Augmenting an online self-directed intervention for gambling disorder with a single motivational interview: study protocol for a randomized controlled trial

Background Despite the success of gold standard cognitive-behavioral therapy for problem and disordered gambling, the majority of individuals with gambling problems do not seek or receive professional treatment. Thus, the development of less intrusive self-directed interventions has been encouraged. Bibliotherapy for problem gambling has shown promise, both alone and in combination with motivational interviews, but there is still a lack of online self-directed intervention research. The current randomized controlled trial proposes to assess the additive benefit of a single digital motivational interview delivered in conjunction with an online self-directed treatment program for problem gambling and gambling disorder. Methods A two-arm randomized controlled trial will be conducted, wherein eligible participants (N=270) will be recruited across Canada via internet advertisements posted to several platforms. All participants will receive access to an online self-directed gambling intervention program. Participants will be randomly assigned to either complete the online program alone or receive a digital motivational interview, conducted through an online audioconferencing platform (i.e., Microsoft Teams) to supplement the online program. The primary outcomes of gambling severity, frequency, and expenditures will be tracked along with secondary outcomes (i.e., depression, anxiety, general distress, alcohol use, and online program user data) over a 24-month period. It is expected that participants in both groups will experience a reduction in symptoms across the board, but more substantial improvements will be observed in the group that receives a supplemental motivational interview. Discussion The results of this trial will expand upon prior gambling intervention research by informing best practices for the provision of online self-help for problem gambling. Trial registration ISRCTN ISRCTN13009468. Registered on 7 July 2020.

The Effect of Psychoeducation Based on Motivational Interview Techniques on Medication Adherence, Hope, and Psychological Well-Being in Schizophrenia Patients

This study was conducted to determine the effect of psychoeducation based on motivational interview techniques on medication adherence, hope, and psychological well-being in schizophrenia patients. There are many studies using Motivational Interviewing for individuals with schizophrenia. However, there are no studies on whether the concept of “adherence to treatment,” which is clearly shown to be corrected with 6 to 8 weeks of motivational interviewing, will positively affect concepts such as “hope and well-being,” which require longer interventions, in a shorter time. In this context, there are not enough studies in which motivational interviewing techniques are integrated into psychoeducational interventions that can be organized with more individuals. The study was conducted with a pretest-posttest control group design. The sample size of the study was determined as 150 schizophrenia patients including 75 in the experimental group and 75 in the control group based on power analysis. The researcher provided the patients in the experimental group with a six-session psychoeducation program based on motivational interview techniques. A “Descriptive Characteristics Form,” the “Herth Hope Index,” the “Morisky Medication Adherence Scale,” and the “Psychological Well-Being Scale” were used to collect the data. In the study, psychoeducation based on motivational interview techniques created a statistically significant difference in the medication adherence, hope and psychological well-being levels of the patients in the experimental and control groups ( p < .05). Psychoeducation based on motivational interview techniques provided for schizophrenia patients was found to be effective in enhancing their medication adherence, hope, and psychological well-being levels.

ŞİZOFRENİ TANILI BİREYLERDE MOTİVASYONEL GÖRÜŞME YÖNTEMİNİN İLAÇ UYUMUNA ETKİSİ: BİR META-ANALİZ ÇALIŞMASI

This main purpose is to reveal the drug compliance of motivational interview method in individuals diagnosed with schizophrenia as an information to previous studies. The research was carried out by scanning the articles in PubMed, Web of Science, EBSCOhost, Pscyh-Info, Turkish Psychiatry Directory, Ulakbim, YÖK National Thesis Center, Dergipark, Turkish Medline and Turkiye Klinikleri databases between January-February 2021. 1713 records were reached in the screening. The full text of 825 articles were examined according to the access and exclusion criteria, and 4 studies reporting results about the effect of motivational interviewing on drug compliance in individuals with schizophrenia were included in the analysis. The studies included a total of 384 individuals, including 190 (49.47%) and 194 (51.53%) individuals in the control group. Three of the studies were randomized controlled experimental studies and one was pretest-posttest controlled experimental study. Our study concluded that the motivational interview method is effective in individuals diagnosed with schizophrenia. Perhaps this research is recommended to be conducted for researches on research articles in Turkish society on the basis of written research.

