Transcript The Efficacy of Motivational Interviewing: A Meta

The Efficacy of Motivational Interviewing:
A Meta-Analysis of Controlled Clinical Trials
By Brian L. Burke, Hal Arkowitz, and
Marisha Menchola
Presented by Jane Canavan
Radford University
Purpose
• To determine if motivational interviewing is an
effective form of treatment for problem
behaviors involving alcohol, drugs, smoking,
HIV-risk-behaviors, and diet/exercise.
Definition of Motivational
Interviewing
• A directive, client-centered counseling style for
eliciting behavior change by helping clients explore
and resolve problem behaviors.
– Motivation to change is elicited from the client, and not
imposed by coercion, persuasion, or constructive
confrontation from the counselor
– The counselor’s job is to identify and examine the
intrinsic values and goals of the client in order to
stimulate behavior change (reason it is considered
directive)
Issues to Consider
• Type of problem area
– Some problem behaviors involve a physiological addiction
(drug and alcohol addiction) while others do not (diet and
exercise)
• Format of the MI
– Alone
– Along with other services
• Study design
– No treatment/placebo
– Active treatment
Literature Review
• Methods
– Article Bibliographies
– Electronic Source
• PsycINFO
– Electronic Message
• To all members of the Motivational Interviewing
Network of Trainers asking for any published or
unpublished studies
• Studies
– 30 were used
Inclusion Criteria
• The intervention was delivered on an
individual (not group) and face-to-face (not
telephone) basis
• Studies had to include the following criteria:
– Random assignment to groups
– At least one comparison group
– Adequate measurement targeting pertinent
problem areas
Dependent Measures
•
•
•
•
•
•
Alcohol
Smoking cessation
Drug Addiction
HIV-risk behaviors
Diet & exercise
Social impact
Potential Moderators
• Clinical problem area
• Severity of drug or alcohol problem
• Format of the motivational interview- standalone intervention or adjunct to other services
• Dose of treatment- minutes per session/ # of
sessions
• Follow- up point
Results Effect Size d over K/N
*Significant
Problem Area
Notreat./placebo
Active
treatment
Alcohol (SEC)
0.25*
12/1,142
0.09
5/826
Drug Addiction
0.56*
3/250
-0.01
2/247
Alcohol (BAC)
0.53*
5/266
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Results Effect Size d over K/N
* Significant
Problem Area
No-treatment/
Placebo
Smoking
0.11
Cessation
2/574
HIV-risk
0.01
behaviors
2/173
Diet & exercise
0.53*
4/366
Social impact
0.47*
7/1,984
Active
treatment
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Factors that may Account for
Differences in Effect Sizes
• Drug Addiction
– Higher dose of treatment
• Diet and exercise
– High dose of treatment
– Low quality studies
Conclusion
• Motivational interviews were equivalent to
other active treatments and are more effective
than placebo and no treatment controls for
problems involving alcohol, drugs, and diet
and exercise.
• There was no support for the efficacy of MI’s
in the areas of smoking and HIV-risk
behaviors.