Titre
Do brief alcohol motivational interventions work like we think they do?
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Bertholet, N.
Auteure/Auteur
Palfai, T.
Auteure/Auteur
Gaume, J.
Auteure/Auteur
Daeppen, J.B.
Auteure/Auteur
Saitz, R.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1530-0277
Statut éditorial
Publié
Date de publication
2014
Volume
38
Numéro
3
Première page
853
Dernière page/numéro d’article
859
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Résumé
BACKGROUND: Questions remain about how brief motivational interventions (BMIs) for unhealthy alcohol use work, and addressing these questions may be important for improving their efficacy. Therefore, we assessed the effects of various characteristics of BMIs on drinking outcomes across 3 randomized controlled trials (RCTs).
METHODS: Audio recordings of 314 BMIs were coded. We used the global rating scales of the Motivational Interviewing Skills Code (MISC) 2.1: counselor's acceptance, empathy, and motivational interviewing (MI) spirit, and patient's self-exploration were rated. MI proficiency was defined as counselor's rating scale scores ≥5. We also used the structure, confrontation, and advice subscale scores of the Therapy Process Rating Scale and the Working Alliance Inventory. We examined these process characteristics in interventions across 1 U.S. RCT of middle-aged medical inpatients with unhealthy alcohol use (n = 124) and 2 Swiss RCTs of young men with binge drinking in a nonclinical setting: Swiss-one (n = 62) and Swiss-two (n = 128). We assessed the associations between these characteristics and drinks/d reported by participants 3 to 6 months after study entry.
RESULTS: In all 3 RCTs, mean MISC counselor's rating scales scores were consistent with MI proficiency. In overdispersed Poisson regression models, most BMI characteristics were not significantly associated with drinks/d in follow-up. In the U.S. RCT, confrontation and self-exploration were associated with more drinking. Giving advice was significantly associated with less drinking in the Swiss-one RCT. Contrary to expectations, MI spirit was not consistently associated with drinking across studies.
CONCLUSIONS: Across different populations and settings, intervention characteristics viewed as central to efficacious BMIs were neither robust nor consistent predictors of drinking outcome. Although there may be alternative reasons why the level of MI processes was not predictive of outcomes in these studies (limited variability in scores), efforts to understand what makes BMIs efficacious may require attention to factors beyond intervention process characteristics typically examined.
METHODS: Audio recordings of 314 BMIs were coded. We used the global rating scales of the Motivational Interviewing Skills Code (MISC) 2.1: counselor's acceptance, empathy, and motivational interviewing (MI) spirit, and patient's self-exploration were rated. MI proficiency was defined as counselor's rating scale scores ≥5. We also used the structure, confrontation, and advice subscale scores of the Therapy Process Rating Scale and the Working Alliance Inventory. We examined these process characteristics in interventions across 1 U.S. RCT of middle-aged medical inpatients with unhealthy alcohol use (n = 124) and 2 Swiss RCTs of young men with binge drinking in a nonclinical setting: Swiss-one (n = 62) and Swiss-two (n = 128). We assessed the associations between these characteristics and drinks/d reported by participants 3 to 6 months after study entry.
RESULTS: In all 3 RCTs, mean MISC counselor's rating scales scores were consistent with MI proficiency. In overdispersed Poisson regression models, most BMI characteristics were not significantly associated with drinks/d in follow-up. In the U.S. RCT, confrontation and self-exploration were associated with more drinking. Giving advice was significantly associated with less drinking in the Swiss-one RCT. Contrary to expectations, MI spirit was not consistently associated with drinking across studies.
CONCLUSIONS: Across different populations and settings, intervention characteristics viewed as central to efficacious BMIs were neither robust nor consistent predictors of drinking outcome. Although there may be alternative reasons why the level of MI processes was not predictive of outcomes in these studies (limited variability in scores), efforts to understand what makes BMIs efficacious may require attention to factors beyond intervention process characteristics typically examined.
PID Serval
serval:BIB_32689EDC63A6
PMID
Date de création
2014-05-01T17:02:48.373Z
Date de création dans IRIS
2025-05-20T19:48:25Z
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BIB_32689EDC63A6.P001.pdf
Version du manuscrit
published
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140.96 KB
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Adobe PDF
PID Serval
serval:BIB_32689EDC63A6.P001
URN
urn:nbn:ch:serval-BIB_32689EDC63A63
Somme de contrôle
(MD5):5a1b7f8d207038905fd0c9c020212daf
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nihms788179.pdf
Version du manuscrit
preprint
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89.66 KB
Format
Adobe PDF
PID Serval
serval:BIB_32689EDC63A6.S001
Somme de contrôle
(MD5):fc348d3b499223b29a163d18a0a452bc