Motivational Interviewing for Substance Use Disorders

Overseen By Margo Hurlocker, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of New Mexico

Disqualifiers: Severe withdrawal, Psychotic, Manic, Suicidal

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

Compensation: Varies

Number of Visits: 1

Duration: 12 weeks

150 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new approach called Motivational Interviewing (MI) to enhance engagement in addiction treatment. Participants will receive either a standard assessment, known as Intake as Usual (IAU), or MI, which involves a focused conversation to boost motivation for change. The goal is to determine which method better aids engagement in outpatient programs for individuals dealing with alcohol or drug use. Ideal participants are English-speaking adults seeking outpatient addiction treatment who are not experiencing severe withdrawal or serious mental health issues. As an unphased trial, this study provides a unique opportunity to explore innovative treatment methods for addiction.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, since participants must be physically withdrawn from alcohol or other drugs, you might need to stop using substances related to your addiction.

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

Research shows that Motivational Interviewing (MI) is generally safe for people with substance use issues. Studies have found that MI helps many reduce their substance use over time, indicating that most handle it well.

Important findings suggest no major negative effects are reported with MI. Participants in MI sessions often find them helpful in reducing substance dependence, indicating the treatment usually doesn't cause harm.

Overall, MI is considered a safe method for addressing substance use problems. Research has not identified any serious safety concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using Motivational Interviewing (MI) for substance use disorders because it offers a distinct approach to engaging clients. Unlike traditional methods, such as cognitive-behavioral therapy (CBT) or 12-step programs, MI is a conversational technique that encourages clients to find their own motivations for change, making it highly personalized. This method focuses on enhancing an individual's intrinsic motivation rather than imposing external goals, which can lead to more meaningful and lasting behavioral changes. Additionally, MI can be seamlessly integrated into the initial intake process, potentially improving client engagement and outcomes right from the start.

What evidence suggests that this trial's treatments could be effective for substance use disorders?

This trial will compare Motivational Interviewing at Intake (MII) with Intake as Usual (IAU). Research has shown that Motivational Interviewing (MI) can help people reduce their substance use. Those who receive MI often cut down on their substance use more than those who do not receive this type of support. MI boosts motivation and encourages adherence to recovery plans. Studies in real-world settings confirm MI's effectiveness. Overall, MI is a promising method for reducing substance use and improving recovery outcomes. ^{1 2 6 7 8}

Who Is on the Research Team?

Margo Hurlocker, PhD

Principal Investigator

University of New Mexico

Are You a Good Fit for This Trial?

This trial is for English-speaking adults seeking outpatient treatment for alcohol or drug use, who are willing to follow study procedures and have given informed consent. It's also open to staff at the treatment programs. Participants must not be physically dependent on substances at the time of intake.

Exclusion Criteria

I am not experiencing severe mental health issues like psychosis, mania, or suicidal thoughts.

Current position: facility owner or clinical director

Experiencing severe withdrawal symptoms

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intake

Participants undergo either a standard assessment or a Motivational Interviewing session at intake

1 session (90 minutes)

1 visit (in-person)

Treatment

Participants engage in a three-month outpatient treatment program

12 weeks

Multiple visits (in-person)

Follow-up

Participants are monitored for completion of the treatment program and engagement metrics

up to 36 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Intake as Usual (IAU)
• Motivational Interviewing at Intake (MII)

Trial Overview The study compares two approaches: usual intake procedures versus Motivational Interviewing at Intake (MII) to see which is more effective in engaging clients in addiction treatment. The trial will also assess how easy it is to integrate MII into regular practice.

How Is the Trial Designed?

Group I: Motivational Interviewing at Intake (MII) Experimental Treatment 1 Intervention

Clients allocated to the MII condition will receive a 90-minute pure Motivational Interviewing (MI) session.

Group II: Intake as Usual (IAU) Active Control 1 Intervention

Clients allocated to the IAU condition will receive the 90-minute standard assessment that is delivered to all clients entering intensive outpatient program (IOP)/outpatient program (OP).

Intake as Usual (IAU) is already approved in United States, European Union for the following indications:

Approved in United States as Intake as Usual for:

• Addiction Treatment
• Substance Use Disorders

Approved in European Union as Standard Intake for:

• Addiction Treatment
• Substance Use Disorders

Who Is Running the Clinical Trial?

University of New Mexico

Lead Sponsor

Trials

393

Recruited

3,526,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Published Research Related to This Trial

Motivational interviewing (MI) significantly reduces substance use compared to no treatment, with the strongest effect observed immediately after the intervention (SMD 0.79), but the effect diminishes over time, becoming non-significant in long-term follow-ups.

MI shows no significant advantage over standard treatment methods, but it outperforms assessment and feedback interventions in medium-term follow-ups (SMD 0.38), indicating its potential value in specific contexts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing for substance abuse. Smedslund, G., Berg, RC., Hammerstrøm, KT., et al.[2022]

Motivational interviewing, originally designed for individual therapy, can be effectively adapted for group settings to help patients with both psychiatric and substance use disorders, as shown in a pilot test with inpatient participants.

