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1
Motivational Interviewing:

Findings from Clinical Trials


  • Updated: 10 December 2004
2
Alcohol
3
Allsop et al., 1997
Addiction, 92:61-74
  • Design Randomized clinical trial
  • Population Alcohol abuse
  • Nation Scotland
  • N 60 adult outpatients
  • MI 8 session group MI + skills
  • Comparison Group discussion TAU
  • Follow-up 6 months



4
Allsop et al., 1997
5
Baer et al., 1992
Journal of Consulting and Clinical Psychology, 60:924-979
  • Design Randomized clinical trial
  • Population College Students
  • Nation US (Seattle, WA))
  • N 134 young adults
  • MI 1 session (60 min)
  • Comparison Two groups:
  • (1) six weekly cognitive behavioral groups (90 minute ea)
  •   (2) a six-unit self-help cognitive behavioral manual
  • Follow-up post-treatment (6 weeks),
  • short-term maintenance (3 & 6 months),
  • long-term maintenance (12 & 24 months)



6
Baer et al., 1992
  • Comparative analyses exclude the self-help manual group because of poor program completion and high drop-out in this group


  • Overall reduction on the three dependent variables were statistically significant at the three follow-up points.


  • Although CB group subjects reported slightly lower numbers on all three drinking measures over time, differences between MI and CB subjects were not statistically significant.


  • Significant interactive effects were noted for age, with increases in drinking during the year subjects reached legal drinking status.
7
Baer et al., 1992
8
Baer et al., 1992
9
Baer et al., 1992
10
Baer et al., 1992
11
Bien et al., 1993
Behavioural & Cognitive Psychotherapy, 21:347-356
  • Design Randomized clinical trial
  • Population Outpatient alcohol (VA)
  • Nation US (Albuquerque, NM)
  • N 32 adults
  • MI 1 session MET (+ TAU)
  • Comparison TAU
  • Follow-up 6 months post discharge



12
Bien et al., 1993
13
Bien et al., 1993
14
Borsari & Carey, 2000
Journal of Consulting & Clinical Psychology, 68:728-733
  • Design Randomized clinical trial
  • Population Binge drinkers
  • Nation US (Syracuse, NY)
  • N 60 college students
  • MI 1 session MET
  • Comparison Assessment only
  • Follow-up 6 weeks



15
Borsari & Carey, 2000
16
Brown & Miller, 1993
Psychology of Addictive Behaviors, 7:211-218
  • Design Randomized clinical trial
  • Population Inpatient alcohol
  • Nation US (Albuquerque, NM)
  • N 28 adults
  • MI 1 session MET (+ TAU)
  • Comparison TAU
  • Follow-up 3 months post discharge



17
Brown & Miller, 1993
18
Brown & Miller, 1993
19
Dench & Bennett, 2000
Behavioural & Cognitive Psychotherapy, 28:121-130
  • Design Randomized clinical trial
  • Population 6 week day treatment program
  • Nation United Kingdom
  • N 51 alcohol dependent patients
  • MI 1 session
  • Comparison Attention placebo education
  • Follow-up 1 and 6 weeks



20
Dench & Bennett, 2000
21
Handmaker et al., 1999
Journal of Studies on Alcohol, 60:285-287
  • Design Randomized clinical trial
  • Population Prenatal care clinics
  • Nation US (Albuquerque, NM)
  • N 42 pregnant drinkers
  • MI 1-hour individual session
  • Comparison Risk-alert letter
  • Follow-up 2 months



22
Handmaker et al., 1999
23
Heather et al., 1996
Drug & Alcohol Review, 15:29-38
  • Design Block assignment
  • Population General hospital inpatients
  • Nation Australia
  • N 174 adult heavy drinkers
  • MI 1 30-40 minute session
  • Comparison Skills training or TAU
  • Follow-up 6 months



24
Heather et al., 1996
25
Kuchipudi et al., 1990
Journal of Consulting & Clinical Psychology, 65:531-541
  • Design Randomized clinical trial
  • Population Acute gastrointestinal ward
  • Nation US (Hines, IL)
  • N 114 alcohol-related admissions
  • MI 5 sessions with 5 practitioners
  • Comparison TAU
  • Follow-up 16 weeks



26
Kuchipudi et al., 1990
27
Kuchipudi et al., 1990
Was it Motivational Interviewing?
  • Each patient talked to by five different clinicians
  • Complete staff turnover 3 times in 5 months
  • “Emphasized the need for and benefits of alcoholism therapy”
  • “Two prolonged sessions on available treatment programs”
  • “The person’s health and drinking were reviewed from the viewpoint and with the authority of the director of the unit”



