Motivational Enhancement Therapy for Alcohol-Related Intimate Partner Violence
(MET-SAH Trial)
Recruiting in Palo Alto (17 mi)
+3 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
No Placebo Group
Trial Summary
What is the purpose of this trial?This is a study to provide much-needed experimental data on the efficacy of a brief alcohol Motivational Enhancement Therapy (MET) pre-group intervention for Veterans receiving group treatment for IPV perpetration. The investigators will compare those assigned to receive this 2-session MET intervention to those receiving a 2-session Alcohol Education (AE) intervention or a 2-session standard treatment as usual (TAU) telephone monitoring intervention. The investigators will examine whether MET leads to greater reductions in alcohol use problems and IPV perpetration, and increased help-seeking behavior for alcohol use problems. Participants will be 300 Veterans drawn from the Strength at Home IPV intervention program across the entire Veterans Health Administration system.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It seems likely that you can continue your medications, as the study does not list any exclusion criteria related to medication use.
What data supports the effectiveness of the treatment Motivational Enhancement Therapy for Alcohol-Related Intimate Partner Violence?
Motivational Enhancement Therapy (MET) has been shown to help people recognize their alcohol problems and improve self-efficacy (confidence in their ability to change), which can reduce alcohol consumption and related issues. However, in the context of partner violence, MET did not show a unique benefit over other alcohol interventions in reducing alcohol use or partner violence.
12345Is Motivational Enhancement Therapy (MET) safe for humans?
Motivational Enhancement Therapy (MET) has been used safely in various settings, including for alcohol use disorders and in psychiatric inpatients with chemical dependence. The studies did not report any significant safety concerns, suggesting that MET is generally safe for humans.
12356How does Motivational Enhancement Therapy differ from other treatments for alcohol-related intimate partner violence?
Motivational Enhancement Therapy (MET) is unique because it focuses on increasing a person's motivation to change by helping them recognize and resolve their mixed feelings about their behavior. Unlike other treatments, MET is a brief, client-centered approach that emphasizes personal feedback and self-efficacy, which can be particularly effective in encouraging individuals to seek further treatment and reduce harmful behaviors.
12378Eligibility Criteria
This trial is for male Veterans at least 18 years old who are enrolled in the Strength at Home program and have alcohol-related problems. They must show evidence of these issues, like scoring high on a specific test (AUDIT), drinking heavily on occasions, or having committed IPV under the influence.Inclusion Criteria
I am a male Veteran, 18 or older, with alcohol-related issues, enrolled in Strength at Home, and I consent to participate.
Exclusion Criteria
Not applicable.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Pre-group Intervention
Participants receive a 2-session Motivational Enhancement Therapy (MET) or Alcohol Education (AE) intervention, or a standard treatment as usual (TAU) telephone monitoring intervention
2 sessions
IPV Group Treatment
Participants are assigned to Strength at Home groups for IPV intervention
3 months
Follow-up
Participants are monitored for safety and effectiveness after treatment, with assessments at multiple intervals
12 months
Baseline, post-treatment, three-month, six-month, nine-month, and twelve-month follow-ups
Participant Groups
The study tests if Motivational Enhancement Therapy (MET) can better reduce alcohol problems and IPV than an Alcohol Education intervention or standard phone monitoring. It's conducted with Veterans from three VA locations to see if MET also encourages seeking help for alcohol use.
3Treatment groups
Experimental Treatment
Group I: Telephone MonitoringExperimental Treatment2 Interventions
Brief supportive telephone monitoring sessions that are commonly delivered while Veterans wait to begin their groups (treatment as usual).
Group II: Motivational Enhancement TherapyExperimental Treatment2 Interventions
Motivational enhancement therapy for alcohol use problems, which includes empathic support, feedback and advice, strategies for enhancing self-efficacy, techniques for eliciting self-motivational statements from the participant, strategies for addressing participant ambivalence about change and participant resistance to change, and methods for eliciting and affirming commitment to a specific change plan (active intervention).
