scholarly journals The alliance in motivational enhancement therapy and counseling as usual for substance use problems.

2009 ◽  
Vol 77 (6) ◽  
pp. 1125-1135 ◽  
Author(s):  
Paul Crits-Christoph ◽  
Robert Gallop ◽  
Christina M. Temes ◽  
George Woody ◽  
Samuel A. Ball ◽  
...  
Keyword(s):  
Substance Use ◽  
Motivational Enhancement Therapy ◽  
Motivational Enhancement ◽  
Substance Use Problems

Non-Pharmacological Therapies for Substance Use Disorders (DRAFT)

2018 ◽  
Author(s):  
Michael F. Weaver
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Behavioral Therapy ◽  
Contingency Management ◽  
Motivational Enhancement Therapy ◽  
Present Level ◽  
Duration Of Treatment ◽  
Motivational Enhancement ◽  
Level Of Understanding

In conjunction with chapters 16 and 17, which described non-pharmacological approaches to pain management, this chapter reviews the available non-pharmacological approaches to substance use disorders (SUD). Specific subtopics include 12-Step programs and facilitation, motivational enhancement therapy, cognitive behavioral therapy, individual and group psychotherapies, contingency management, community reinforcement, family therapy, relapse management, and the terminal consideration of all therapies, termination (what is the duration of treatment)? Each subtopic is addressed in abstract rather than in comprehensive format, to allow the primary care provider to identify her level of interest and present level of understanding, and to inform further reading. The chapter concludes with a text box providing additional resources.

Mystical-type experiences occasioned by ketamine mediate its impact on at-risk drinking: Results from a randomized, controlled trial

2020 ◽  
pp. 026988112097087
Author(s):  
Rebecca L Rothberg ◽  
Nour Azhari ◽  
Nancy A Haug ◽  
Elias Dakwar
Keyword(s):  
At Risk ◽  
Substance Use ◽  
Addiction Treatment ◽  
Drinking Behavior ◽  
Future Research ◽  
Motivational Enhancement Therapy ◽  
Motivational Enhancement ◽  
Psychoactive Effects ◽  
Dissociative States ◽  
Alcohol Dependent

Background: Sub-anesthetic ketamine administration may be helpful for substance use disorders. Converging evidence suggests that the efficacy of ketamine for certain conditions may implicate a subset of its psychoactive effects. Aims: The aim of this analysis is to evaluate whether the mystical-type effects of ketamine are critical for clinical efficacy in alcohol-dependent individuals. In this secondary analysis, we determine if a subset of the psychoactive effects of ketamine, the so-called mystical-type experience, mediates the effect of ketamine, when combined with motivational enhancement therapy, on at-risk drinking behavior in alcohol-dependent individuals interested in treatment. Methods: Forty alcohol dependent adults were randomized to either a 52-minute infusion of ketamine or midazolam, which they received on a designated quit-day during the second week of a five-week motivational enhancement therapy regimen. Psychoactive effects were assessed following the infusion, and alcohol use was monitored for the subsequent 3 weeks at each twice-weekly visit. Results: We found that ketamine leads to significantly greater mystical-type effects (by Hood Mysticism Scale) and dissociation (by Clinician Administered Dissociative States Scale) compared to the active control. Ketamine also led to significant reduction in at-risk drinking. The Hood Mysticism Scale, but not Clinician Administered Dissociative States Scale score, was found to mediate the effect of ketamine on drinking behavior. Conclusions: This trial adds evidence to the literature on the importance of mystical-type experiences in addiction treatment. Future research should continue to investigate the relationship between the psychoactive effects of psychedelic therapeutics and clinical outcomes for other substance use and mental health disorders.

scholarly journals Application of Motivational Enhancement Therapy in Group settings among Patients with Substance Abuse

2019 ◽  
Vol 10 (1) ◽  
pp. 22
Author(s):  
Prashant Srivastava ◽  
Kuldeep Singh ◽  
Savita Chahal
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Clinical Teaching ◽  
Sampling Technique ◽  
Psychosocial Interventions ◽  
Motivational Enhancement Therapy ◽  
Motivational Enhancement ◽  
Group Settings ◽  
Motivation Enhancement ◽  
Motivation Enhancement Therapy

Background: Substance abuse is defined as the use of a drug or any other substance for a non-medical purpose with the aim of producing some type of "mind-altering "effect in the users. Motivational Enhancement Therapy (MET) is a systematic intervention approach for evoking change. It is based on principles of motivational psychology and is designed to produce rapid and internal motivation. Aims and Objectives: Present study aims to assess and compare desire to quit substance use among substance users and the effectiveness of Motivation Enhancement Therapy on the desire to quit substance use in an experimental group. Sample and Sampling: A total number of 70 participants were selected using purposive sampling technique. The sample comprised of 35 from inpatient unit and 35 from the out-patient department of psychiatry, Kalpana Chawla Government Medical College and Hospital, Karnal, Haryana, India. Results and Conclusions: The present study suggests that comprehensive patient-friendly treatments are more effective in increasing the desire to quit substance use than the standard pharmacological treatment. Hence, combining pharmacolo­gical treatment with appropriate psychosocial interventions focusing on the specific problem of the patient may provide a better outcome than either one alone. Clinicians can arrange the clinical teaching regarding MET for a larger group at whole including family interventions. Keywords: Motivation enhancement therapy, substance abuse

scholarly journals Behaviour change interventions to reduce risky substance use and improve mental health in children in care: the SOLID three-arm feasibility RCT

2020 ◽  
Vol 8 (13) ◽  
pp. 1-162
Author(s):  
Hayley Alderson ◽  
Eileen Kaner ◽  
Rebecca Brown ◽  
Denise Howel ◽  
Elaine McColl ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Randomised Controlled Trial ◽  
Social Behaviour ◽  
Controlled Trial ◽  
Motivational Enhancement Therapy ◽  
Motivational Enhancement ◽  
Network Therapy ◽  
Randomised Controlled ◽  
Children In Care

