Motivational Interviewing for Substance Use Disorders

Overseen by Margo Hurlocker, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of New Mexico

Disqualifiers: Severe withdrawal, Psychotic, Manic, Suicidal

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial is testing if a special way of talking to patients when they start addiction treatment can help them stay engaged. The method involves counselors helping patients find their own reasons for wanting to change.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, since participants must be physically withdrawn from alcohol or other drugs, you might need to stop using substances related to your addiction.

What data supports the effectiveness of the treatment Motivational Interviewing for Substance Use Disorders?

Motivational Interviewing (MI) is shown to be effective in promoting change in problematic alcohol and drug use by helping clients explore and resolve ambivalence (mixed feelings). It is a client-centered approach that aims to increase motivation and commitment to change, although its effectiveness can vary among individuals. ^{1 2 3 4 5}

Is Motivational Interviewing safe for humans?

Motivational Interviewing (MI) is generally considered safe as it is a client-centered approach that focuses on enhancing motivation and commitment to change in a supportive and compassionate environment. It has been used in various settings without reports of harm, indicating it is safe for human use. ^{1 2 4 5 6}

How is Motivational Interviewing at Intake (MII) different from other treatments for substance use disorders?

Motivational Interviewing at Intake (MII) is unique because it focuses on enhancing a person's own motivation to change by exploring their reasons for change and resolving mixed feelings in a supportive environment, rather than directly instructing them on what to do. ^{1 2 5 7 8}

Research Team

Margo Hurlocker, PhD

Principal Investigator

University of New Mexico

Eligibility Criteria

This trial is for English-speaking adults seeking outpatient treatment for alcohol or drug use, who are willing to follow study procedures and have given informed consent. It's also open to staff at the treatment programs. Participants must not be physically dependent on substances at the time of intake.

Exclusion Criteria

I am not experiencing severe mental health issues like psychosis, mania, or suicidal thoughts.

Current position: facility owner or clinical director

Experiencing severe withdrawal symptoms

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intake

Participants undergo either a standard assessment or a Motivational Interviewing session at intake

1 session (90 minutes)

1 visit (in-person)

Treatment

Participants engage in a three-month outpatient treatment program

12 weeks

Multiple visits (in-person)

Follow-up

Participants are monitored for completion of the treatment program and engagement metrics

up to 36 weeks

Treatment Details

Interventions

• Intake as Usual (IAU) (Behavioral Intervention)
• Motivational Interviewing at Intake (MII) (Behavioral Intervention)

Trial Overview The study compares two approaches: usual intake procedures versus Motivational Interviewing at Intake (MII) to see which is more effective in engaging clients in addiction treatment. The trial will also assess how easy it is to integrate MII into regular practice.

Participant Groups

Group I: Motivational Interviewing at Intake (MII) Experimental Treatment 1 Intervention

Clients allocated to the MII condition will receive a 90-minute pure Motivational Interviewing (MI) session.

Group II: Intake as Usual (IAU) Active Control 1 Intervention

Clients allocated to the IAU condition will receive the 90-minute standard assessment that is delivered to all clients entering intensive outpatient program (IOP)/outpatient program (OP).

Who Is Running the Clinical Trial?

University of New Mexico

Lead Sponsor

Trials

393

Recruited

3,526,000+

Lisa Kuuttila

University of New Mexico

Chief Executive Officer since 2013

PhD in Pharmaceutical Sciences

David L. Perkins

University of New Mexico

Chief Medical Officer since 2015

MD, PhD

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Dr. Nora Volkow

National Institute on Drug Abuse (NIDA)

Chief Executive Officer since 2003

MD from National Autonomous University of Mexico

Dr. Nora Volkow

National Institute on Drug Abuse (NIDA)

Chief Medical Officer since 2003

MD from National Autonomous University of Mexico

Findings from Research

Clients who expressed ambivalence about their substance use early in motivational interviewing sessions showed a significant increase in their willingness to discuss change, suggesting they may benefit more from this approach.

