MODELING AND MODIFYING MOTIVATION FOR CHANGE

治疗药物依赖的一个公认的障碍是明显缺乏 客户变革的动力。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 旨在阐明药物变革动因的结构 滥用/依赖，同时测试一种有希望的疗效 增强动力的治疗程序。该项目还 代表了临床研究和基础科学的一种新的合并 承诺的心理语言学，专注于 客户和心理医生。建议与客户进行一系列的四项研究 因药物问题而接受门诊或住院治疗。这个 前三项是激励增强疗法的随机试验 (MET)，一系列先前试验中显示有效的程序 减少酒精的使用和在服用前或替代服用时出现的问题 治疗。这三项试验的目标人群是女性。 门诊病人、男性门诊病人和住院病人进入药物滥用治疗 在UNM-CASAA或阿尔伯克基V.A.医疗中心的项目。科目 将随机接受或不接受MET干预 正在接受治疗。第四项研究将考察 具有潜在成本效益的大都会艺术博物馆小组形式。通过使用 广泛通用的前处理评估电池，这些样品也可以 结合对激励因素进行因子分析和聚类分析 构造。心理语言学分析将与自然 受试者关于他们的药物使用和改变的愿望的语言使用， 以下是关于语言的有趣的先前发现 承诺。将在3个月(影响最大时)进行跟踪 预计)，并在6个月和12个月(以确定维持先前 变化和干预措施的长期影响)。一系列 将进行二级多变量分析以确定 (在七个激励领域中)最佳地预测客户行为 改变(例如，治疗依从性、药物使用结果)，并确定 “匹配的‘特征，标志着对MET的不同反应。 除了对MET疗效的明确评估外，这项研究还将 提供有关结构、影响和测量的新知识 客户前处理的动机特征，并可能产生 具有实际意义的测量和干预工具 毒品问题的治疗。

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.