28
Marlatt et al., 1998
Journal of Consulting and Clinical Psychology, 66:604-615
  • Design Randomized clinical trial
  • Population College students
  • Nation US (Seattle, WA)
  • N 348 heavy drinkers
  • MI 1 individual session
  • Comparison Assessment only
  • Follow-up 2 years



29
Marlatt et al., 1998
30
Miller et al., 1988
Behavioural Psychotherapy, 16:251-268
  • Design Randomized clinical trial
  • Population Self-referred problem drinkers
  • Nation US (Albuquerque, NM)
  • N 42 adults
  • MI Assessment + 1 MET session
  • Comparison Confrontational counseling
  • Waiting list (6 weeks)
  • Follow-up 18 months



31
Miller et al., 1988
32
Miller et al., 1993
Journal of Consulting & Clinical Psychology, 61:455-461
  • Design Randomized clinical trial
  • Population Self-referred problem drinkers
  • Nation US (Albuquerque, NM)
  • N 42 problem drinkers
  • MI Assessment + 1 MET session
  • Comparison Confrontational counseling
  • Waiting list (6 weeks)
  • Follow-up 12 months



33
Miller et al., 1993
34
Miller et al., 1993
35
Miller et al., 1993
36
Miller et al., 1993
37
Monti et al., 1999
Journal of Consulting and Clinical Psychology, 67:989-994
  • Design Randomized clinical trial
  • Population Emergency room
  • Nation US (Providence, RI)
  • N 94 adolescents (18-19)
  • MI 1 session (35-40 min)
  • Comparison Standard care
  • Follow-up 6 months



38
Monti et al., 1999
39
Murphy et al., 2001
Psychology of Addictive Behaviors, 15:373-379
  • Design Randomized clinical trial
  • Population College Students
  • Nation US (Auburn, AL)
  • N 99 drinkers
  • MI 1 session (50 min)
  • Comparison Alcohol education;  No intervention
  • Follow-up 9 months



40
Murphy et al., 2001
41
Project MATCH, 1997
Journal of Studies on Alcohol, 58:7-29
  • Design Randomized clinical trial
  • Population Outpatient and aftercare
  • Nation US (9 sites)
  • N 1,726 adults
  • MI 4 session MET
  • Comparison 12 session CBT or TSF
  • Follow-up 15 months post-treatment



42
Project MATCH, 1997
43
Project MATCH, 1998
Alcoholism: Clinical and Experimental Research, 22:1300-1311
44
Sellman et al., 2001
Journal of Studies on Alcohol, 62:389-396
  • Design Randomized clinical trial
  • Population Mild/moderate dependence
  • Nation New Zealand
  • N 125 alcohol outpatients
  • MI MET 4 sessions
  • Comparison Nondirective reflective listening
  • Control: No further counseling
  • Follow-up 6 months post-treatment



45
Sellman et al., 2001
46
Senft et al., 1997
American Journal of Preventive Medicine, 13:464-470
  • Design Randomized clinical trial
  • Population Primary care
  • Nation US (Portland, OR)
  • N 516 adults
  • MI 1 session, 15 min (+ TAU)
  • Comparison TAU
  • Follow-up 12 months



47
Senft et al., 1997
48
Senft et al., 1997
49
Smith et al., 2003
Addiction, 98:43-52
  • Design Randomized clinical trial
  • Population Oral and maxillofacial surgery
  • clinic out-patients
  • Nation UK (Cardiff, Wales)
  • N 151 young males with alcohol- related facial injuries
  • MI 1 manual-guided session (+ TAU)
  • Comparison TAU
  • Follow-up 3 months and one year



50
Smith et al., 2003
51
Smith et al., 2003
52
Smith et al., 2003
53
Cardiovascular Health
54
Scales, 1998
Doctoral dissertation, University of New Mexico
  • Design Randomized clinical trial
  • Population Cardiovascular rehab
  • Nation US (Albuquerque, NM)
  • N 61
  • MI TAU + MET (1 hr) + skills based health ed (90 min)
  • Comparison TAU traditional rehab
  • Follow-up 12 weeks



55
Scales, 1998
  • Significantly greater decrease in MI group, compared with TAU, in linear combination of three risk scores
    • Perceived stress
    • Physical activity
    • Dietary fat
  • All three contributed to the significant difference, but only stress was significant in a univariate test


