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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore how well a brief Motivational Enhancement Therapy (MET) can help Veterans reduce alcohol use and intimate partner violence (IPV). Participants will receive one of three treatments: MET, Alcohol Education (a standard educational program about alcohol), or standard Telephone Monitoring. The goal is to determine which treatment most effectively lowers alcohol-related issues and encourages help-seeking behavior. Veterans in the Strength at Home program with alcohol-related problems, such as heavy drinking or experiencing IPV while under the influence, are ideal candidates for this trial.

As an unphased trial, this study offers Veterans a unique opportunity to contribute to understanding and improving treatments for alcohol-related issues and IPV.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Motivational Enhancement Therapy (MET) for alcohol use is generally manageable for participants. In one study involving men with drinking problems and a history of partner violence, most participants remained in the program, with 78% completing follow-up interviews. This suggests that individuals can adhere to the therapy, indicating its safety. While any treatment may have side effects, MET emphasizes supportive conversations and personal growth, reducing the likelihood of harm compared to medication-based treatments.

The Alcohol Education intervention, another treatment under study, provides information and encourages healthy choices. It appears safe because it is primarily educational. Both MET and Alcohol Education aim to assist without causing discomfort. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for alcohol-related intimate partner violence because they tackle the issue from different angles. Motivational Enhancement Therapy (MET) is distinctive because it focuses on enhancing a person's motivation to change their drinking behavior through empathic support and personalized feedback, which can be more engaging than traditional methods. The Alcohol Education Control provides a comprehensive psychoeducational approach by dispelling myths about alcohol and promoting healthier decision-making. Unlike standard treatments, these interventions aim to address both the psychological and educational aspects of alcohol misuse, potentially leading to more sustainable behavior change.

What evidence suggests that this trial's treatments could be effective for alcohol-related intimate partner violence?

Research has shown that Motivational Enhancement Therapy (MET), one of the treatments in this trial, can help reduce alcohol use and related problems. Studies have found that brief alcohol interventions, like MET, lead to less drinking and reduced partner violence. Specifically, one study found that MET was effective in community programs for intimate partner violence (IPV), showing good results in cutting down alcohol use. MET increases self-motivation and commitment to change, which has been helpful in addressing alcohol-related issues. Overall, evidence supports that MET may help lower alcohol use and related negative behaviors. Participants in this trial may receive MET, Alcohol Education Control, or Telephone Monitoring as part of their treatment. ^{1 3 5 6 7}

Who Is on the Research Team?

Casey Tyler Taft, PhD

Principal Investigator

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

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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 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]

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 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]

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]

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]

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]

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]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/29706170/

A randomized clinical trial of motivational enhancement ... This study examined the efficacy of brief alcohol intervention in the context of community-based treatment for partner violence. In a randomized clinical ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5930382/

A Randomized Clinical Trial of Motivational Enhancement ... This study examined the efficacy of brief alcohol intervention in the context of community-based treatment for partner violence.

3. jsatjournal.com jsatjournal.com/article/S0740-5472(17)30247-7/abstract

A randomized clinical trial of motivational enhancement ... This study examined the efficacy of brief alcohol intervention in the context of community-based treatment for partner violence. In a randomized clinical trial, ...

4. case.edu case.edu/socialwork/centerforebp/sites/default/files/2024-11/MI%20and%20MET%20for%20AUD%20Full%20Report-09242024-upd-11-15-2024.pdf

Motivational interviewing and motivational enhancement ... Three studies yielded mixed but promising results on the effectiveness of motivational interventions for reducing alcohol use. Dieperink et ...

5. jamanetwork.com jamanetwork.com/journals/jama/fullarticle/2422543

Brief Motivational Intervention for Intimate Partner Violence ... In the ED setting, brief interventions have been found to be effective in reducing alcohol consumption and alcohol-related injury among patients ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05287711

Adjunctive Motivational Alcohol Intervention to Prevent IPV This is a study to provide much-needed experimental data on the efficacy of a brief alcohol Motivational Enhancement Therapy (MET) pre-group intervention ...

7. withpower.com withpower.com/trial/phase-alcohol-use-and-intimate-partner-violence-6-2022-3d48c?lat=34.60184&lng=-117.81218

Motivational Enhancement Therapy for Alcohol-Related ... The investigators will examine whether MET leads to greater reductions in alcohol use problems and IPV perpetration, and increased help-seeking behavior for ...