488Trial design and statistical considerations for a trial comparing group and individual treatments

Focus of Presentation A randomized clinical trial is considered the best experimental study design for comparing the effect of an intervention against a control. Selecting a trial design depends on the trial objective, a better choice would be a design that provides optimal estimation of the intervention effect, i.e. a design that yields smaller variance for the estimated intervention effect and giving stable estimates. The choice of analysis method depends on trial design aspects, reasonable assumption on the underlying probabilistic model generating the data and the credibility of findings depend on the appropriateness of the analysis method used. Here, we describe a planned randomized standard of care-controlled trial on interactive weekly mobile text messaging added to a motivational interviewing intervention aimed at sustaining continued breastfeeding among women living with HIV in South Africa. Under the “findings” heading, we highlight some of the trial design and statistical issues for discussion at the early career workshop, to gain insights on possible approaches to address the methods issues. Methods and trial design: Women from peri-urban informal settlements and a rural setting will be invited to participate within 24 hours of giving birth at selected primary healthcare facilities. Eligible women will be individually randomized to intervention or control arm after providing written informed consent. The intervention will consist of a weekly text message encouraging women to exclusively breastfeed and inquiring if they have any problems breastfeeding their infants. In addition to text messaging, women assigned to the intervention arm must visit the research site where a research nurse or counsellor will conduct an individual motivational interview, at weeks 2, 6, and 10 post-delivery. Women assigned to the control arm will be counselled by the standard of care service, i.e. primary healthcare nurses and trained counsellors will counsel women to exclusively breastfeed for the first six months through group educational infant feeding counselling sessions. Study participation will not change standard of care of participants, so women assigned to the intervention arm will receive the standard of care service, in line with provincial guidelines applicable in the sector during the study period. The primary outcomes are 1) number of women who are exclusively breastfeeding at week 24 post-delivery and 2) number of women reporting any breastfeeding at week 24 post-delivery. Findings or trial design and statistical issues Although women are individually randomly assigned to intervention and control arms, the standard of care at the primary health care facility may induce a dependency between these participants, also called the group therapy effect. For example, promotion of exclusive breastfeeding in HIV-infected women may be enhanced through positive feedback from women who follow this practice or vice versa. The standard of care will be clustered within group infant feeding counselling session, where participants (both assigned to the control and intervention arm) will receive the standard of care in groups. Women assigned to the intervention arm will receive individual motivational interview and the text messages will be send separately, to each woman’s mobile phone. Implications The trial objective will be to determine whether at week 24 following delivery, weekly text message added to motivational interview leads to better adherence to exclusive breastfeeding and leads to extended breastfeeding than standard of care. Trial design and statistical issues to discuss during the workshop will include a discussion around: 1) the appropriateness of invoking the standard experimental design to address the study objectives, and possible alternatives 2) Sample size estimation for a trial comparing group and individual treatments? 3) Reasonable assumption on the underlying probabilistic model generating the outcome data and 4) Candidate statistical models. Key messages Use of sound statistical principles of experimental design established for clinical trials allow objective and unbiased comparisons.

Augmenting an online self-directed intervention for gambling disorder with a single motivational interview: Study protocol for a randomised controlled trial

Background: Despite the success of gold standard cognitive-behavioural therapy for problem and disordered gambling, the majority of individuals with gambling problems do not seek or receive professional treatment. Thus, the development of less intrusive self-directed interventions has been encouraged. Bibliotherapy for problem gambling has shown promise, both alone and in combination with motivational interviews, but there is still a lack of online self-directed intervention research. The current randomised controlled trial proposes to assess the efficacy of an online self-directed treatment program for problem gambling and gambling disorder, both alone and in combination with a single motivational interview delivered digitally. Methods: A two-arm randomised controlled trial will be conducted, wherein eligible participants (N=270) will be recruited across Canada via internet advertisements posted to several platforms. All participants will receive access to an online self-directed gambling intervention program. Participants will be randomly assigned to either complete the online program alone or receive a digital motivational interview, conducted through an online audioconferencing platform (i.e., Microsoft Teams) to supplement the online program. Gambling severity, frequency, and expenditures will be tracked along with other mental health outcome data over a 24-month period. It is expected that participants in both groups will experience a reduction in symptoms across the board, but more substantial improvements will be observed in the group that receives a supplemental motivational interview.Discussion: The results of this trial will expand upon prior gambling intervention research by informing best practices for the provision of online self-help for problem gambling. Trial registration: ISRCTN, ISRCTN13009468. Registered on 7 July 2020 at https://www.isrctn.com/ISRCTN13009468.

Implementation of motivational interview and dropout to treatment

Dropout is a recurring problem in psychological treatments, generally, it has been attributed to patient variables, however, these effects are probably due to the therapist’s skills, therefore, since the Motivational Interview is a strategy that seeks to increase treatment adherence, it is necessary to evaluate the skills of the therapists. La deserción es un problema recurrente en los tratamientos psicológicos y generalmente se atribuye a variables de los pacientes, sin embargo, probablemente estos efectos se deban a las habilidades del terapeuta, por lo que, al ser la Entrevista Motivacional una estrategia que busca incrementarla adherencia al tratamiento es necesario evaluar las habilidades de los terapeutas.