Group III: Alcohol Education ControlExperimental Treatment2 Interventions
Psychoeducational intervention intended to: (1) dispel myths about the effects of alcohol, (2) provide information about the general risks of drinking and process of recovery from alcohol problems, (3) provide information about the specific risks related to family relationships and IPV, (4) offer self-help program information and related strategies to address drinking problems, (5) promote and encourage healthy decision-making, and (6) reinforce the benefits of abstinence or controlled drinking.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
VA Ann Arbor Healthcare System, Ann Arbor, MIAnn Arbor, MI
Phoenix VA Health Care System, Phoenix, AZPhoenix, AZ
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MABoston, MA
Minneapolis VA Health Care System, Minneapolis, MNMinneapolis, MN
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Who Is Running the Clinical Trial?
VA Office of Research and DevelopmentLead Sponsor
References
A randomized clinical trial of motivational enhancement therapy for alcohol problems in partner violent men. [2021]This study examined the efficacy of brief alcohol intervention in the context of community-based treatment for partner violence. In a randomized clinical trial, 228 partner-violent men with hazardous or problem drinking were recruited at three Intimate Partner Violence (IPV) treatment agencies and randomly assigned to receive one of two 4-session alcohol interventions: Motivational Enhancement Therapy (MET: N = 110) or Alcohol Education (AE: N = 118). After completing alcohol intervention, participants received standard agency counseling services for IPV. Participants completed assessments of alcohol use, drug use, and IPV at pre-treatment, post-alcohol intervention, and quarterly follow-ups for 12 months. At the end of the 4-session alcohol intervention, MET participants displayed greater acknowledgment of problems with alcohol than AE participants (Partial ή2 = 0.039, p = 0.006). Significant changes from baseline across treatment conditions (at p < 0.001) were observed for percent days of alcohol abstinence [95% empirical CI for Partial ή2 =0.226, 0.296], heavy drinking [0.292, 0.349], illicit drug use [0.096, 0.156] and partner violence [0.282, 0.334]. No significant condition differences (treatment by time interactions) were found for alcohol abstinence [95% empirical CI for Partial ή2 = 0.007, 0.036], heavy drinking [0.016, 0.055], illicit drug use [0.005, 0.035] or partner violence [0.001, 0.004]. Results encourage continued use of brief alcohol interventions in community IPV services, but do not provide evidence of a unique benefit of MET in reducing alcohol use in this population.
A qualitative interview study of patient experiences of receiving motivational enhancement therapy in a Swedish addiction specialist treatment setting. [2023]Motivational enhancement therapy (MET) has shown to be efficacious as treatment of alcohol use disorder (AUD), in reducing alcohol consumption and related consequences. However, qualitative research on how patients perceive this treatment is lacking. The aim of this study was to explore how patients experience MET as a treatment for AUD.
Effect of Motivational Enhancement Therapy (MET) on the self efficacy of Individuals of Alcohol dependence. [2022]Motivational enhancement therapy is characterized as a directive, client-centered intervention which helps in modification of behavior by helping subjects in identifying and resolving the ambivalence toward a change in self. In order to free one from the vicious cycle of the alcohol trap one needs self-efficacy, which serves a protective role to prevent from relapses. The study aims to assess and compare the effectiveness of MET on the self-efficacy of individuals pre and posttest with control design were applied.
A randomized trial of methods to help clinicians learn motivational interviewing. [2022]The Evaluating Methods for Motivational Enhancement Education trial evaluated methods for learning motivational interviewing (MI). Licensed substance abuse professionals (N = 140) were randomized to 5 training conditions: (a) clinical workshop only; (b) workshop plus practice feedback; (c) workshop plus individual coaching sessions; (d) workshop, feedback, and coaching; or (e) a waiting list control group of self-guided training. Audiotaped practice samples were analyzed at baseline, posttraining, and 4, 8, and 12 months later. Relative to controls, the 4 trained groups showed larger gains in proficiency. Coaching and/or feedback also increased posttraining proficiency. After delayed training, the waiting list group showed modest gains in proficiency. Posttraining proficiency was generally well maintained throughout follow-up. Clinician self-reports of MI skillfulness were unrelated to proficiency levels in observed practice.