56
Scales, 1998
57
Woollard et al., 1995
Clinical & Experimental Pharmacology & Physiology, 22:466-468
  • Design Randomized clinical trial
  • Population General practice
  • Nation Australia (Perth, WA)
  • N 166 patients with hypertension
  • MI High: 6 nurse sessions (45 min)
  • Low: 1 session + 5 phone (15 min)
  • Comparison TAU
  • Follow-up 18 weeks



58
Woollard et al., 1995
59
Woollard et al., 1995
60
Diabetes
61
Smith et al., 1997
Diabetes Care, 20:52-54
  • Design Randomized clinical trial
  • Population Recruited by newspaper
  • Nation US (Birmingham, AL)
  • N 22 older obese women
  • MI 3 sessions MI + TAU
  • Comparison TAU (behavior therapy)
  • Follow-up Post-treatment



62
Smith et al., 1997
63
Smith et al., 1997
64
Drug Abuse
65
Aubrey, 1998
Doctoral dissertation, University of New Mexico
  • Design Randomized clinical trial
  • Population Adolescent drug abuse treatment
  • Nation US (Albuquerque, NM)
  • N 77 adolescents entering treatment
  • MI 1 individual session + TAU
  • Comparison TAU
  • Follow-up 3 months



66
Aubrey, 1998
67
Aubrey, 1998
68
Aubrey, 1998
69
Aubrey, 1998
70
Aubrey, 1998
71
Baker et al., 2001
Addiction, 96:1279-1287
  • Design Randomized clinical trial
  • Population Regular amphetamine users
  • Nation Australia
  • N 64 adults
  • MI 2 individual sessions + book
  • 4 session MI + skill training
  • Comparison Self-help book
  • Follow-up 6 months



72
Baker et al., 2001
73
Baker et al., 2002
Addiction, 97:1329-1337
Acta Psychiatrica Scandinavica, 105:xx
  • Design Randomized clinical trial
  • Population Inpatient psychiatric hospital
  • Nation Australia
  • N 160 adults with concomitant
  • disorders
  • MI 30-45 minute individual session
  • Comparison Self-help book and brief advice
  • Follow-up 12 months



74
Baker et al., 2002
75
Baker et al., 2002
76
Lincourt et al., in press
Addictive Behavior
  • Design Quasi-experiment (attendance)
  • Population Mandated outpatient treatment
  • Nation US (New York)
  • N 167 adults (substance abuse)
  • MI 6 session group + TAU
  • Comparison TAU
  • Follow-up End of treatment



77
Lincourt et al., in press
78
Longshore et al., 1999
Substance Use & Misuse, 34:1223-1241
  • Design Quasi-experiment (attendance)
  • Population Mandated outpatient treatment
  • Nation US (Los Angeles, CA)
  • N 222 African-American drug users
  • MI 1 session
  • Comparison Needs assessment
  • Follow-up End of treatment



79
Longshore et al., 1999
  • MI group rated (non-blind) significantly higher:
  • Treatment involvement (self-report; p<.04)
  • Motivation for change (self-report; p<.05)
  • Treatment participation (clinician rating; p<.0001)
  • Self-disclosure (clinician rating; p<.0001)
  • Preparation for change (clinician rating; p<.0003)



80
Marijuana Treatment Project Research Group (2004)
Journal of Consulting and Clinical Psychology, 72:455-466
  • Design Randomized clinical trial
  • Population Inpatient or outpatient treatment
  • Nation US (3 sites)
  • N 450 adult marijuana smokers
  • MI 2 session MET
  • Comparison 9-session MET + behavior therapy
  • Control 4-month waiting list control
  • Follow-up 15 months



81
Marijuana Treatment Project Research Group (2004)
82
Marijuana Treatment Project Research Group (2004)

Marijuana Joints per Week
83
Miller, Yahne & Tonigan (2003)
Journal of Consulting and Clinical Psychology, 71:754-763
  • Design Randomized clinical trial
  • Population Inpatient or outpatient treatment
  • Nation US (Albuquerque, NM)
  • N 208 drug dependent adults
  • MI 1 session + TAU
  • Comparison TAU only
  • Follow-up 12 months



84
Miller et al. (2003)
Percent Days Abstinent from Alcohol/Drugs
85
Saunders et al., 1995
Addiction, 90:415-424
  • Design Randomized clinical trial
  • Population Methadone maintenance clinic
  • Nation Australia (Perth, WA)
  • N 122 adults
  • MI 1 session (1 hour)
  • Comparison Educational control
  • Follow-up 6 months



