Motivational Enhancement Therapy for Alcohol-Related Intimate Partner Violence

(MET-SAH Trial)

Recruiting at 3 trial locations

Overseen By Samuel F Frank, BA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

300 Participants Needed

Trial Summary

What is the purpose of this trial?

This is a study to provide much-needed experimental data on the efficacy of a brief alcohol Motivational Enhancement Therapy (MET) pre-group intervention for Veterans receiving group treatment for IPV perpetration. The investigators will compare those assigned to receive this 2-session MET intervention to those receiving a 2-session Alcohol Education (AE) intervention or a 2-session standard treatment as usual (TAU) telephone monitoring intervention. The investigators will examine whether MET leads to greater reductions in alcohol use problems and IPV perpetration, and increased help-seeking behavior for alcohol use problems. Participants will be 300 Veterans drawn from the Strength at Home IPV intervention program across the entire Veterans Health Administration system.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems likely that you can continue your medications, as the study does not list any exclusion criteria related to medication use.

What data supports the effectiveness of the treatment Motivational Enhancement Therapy for Alcohol-Related Intimate Partner Violence?

Motivational Enhancement Therapy (MET) has been shown to help people recognize their alcohol problems and improve self-efficacy (confidence in their ability to change), which can reduce alcohol consumption and related issues. However, in the context of partner violence, MET did not show a unique benefit over other alcohol interventions in reducing alcohol use or partner violence. ^{1 2 3 4 5}

Is Motivational Enhancement Therapy (MET) safe for humans?

Motivational Enhancement Therapy (MET) has been used safely in various settings, including for alcohol use disorders and in psychiatric inpatients with chemical dependence. The studies did not report any significant safety concerns, suggesting that MET is generally safe for humans. ^{1 2 3 5 6}

How does Motivational Enhancement Therapy differ from other treatments for alcohol-related intimate partner violence?

Motivational Enhancement Therapy (MET) is unique because it focuses on increasing a person's motivation to change by helping them recognize and resolve their mixed feelings about their behavior. Unlike other treatments, MET is a brief, client-centered approach that emphasizes personal feedback and self-efficacy, which can be particularly effective in encouraging individuals to seek further treatment and reduce harmful behaviors. ^{1 2 3 7 8}

Research Team

Casey Tyler Taft, PhD

Principal Investigator

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Eligibility Criteria

This trial is for male Veterans at least 18 years old who are enrolled in the Strength at Home program and have alcohol-related problems. They must show evidence of these issues, like scoring high on a specific test (AUDIT), drinking heavily on occasions, or having committed IPV under the influence.

Inclusion Criteria

I am a male Veteran, 18 or older, with alcohol-related issues, enrolled in Strength at Home, and I consent to participate.

Exclusion Criteria

Not applicable.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-group Intervention

Participants receive a 2-session Motivational Enhancement Therapy (MET) or Alcohol Education (AE) intervention, or a standard treatment as usual (TAU) telephone monitoring intervention

2 sessions

IPV Group Treatment

Participants are assigned to Strength at Home groups for IPV intervention

3 months

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at multiple intervals

12 months

Baseline, post-treatment, three-month, six-month, nine-month, and twelve-month follow-ups

Treatment Details

Interventions

• Alcohol Education Control
• Motivational Enhancement Therapy
• Treatment as Usual

Trial Overview The study tests if Motivational Enhancement Therapy (MET) can better reduce alcohol problems and IPV than an Alcohol Education intervention or standard phone monitoring. It's conducted with Veterans from three VA locations to see if MET also encourages seeking help for alcohol use.

Participant Groups

Group I: Telephone Monitoring Experimental Treatment 2 Interventions

Brief supportive telephone monitoring sessions that are commonly delivered while Veterans wait to begin their groups (treatment as usual).

Group II: Motivational Enhancement Therapy Experimental Treatment 2 Interventions

Motivational enhancement therapy for alcohol use problems, which includes empathic support, feedback and advice, strategies for enhancing self-efficacy, techniques for eliciting self-motivational statements from the participant, strategies for addressing participant ambivalence about change and participant resistance to change, and methods for eliciting and affirming commitment to a specific change plan (active intervention).

Group III: Alcohol Education Control Experimental Treatment 2 Interventions

Psychoeducational intervention intended to: (1) dispel myths about the effects of alcohol, (2) provide information about the general risks of drinking and process of recovery from alcohol problems, (3) provide information about the specific risks related to family relationships and IPV, (4) offer self-help program information and related strategies to address drinking problems, (5) promote and encourage healthy decision-making, and (6) reinforce the benefits of abstinence or controlled drinking.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

In a study involving 228 partner-violent men with hazardous drinking, both Motivational Enhancement Therapy (MET) and Alcohol Education (AE) interventions led to significant improvements in alcohol use and reductions in partner violence after treatment.

While MET participants showed greater acknowledgment of their alcohol problems, there were no significant differences in alcohol abstinence or heavy drinking between the two intervention groups, suggesting that both interventions are effective but MET does not offer unique benefits in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized clinical trial of motivational enhancement therapy for alcohol problems in partner violent men. Murphy, CM., Ting, LA., Jordan, LC., et al.[2021]

Patients found motivational enhancement therapy (MET) effective for alcohol use disorder, appreciating the supportive relationship with their therapist, which was crucial for fostering a positive therapeutic environment.

