Efficacy of Group Motivational Interviewing

描述（由申请人提供）：双重诊断患者对善后治疗的依从性差是一个昂贵且普遍的健康问题，限制了住院戒毒的有效性。目前的策略，以提高遵守善后处理是最低限度的有效性。拟议的项目旨在通过研究将群体动机访谈（GMI）添加到住院精神病医院的标准治疗计划中，以改善现有的策略，这些计划适用于患有共存精神病和物质使用障碍的个人。该项目旨在显著提高对善后治疗（如AA/NA、门诊治疗）的依从性，并在仅进行标准住院治疗的基础上减少药物使用。该研究专门针对健康人2010年的目标，以减少对同时存在物质使用和精神问题的个人的治疗差距，并通过专门针对患者层面的障碍和动机来减少上个月使用酒精和非法物质。充分的证据表明，动机访谈（MI）显着减少药物滥用和增加治疗的参与。因此，MI在住院环境中的应用前景广阔，可能代表着所提供的治疗服务的重大升级。然而，MI传统上是一对一提供的。该项目旨在以小组形式展示GMI的有效性。 在这一点实现之前，MI在依赖于团体治疗的住院或药物滥用治疗环境中仍将未得到充分利用。其结果是，尽管这种干预可能会给患者、他们的家庭和整个社区带来实质性的好处，但在住院治疗中，动机性访谈仍然无法实现。符合合格性标准的住院患者将使用区组随机化分配至GMI +标准治疗（ST）组或ST单药组。在入院、筛选和知情同意程序后，将邀请一组包含5-6名受试者的受试者完成治疗前问卷。分配接受GMI + ST的患者将被邀请在接下来的两天返回，参加两个90分钟的小组会议，以动机访谈的方式进行。单独接受ST的患者将被邀请在接下来的两天返回进行非实验组活动，以控制治疗师注意力的影响。在出院后的一个月和三个月随访期内，将联系所有参与者和旁系动物，以评估对后续治疗的依从性以及酒精和其他药物消耗率。

DESCRIPTION (provided by applicant): Poor compliance with aftercare treatment among dually diagnosed patients is a costly and pervasive health problem that limits the effectiveness of inpatient detoxification. Current strategies for improving compliance with aftercare treatment are minimally effective. The proposed project intends to improve current strategies by examining the impact of adding group motivational interviewing (GMI) to the standard treatment program of an inpatient psychiatric hospital for individuals with coexisting psychiatric and substance use disorders. The project aims to significantly improve compliance with aftercare treatment (e.g. AA/NA, outpatient therapy) and reduce substance use over standard inpatient treatment alone. The study specifically addresses Healthy People 2010 objectives to reduce the treatment gap for individuals with coexisting substance use and psychiatric problems and to reduce past-month use of alcohol and illicit substances by specifically targeting patient-level barriers and motivation. Ample evidence shows that motivational interviewing (MI) significantly reduces substance abuse and increases treatment engagement. As such, MI holds great promise for use in the inpatient setting and may represent a significant upgrade in the treatment services provided. However, MI is traditionally delivered one-on-one. The project seeks to demonstrate the efficacy of GMI in a group format. Until this is accomplished, MI will remain underutilized in inpatient or substance abuse treatment settings that rely on group therapy. The consequence is that motivational interviewing continues to go undelivered in inpatient settings despite the fact that this intervention may result in substantial benefits for patients, their families, and the community at large. Inpatients meeting eligibility criteria will be allocated to GMI + Standard Treatment (ST) or to ST alone using block randomization. Following admission, screening, and informed consent procedures, a group containing 5-6 participants will be invited to complete pretreatment questionnaires. Patients assigned to receive GMI + ST will be invited to return the following two days to attend two 90-minute group sessions delivered in the style of motivational interviewing. Patients receiving ST alone will be invited to return the following two days for a non-experimental group activity to control for therapist attention effects. All participants and collaterals will be contacted at a one and three month follow-up period after discharge to evaluate compliance with aftercare treatment and rate of alcohol and other drug consumption.