86
Saunders et al., 1995
87
Saunders et al., 1995
MI vs. Educational Control Group
  • The MI group showed greater:
  • Immediate (1 week) advance to contemplation stage (p<.03)
  • Positive view of abstinence at 3 months(p<.05)
  • Reduction in drug-related problems at 6 months (p<.04)
  • Time to relapse to heroin use (p<.05)


88
Schneider et al., 2000
Journal of Behavioral Health Services and Research, 27:60-74
  • Design Quasi-experimental
  • Population Employee assistance programs
  • Nation US (Boston, MA)
  • N 89 clients with substance abuse
  • MI 2 session MET
  • Comparison 2 session confrontation/feedback
  • Follow-up 3 and 9 months


89
Schneider et al., 2000
90
Schneider et al., 2000
91
Stein et al., 2002
Addiction, 97:691-700
  • Design Randomized clinical trial
  • Population Needle exchange program recipients
  • Nation US (Providence, RI)
  • N 187 active injection drug users
  • MI 2 sessions (60 min each)
  • - one month apart
  • Comparison Assessment only
  • Follow-up 1 and 6 months



92
Stein et al., 2002
  • MI subjects (based on observed percentage differences and odds ratios) were more likely than controls to be abstinent at 6 months.


  • MI subjects reported lower mean heroin use frequency than controls at 6 months.


  • MI subjects’ 37.5% reduction in drinking days is larger than that of most brief alcohol intervention trials.


  • MI subjects with above median (>9) baseline drinking day frequency were over two times more likely than controls to report reductions of 7 or more days (p<.05) at 6 months.


93
Stein et al., 2002
94
Stephens et al., 2000
Journal of Consulting & Clinical Psychology, 68:898-908
  • Design Randomized clinical trial
  • Population Recruited by newspaper
  • Nation US (Seattle, WA)
  • N 291 marijuana users
  • MI 2 sessions MET (90 min)
  • Comparison 14 sessions group behavior therapy (2 hours)
  • Waiting list (4 months)
  • Follow-up 16 months



95
Stephens et al., 2000
96
Stephens et al., 2000
97
Stephens et al., 2000
98
Stephens et al., 2000
99
Stotts et al., 2001
Journal of Consulting & Clinical Psychology, 69:858-862
  • Design Randomized clinical trial
  • Population Outpatient cocaine detoxification
  • Nation US (Houston, TX)
  • N 105 cocaine dependent
  • MI 2 sessions MET (1 hour)
  • Comparison Detoxification only
  • Follow-up 12 weeks post-detox



100
Stotts et al., 2001
101
Stotts et al., 2001
102
Dual Diagnosis
103
Barrowclough et al, 2001
American Journal of Psychiatry, 158:1706-1713
  • Design Randomized trial
  • Population Schizophrenia or schizoaffective + substance use disorder
  • Nation US
  • N 36 adults (marijuana)
  • MI 5 sessions + 24 CBT sessions
  • Comparison 24 CBT sessions
  • Follow-up 1 year



104
Barrowclough et al., 1998
105
Daley et al, 1998
American Journal of Psychiatry, 155:1611-1613
  • Design Consecutive assignment
  • Population Discharge from treatment
  • Nation US (Pittsburgh, PA)
  • N 23 adults (cocaine+depression)
  • MI 5 individual + 4 group sessions
  • Comparison TAU
  • Follow-up 1 year



106
Daley et al., 1998
107
Daley & Zuckoff, 1998
Social Work, 43:470-473
  • Design Consecutive cohorts
  • Population Dual diagnosis inpatients
  • Nation US (Pittsburgh, PA)
  • N “Nearly 100”
  • MI 1 pre-discharge session
  • Comparison TAU (no MI)
  • Follow-up Proximal



108
Daley & Zuckoff, 1998
109
Martino et al., 2000
American Journal on Addictions, 9:88-91
  • Design Randomized clinical trial
  • Population Partial hospital program
  • Nation US (New Haven, CT)
  • N 23 dual diagnosis patients
  • MI 1 session (45-60 min)
  • Comparison TAU
  • Follow-up End of treatment (12 wk)



110
Martino et al., 2000
111
Eating Disorders
112
Treasure et al., 1999
Behaviour Research & Therapy, 37:405-418
  • Design Randomized clinical trial
  • Population Bulimia
  • Nation UK (London, Maudsley)
  • N 125 outpatients
  • MI 4 session MET
  • Comparison 4 session behavior therapy
  • Follow-up 4 weeks



113
Treasure et al., 1999
  • No significant differences between MI and behavior therapy at 4 weeks on:
  • Drop-out rate
  • Binge eating
  • Vomiting
  • Laxative abuse