Background Looked-after children and care leavers (henceforth children in care) are young people placed under the care of local authorities, often because of a history of family abuse and/or neglect. These young people have significantly increased risk of substance use and mental health problems compared with peers. Aim The Supporting Looked After Children and Care Leavers In Decreasing Drugs, and alcohol (SOLID) trial aimed to investigate the feasibility of a definitive randomised controlled trial comparing two behaviour change interventions to reduce risky substance use (illicit drugs and alcohol) in and improve the mental health of children in care aged 12–20 years. Methods The study consisted of two phases: (1) a formative phase that adapted the motivational enhancement therapy and social behaviour and network therapy interventions for use with children in care and (2) a three-arm pilot randomised controlled trial (comparing motivational enhancement therapy, social behaviour and network therapy and usual care), and a linked process and economic (return on investment) evaluation. Trial feasibility was compared with prespecified STOP/GO criteria. Setting Six local authority areas in the north-east of England. Participants Children in care (aged 12–20 years) who screened positive for drug and/or alcohol use within the last 12 months were eligible for the trial. The formative and process evaluations included children in care, carers, social workers, and drug and alcohol workers. Outcome measures The primary outcomes were recruitment and retention rates at 12 months’ follow-up. Baseline and 12-month follow-up questionnaires measured self-reported drug and alcohol use, mental health and health-related quality of life. The process evaluation considered acceptability and engagement with the interventions and trial procedures. Results Formative findings (n = 65) highlighted the need for interventions to increase the emphasis on therapeutic relationships, use creative methods of engagement and support the identification of treatment goals wider than substance misuse. Within the randomised controlled trial, of 860 participants screened, 211 (24.5%) met the inclusion criteria. One hundred and twelve (53%) of the 211 eligible children were recruited and randomised. Just 15 of the 76 (20%) participants allocated to intervention attended any of the motivational enhancement therapy of social behaviour and network therapy sessions, and 60 (54%) participants completed the 12-month follow-up. The screening and recruitment of children in care required significantly more time and resource investment by researchers and children’s services than planned. The process evaluation (n = 116) demonstrated that, despite participants engaging in risky substance use, they did not often acknowledge this nor felt that they needed help. Children in care had complex, chaotic lives and children’s services departments were less research mature and extremely stretched; this, coupled with the multiple steps in the intervention pathway and study protocol, resulted in low adherence to the intervention and the trial. Conclusions The SOLID trial demonstrated successful engagement with children in care to adapt the motivational enhancement therapy and social behaviour and network therapy interventions. However, the pilot randomised controlled trial found that a definitive trial is not feasible. The current screen, refer and treat pathway for children in care did not work. There is an urgent need to radically rethink how we deliver therapeutic services for children in care. A pragmatic evaluation design, coupled with additional research resource for children’s services, is needed to evaluate these novel models of care at scale. Trial registration This study is registered as PROSPERO CRD42018098974 and Current Controlled Trials ISRCTN80786829. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 13. See the NIHR Journals Library website for further project information.

Motivational Interviewing: Ein Literaturüberblick

2001 ◽  
Vol 47 (3) ◽  
pp. 171-188 ◽  
Author(s):  
Ralf Demmel
Keyword(s):  
Motivational Interviewing ◽  
Harm Reduction ◽  
Motivational Enhancement Therapy ◽  
Motivational Enhancement ◽  
Motivationale Interventionen

Der dysfunktionale Konsum psychotroper Substanzen geht in der Regel mit einem Zwiespalt zwischen Abstinenzvorsatz bzw. der Absicht, den Konsum zu reduzieren, einerseits und dem Wunsch oder Zwang, den Konsum fortzusetzen, andererseits einher. Das von Miller und Rollnick (1991) beschriebene Motivational Interviewing (MI) ist ein zugleich klientenzentrierter und direktiver Behandlungsstil, der dieser Ambivalenz Rechnung tragen und somit Veränderungsbereitschaft erhöhen soll. Miller und Rollnick (1991) nennen fünf Prinzipien motivationaler Gesprächsführung: <OL><LI>Empathie, <LI>Widersprüche aufzeigen, <LI>Wortgefechte vermeiden, <LI>Nachgiebig auf Widerstand reagieren und <LI>Selbstwirksamkeit fördern.</OL> Diese Prinzipien stimmen mit den Annahmen (sozial-) psychologischer Modelle der Einstellungs- und Verhaltensänderung überein. Seit Ende der achtziger Jahre wurden vorwiegend in den angelsächsischen Ländern verschiedene motivationale Interventionen zur Sekundärprävention und Behandlung von Substanzabhängigkeit und -missbrauch entwickelt, die den von Miller und Rollnick (1991) formulierten Behandlungsprinzipien entsprechen (der Drinker’s Checkup, Motivational Enhancement Therapy, das Harm-Reduction-Programm BASICS, Brief Motivational Interviewing, Brief Negotiation sowie eine Reihe weiterer motivationaler Kurzinterventionen). Vor dem Hintergrund der bislang vorliegenden Literatur erscheint insbesondere die Durchführung standardisierter motivationaler Interventionen zur Reduktion dysfunktionalen Alkoholkonsums bzw. der negativen Konsequenzen eines fortgesetzten Alkoholmissbrauchs gerechtfertigt. Voraussetzungen einer Optimierung des Behandlungserfolgs sind neben der Identifikation zentraler Wirkmechanismen u.a. eine fortlaufende Prozess-Evaluation der Implementierung motivationaler Interventionen sowie eine evidenzbasierte Ausbildung.

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