的有趣发现， 承诺.随访将在3个月时进行（当影响最大时 预计将在6个月和12个月（以确定维持 变化和干预措施的长期影响）。一系列 将进行二次多变量分析，以确定 （在七个）动机领域最佳预测客户行为 改变（例如，治疗依从性，药物使用结果），并确定 “匹配”特征，标志着对MET的不同反应性。 除了明确评估MET的疗效外，该研究还将 贡献关于结构、影响和测量的新知识 客户端预处理动机特征，并可能产生 具有实际重要性的衡量和干预工具， 治疗毒品问题。

A widely recognized obstacle in treating drug dependence is apparent lack of client motivation for change. Yet there is no current consensus regarding how best to measure and modify such motivation. This project aims to clarify the construct structure of motivation for change in drug abuse/dependence, and simultaneously to test the efficacy of a promising therapeutic procedure for enhancing motivation. The project also represents a novel merger of clinical research and basic science regarding the psycholinguistics of commitment, focusing on verbal interactions of clients and therapists. A series of four studies is proposed with clients presenting for outpatient or inpatient treatment for drug problems. The first three are randomized trials of motivational enhancement therapy (MET), a procedure shown in a series of prior trials to be effective in reducing alcohol use and problems when administered prior to or in lieu of treatment. The target populations for these three trials are female outpatients, male Outpatients and inpatients entering drug abuse treatment programs at UNM-CASAA or the Albuquerque V.A. Medical Center. Subjects will be randomized to receive or not receive a MET intervention prior to entering treatment. A fourth study will examine the impact of a potentially cost-effective group form of MET. Through the use of an extensive common pretreatment assessment battery, these samples can also be combined to conduct factor and cluster analyses of motivational constructs. Psycholinguistic analyses will be conducted with natural language usage of subjects regarding their drug use and desire for change, following on interesting prior findings regarding the language of commitment. Follow-ups will be conducted at 3 months (when maximal impact is expected) and at 6 and 12 months (to determine the maintenance of prior changes and the longer-term impact of interventions). A series of secondary multivariate analyses will be conducted to determine which (among seven) motivational domains optimally predict client behavior change (e.g., treatment compliance, drug use outcomes), and to determine "matching' characteristics that mark differential responsiveness to MET. Beyond a clear evaluation of the efficacy of MET, the study will contribute new knowledge regarding the structure, impact, and measurement of client pretreatment motivational characteristics, and may yield measurement and intervention tools of practical importance in the treatment of drug problems.