Efficacy of group motivational interviewing (GMI) for psychiatric inpatients with chemical dependence. [2009]Dually diagnosed patients with chemical dependency and a comorbid psychiatric disorder typically show poor compliance with aftercare treatment, which may result in costly and pervasive individual and societal problems. In this study, the authors investigated the effect of adding motivational interviewing in a group format to standard treatment for dually diagnosed psychiatric inpatients. The patients (n = 101) all received standard care and in addition were assigned to either group motivational interviewing (GMI) or a therapist attention activity control group (TAAC). Of patients who attended aftercare and who used alcohol or drugs, those who participated in GMI attended significantly more aftercare treatment sessions, consumed less alcohol, and engaged in less binge drinking at follow-up compared with those in TAAC. Differences between conditions in the overall percentage of participants who achieved complete abstinence or who attended aftercare treatment were not significant, possibly because of a lack of power. These results provide preliminary evidence for the efficacy of GMI when added at the outset to an inpatient program.
Motivational enhancement therapy to increase resident physician engagement in substance abuse education. [2021]Rates of screening, brief intervention, and referral to treatment (SBIRT) for alcohol and drug use by physicians remain low, despite evidence of efficacy. Motivational enhancement therapy (MET) may be a promising means to help physicians resolve ambivalence about intervening with alcohol and drug users and take advantage of educational opportunities. In the present study, 9 internal medicine residents received brief MET prior to standard education in SBIRT. Residents' self-reported SBIRT attitudes and behaviors were measured before the intervention and at a 5-week follow-up point. Changes in SBIRT attitudes and behaviors all occurred in the expected direction, although, due to the small sample size, none reached statistical significance. Results suggest that MET may enhance educational opportunities and lead to changes in SBIRT behavior.
A Telephone Intervention for Substance-Using Adult Male Perpetrators of Intimate Partner Violence. [2021]OBJECTIVE: To preliminarily evaluate telephone-delivered motivational enhancement therapy (MET) in motivating unadjudicated and nontreatment seeking intimate partner violence (IPV) perpetrators, who also use substances, to self-refer into treatment. METHOD: 124 adult men were recruited via a multimedia marketing campaign and were randomly assigned to the intervention (MET) or comparison group following a baseline assessment. Participants in the MET condition received a personalized feedback report on their IPV and substance-use behaviors, consequences, and social norms beliefs. RESULTS: Results supported the likely effectiveness of MET in short-term reduction of IPV behavior, increasing motivation for treatment seeking, and changing perceived norms for IPV and substance abuse (SA). CONCLUSIONS: Applications for brief MET interventions to facilitate voluntary treatment entry among substance-using IPV perpetrators are discussed.
Individual Versus Group Cognitive-Behavioral Therapy for Partner-Violent Men: A Preliminary Randomized Trial. [2021]A randomized clinical trial tested the hypothesis that a flexible, case formulation-based, individual treatment approach integrating motivational interviewing strategies with cognitive-behavioral therapy (ICBT) is more efficacious than a standardized group cognitive-behavioral approach (GCBT) for perpetrators of intimate partner violence (IPV). Forty-two men presenting for services at a community domestic violence agency were randomized to receive 20 sessions of ICBT or a 20-week group cognitive-behavioral therapy (CBT) program. Participants and their relationship partners completed assessments of relationship abuse and relationship functioning at baseline and quarterly follow-ups for 1 year. Treatment uptake and session attendance were significantly higher in ICBT than GCBT. However, contrary to the study hypothesis, GCBT produced consistently equivalent or greater benefits than ICBT. Participant self-reports revealed significant reductions in abusive behavior and injuries across conditions with no differential benefits between conditions. Victim partner reports revealed more favorable outcomes for group treatment, including a statistically significant difference in psychological aggression, and differences exceeding a medium effect size for physical assault, emotional abuse, and partner relationship adjustment. In response to hypothetical relationship scenarios, GCBT was associated with greater reductions than ICBT (exceeding a medium effect) in articulated cognitive distortions and aggressive intentions. Treatment competence ratings suggest that flexible, individualized administration of CBT creates challenges in session agenda setting, homework implementation, and formal aspects of relationship skills training. Although caution is needed in generalizing findings from this small-scale trial, the results suggest that the mutual support and positive social influence available in group intervention may be particularly helpful for IPV perpetrators.