However, participants expressed a desire for more guidance in goal-setting and longer treatment duration to better support their self-efficacy for change, indicating that while MET is beneficial, adjustments could enhance its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A qualitative interview study of patient experiences of receiving motivational enhancement therapy in a Swedish addiction specialist treatment setting. Ingesson Hammarberg, S., Sundbye, J., Tingvall, R., et al.[2023]

Motivational enhancement therapy (MET) significantly improved self-efficacy in alcohol-dependent individuals, with a notable increase from a mean score of 56.30 before treatment to 60.75 after 10 sessions, indicating its effectiveness in promoting abstinence.

The study involved 40 alcohol-dependent subjects, divided into two groups, with one receiving MET alongside standard treatment, demonstrating that MET can be a valuable intervention in enhancing self-efficacy and reducing alcohol dependence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Motivational Enhancement Therapy (MET) on the self efficacy of Individuals of Alcohol dependence. Kumar, S., Srivastava, M., Srivastava, M., et al.[2022]

In a study involving 140 licensed substance abuse professionals, various training methods for motivational interviewing (MI) were tested, showing that those who received training (workshop plus feedback or coaching) significantly improved their proficiency compared to a control group.

The improvements in MI skills were generally maintained over time, indicating that effective training methods can lead to lasting benefits in clinician performance, although self-reported skillfulness did not correlate with actual observed proficiency.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized trial of methods to help clinicians learn motivational interviewing. Miller, WR., Yahne, CE., Moyers, TB., et al.[2022]

In a study of 101 dually diagnosed psychiatric inpatients, adding group motivational interviewing (GMI) to standard treatment led to significantly higher attendance in aftercare sessions and reduced alcohol consumption compared to a control group.

While GMI showed benefits in treatment engagement and substance use reduction, the overall rates of complete abstinence and aftercare attendance did not differ significantly between groups, possibly due to insufficient sample size for detecting these differences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of group motivational interviewing (GMI) for psychiatric inpatients with chemical dependence. Santa Ana, EJ., Wulfert, E., Nietert, PJ.[2009]

A study involving 9 internal medicine residents indicated that brief motivational enhancement therapy (MET) prior to standard education on screening, brief intervention, and referral to treatment (SBIRT) may positively influence attitudes and behaviors towards intervening with alcohol and drug users.

Although the changes in attitudes and behaviors were in the expected direction, the small sample size prevented these results from reaching statistical significance, suggesting further research is needed to confirm MET's effectiveness in enhancing SBIRT practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational enhancement therapy to increase resident physician engagement in substance abuse education. Hettema, JE., Sorensen, JL., Uy, M., et al.[2021]

Telephone-delivered motivational enhancement therapy (MET) was evaluated in a study with 124 adult men who were perpetrators of intimate partner violence (IPV) and substance users, showing promising short-term effectiveness in reducing IPV behaviors.

Participants receiving MET reported increased motivation to seek treatment and changes in their perceptions of social norms regarding IPV and substance abuse, suggesting that MET could be a valuable tool for encouraging voluntary treatment entry.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Telephone Intervention for Substance-Using Adult Male Perpetrators of Intimate Partner Violence. Mbilinyi, LF., Neighbors, C., Walker, DD., et al.[2021]

A randomized trial with 42 men showed that while individualized cognitive-behavioral therapy (ICBT) had higher attendance rates, the standardized group cognitive-behavioral therapy (GCBT) was more effective in reducing intimate partner violence (IPV) behaviors and improving relationship functioning.

Participants reported significant reductions in abusive behaviors in both treatment conditions, but GCBT led to greater improvements in psychological aggression and physical assault, suggesting that the group setting may provide beneficial social support for IPV perpetrators.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual Versus Group Cognitive-Behavioral Therapy for Partner-Violent Men: A Preliminary Randomized Trial. Murphy, CM., Eckhardt, CI., Clifford, JM., et al.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

A randomized clinical trial of motivational enhancement therapy for alcohol problems in partner violent men. [2021]

2. England pubmed.ncbi.nlm.nih.gov

A qualitative interview study of patient experiences of receiving motivational enhancement therapy in a Swedish addiction specialist treatment setting. [2023]

3. India pubmed.ncbi.nlm.nih.gov

Effect of Motivational Enhancement Therapy (MET) on the self efficacy of Individuals of Alcohol dependence. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

A randomized trial of methods to help clinicians learn motivational interviewing. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Efficacy of group motivational interviewing (GMI) for psychiatric inpatients with chemical dependence. [2009]

6. United States pubmed.ncbi.nlm.nih.gov

Motivational enhancement therapy to increase resident physician engagement in substance abuse education. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

A Telephone Intervention for Substance-Using Adult Male Perpetrators of Intimate Partner Violence. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Individual Versus Group Cognitive-Behavioral Therapy for Partner-Violent Men: A Preliminary Randomized Trial. [2021]