In contrast, clients who indicated readiness to change actually experienced a decrease in their willingness to engage in change talk during the session, indicating that motivational interviewing may not be as effective for them.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What can clients tell us about whether to use motivational interviewing? An analysis of early-session ambivalent language. Forman, DP., Moyers, TB., Houck, JM.[2023]

In a clinical trial involving 208 participants (152 outpatients and 56 inpatients), a single session of motivational interviewing (MI) did not significantly impact drug use outcomes when added to standard treatment for drug problems.

Despite the lack of effect from MI, both inpatient and outpatient groups experienced substantial increases in abstinence from illicit drugs and alcohol over the study period, indicating that standard treatment approaches were effective.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing in drug abuse services: a randomized trial. Miller, WR., Yahne, CE., Tonigan, JS.[2022]

The MAPIT trial is a large-scale study involving 600 offenders across two sites (Baltimore and Dallas) to evaluate the effectiveness of motivational interviewing (MI) and a motivational computer program (MC) in improving addiction treatment initiation and retention among probationers.

This research aims to provide insights into how different motivational strategies, including in-person and technological approaches, can enhance treatment engagement and reduce recidivism, ultimately benefiting public health and safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational tools to improve probationer treatment outcomes. Taxman, FS., Walters, ST., Sloas, LB., et al.[2021]

This study will compare the effectiveness of a standard comprehensive intake assessment with a person-centered Motivational Interviewing (MI) intervention for adults seeking outpatient addiction treatment, involving 150 participants (75 in each group).

The trial aims to assess whether the MI approach can improve client engagement in treatment, as well as its feasibility and sustainability within addiction treatment programs, potentially reducing the high attrition rates seen during initial intakes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and feasibility of a motivational interviewing intake (MII) intervention for increasing client engagement in outpatient addiction treatment: an effectiveness-implementation hybrid design protocol. Hurlocker, MC., Moyers, TB., Hatch, M., et al.[2023]

Motivational interviewing (MI) may lead to a small to moderate reduction in substance use compared to no intervention, particularly in the short term, based on a systematic review of 93 studies involving 22,776 participants.

MI shows slight benefits over assessment and feedback in reducing substance use in the medium and long term, but it appears to have little to no effect compared to treatment as usual or other active interventions, indicating that its effectiveness may vary depending on the context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing for substance use reduction. Schwenker, R., Dietrich, CE., Hirpa, S., et al.[2023]

Motivational interviewing, originally designed for individual therapy, can be effectively adapted for group settings to help patients with both psychiatric and substance use disorders, as shown in a pilot test with inpatient participants.

The group format was engaging and helped participants explore their feelings about change, indicating that this approach may enhance treatment outcomes for those with dual diagnoses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot test of motivational interviewing groups for dually diagnosed inpatients. Van Horn, DH., Bux, DA.[2019]

Training in motivational interviewing (MI) for substance use disorder (SUD) treatment did not consistently lead to sustained practice change, with only 2 out of 20 studies achieving the target of 75% of clinicians reaching proficiency after training.

The review highlighted that ongoing competency monitoring and training are necessary for clinicians to effectively implement MI, and the impact of this training on client outcomes remains unclear, indicating a need for further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing? Hall, K., Staiger, PK., Simpson, A., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

What can clients tell us about whether to use motivational interviewing? An analysis of early-session ambivalent language. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Motivational interviewing in drug abuse services: a randomized trial. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Motivational tools to improve probationer treatment outcomes. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Effectiveness and feasibility of a motivational interviewing intake (MII) intervention for increasing client engagement in outpatient addiction treatment: an effectiveness-implementation hybrid design protocol. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Motivational interviewing for substance use reduction. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

A pilot test of motivational interviewing groups for dually diagnosed inpatients. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Motivational interviewing for substance abuse. [2022]

8. England pubmed.ncbi.nlm.nih.gov

After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing? [2022]