114
Gambling
115
Hodgins et al., 2001
Journal of Consulting & Clinical Psychology, 69:50-57
  • Design Randomized clinical trial
  • Population Problem gambling
  • Nation Canada (Calgary, Alberta)
  • N 102 adults
  • MI 1 phone session (20-45 min)
  • Comparison Mailed self-help book
  • Waiting list control
  • Follow-up 12 months



116
Hodgins et al., 2001
117
Health Promotion
118
Resnicow et al, 2001
American Journal of Public Health, 91, 1686-1693.
  • Design Randomized Clinical Trial
  • Population Adults recruited through Black Churches
  • Nation US (Atlanta, GA)
  • N 861 adults
  • MI 3 telephone contacts by trained dietitians
  • Comparison 1) Health Education only, 2) Self-help materials plus one non-MI phone call
  • Main Outcome Self-reported fruit & vegetable intake (F &V)
  • Follow-up 1 year



119
Resnicow et al, 2001
120
Thevos et al, 2000
Health Promotion International, 15:207-214
  • Design Comparison zones
  • Population Households
  • Nation Zambia, Africa
  • N 332 households
  • MI Health visitor consults
  • Comparison Health education
  • Follow-up 6 months



121
Thevos et al., 2000
122
HIV Risk
123
Carey et al., 1997
Journal of Consulting & Clinical Psychology, 65:531-541
  • Design Randomized clinical trial
  • Population Women at risk for HIV
  • Nation US (Syracuse, NY)
  • N 102 women from community
  • MI 4 group MET sessions
  • Comparison Attention placebo group
  • Follow-up 3 months



124
Carey et al., 1997
MI vs. Educational Control Group
  • The MI group showed greater:
  • HIV knowledge (p<.0001)
  • Perception of HIV risk (p<.001)
  • Intention to protect (p<.003)
  • Communication with partner (p<.05)
  • And significantly lower rates of:
  • Unprotected intercourse (p<.01)
  • Substance abuse before sex (p<.001)



125
Carey et al., 2000
Health Psychology, 19:3-11
  • Design Randomized clinical trial
  • Population Women at risk for HIV
  • Nation US (Syracuse, NY)
  • N 102 women from community
  • MI 4 group MET sessions
  • Comparison Attention placebo group
  • Follow-up 3 and 12 weeks



126
Carey et al., 2000
MI vs. Educational Control Group
  • The MI group showed greater:
  • HIV knowledge (p<.003)
  • Intention to protect (p<.001)


  • And significantly lower rates of:
  • Unprotected intercourse (p<.001)
  •      among women with imperfect intentions



127
Mental Health
128
Kemp et al., 1998
British Journal of Psychiatry, 172:413-419
  • Design Randomized clinical trial
  • Population Acute psychiatric unit
  • Nation UK (London, Maudsley Hospital)
  • N 74 patients with psychosis
  • MI 4-6 session Compliance Therapy
  • Comparison 4-6 session supportive therapy
  • Follow-up 18 months



129
Kemp et al., 1998
Clinician (Non-blind) Ratings of Improvement
  • MI group rates significantly higher on
  • Insight
  • Global functioning
  • Attitudes toward drug use
  • Compliance



130
Kemp et al., 1998
  • MI group showed lower rates of:
  • Treatment drop-out
  • 28% vs. 43%  (ns)
  • Readmission
  • Relative risk of controls = 2.2




131
Swanson et al., 1999
Journal of Nervous & Mental Disease, 187:630-635
  • Design Randomized clinical trial
  • Population Psychiatric inpatients
  • Nation US (New York)
  • N 121 inpatients
  • MI 2 sessions (15, 60 min) + TAU
  • Comparison TAU
  • Follow-up Transition to aftercare



132
Swanson et al., 1999
133
Smoking
134
Colby et al., 1998
Journal of Consulting & Clinical Psychology, 66:574-578
  • Design Randomized clinical trial
  • Population Hospital emergency room
  • Nation US (Providence, RI)
  • N 40 adolescent smokers
  • MI 1 MET session with 4 videos
  • Comparison Brief advice
  • Follow-up 3 months



135
Colby et al., 1998
136
Stotts et al., 2002
Addictive Behaviors, 27:275-292
  • Design Randomized clinical trial
  • Population 21 prenatal care clinics
  • Nation USA (Houston and Dallas, TX)
  • N 269 resistant pregnant smokers
  • MI 2 MI phone calls (20-30 min)
  • Comparison TAU
  • Follow-up to 6 months post-partum



137
Stotts et al., 2002
138
Stotts et al., 2002