The group format was engaging and helped participants explore their feelings about change, indicating that this approach may enhance treatment outcomes for those with dual diagnoses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot test of motivational interviewing groups for dually diagnosed inpatients. Van Horn, DH., Bux, DA.[2019]

The MAPIT trial is a large-scale study involving 600 offenders across two sites (Baltimore and Dallas) to evaluate the effectiveness of motivational interviewing (MI) and a motivational computer program (MC) in improving addiction treatment initiation and retention among probationers.

This research aims to provide insights into how different motivational strategies, including in-person and technological approaches, can enhance treatment engagement and reduce recidivism, ultimately benefiting public health and safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational tools to improve probationer treatment outcomes. Taxman, FS., Walters, ST., Sloas, LB., et al.[2021]

This study will compare the effectiveness of a standard comprehensive intake assessment with a person-centered Motivational Interviewing (MI) intervention for adults seeking outpatient addiction treatment, involving 150 participants (75 in each group).

The trial aims to assess whether the MI approach can improve client engagement in treatment, as well as its feasibility and sustainability within addiction treatment programs, potentially reducing the high attrition rates seen during initial intakes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and feasibility of a motivational interviewing intake (MII) intervention for increasing client engagement in outpatient addiction treatment: an effectiveness-implementation hybrid design protocol. Hurlocker, MC., Moyers, TB., Hatch, M., et al.[2023]

Motivational interviewing (MI) may lead to a small to moderate reduction in substance use compared to no intervention, particularly in the short term, based on a systematic review of 93 studies involving 22,776 participants.

MI shows slight benefits over assessment and feedback in reducing substance use in the medium and long term, but it appears to have little to no effect compared to treatment as usual or other active interventions, indicating that its effectiveness may vary depending on the context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing for substance use reduction. Schwenker, R., Dietrich, CE., Hirpa, S., et al.[2023]

In a clinical trial involving 208 participants (152 outpatients and 56 inpatients), a single session of motivational interviewing (MI) did not significantly impact drug use outcomes when added to standard treatment for drug problems.

Despite the lack of effect from MI, both inpatient and outpatient groups experienced substantial increases in abstinence from illicit drugs and alcohol over the study period, indicating that standard treatment approaches were effective.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motivational interviewing in drug abuse services: a randomized trial. Miller, WR., Yahne, CE., Tonigan, JS.[2022]

Training in motivational interviewing (MI) for substance use disorder (SUD) treatment did not consistently lead to sustained practice change, with only 2 out of 20 studies achieving the target of 75% of clinicians reaching proficiency after training.

The review highlighted that ongoing competency monitoring and training are necessary for clinicians to effectively implement MI, and the impact of this training on client outcomes remains unclear, indicating a need for further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing? Hall, K., Staiger, PK., Simpson, A., et al.[2022]

Clients who expressed ambivalence about their substance use early in motivational interviewing sessions showed a significant increase in their willingness to discuss change, suggesting they may benefit more from this approach.

In contrast, clients who indicated readiness to change actually experienced a decrease in their willingness to engage in change talk during the session, indicating that motivational interviewing may not be as effective for them.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What can clients tell us about whether to use motivational interviewing? An analysis of early-session ambivalent language. Forman, DP., Moyers, TB., Houck, JM.[2023]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38084817/

Motivational interviewing for substance use reduction Motivational interviewing may reduce substance use compared with no intervention up to a short follow-up period.

2. sciencedirect.com sciencedirect.com/science/article/pii/S2772724625000150

Real-world effectiveness of Motivational Enhancement for ... This study tests the real-world effectiveness of MEET for individuals transitioning between SUD treatment settings.

3. uptodate.com uptodate.com/contents/substance-use-disorders-motivational-interviewing

Substance use disorders: Motivational interviewing - UpToDate Motivational interviewing has been found to reduce substance use among individuals with substance use disorders (SUDs) [2]. This topic describes ...

4. case.edu case.edu/socialwork/centerforebp/sites/default/files/2024-09/MI%20and%20MET%20for%20Opioid%20Use%20Disorders%20Research%20Summary%20Report.pdf

MI and MET for Opioid Use Disorders ... Motivational interviewing and motivational enhancement therapy may enhance motivation, treatment engagement, and improve drug use outcomes when incorporated ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8939890/

Motivational interviewing for substance abuse - PMC The results show that people who have received MI have reduced their use of substances more than people who have not received any treatment. However, it seems ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2148493/

Site Matters: Multisite Randomized Trial of Motivational ... MET resulted in more sustained substance use reductions than CAU among primary alcohol users, but no difference was found for primary drug users.

7. cochranelibrary.com cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008063.pub3/full

Motivational interviewing for substance use reduction The results show that motivational interviewing may make little to no difference to substance use compared with regular treatment or another ...

8. library.samhsa.gov library.samhsa.gov/sites/default/files/tip-35-pep19-02-01-003.pdf

SAMHSA TIP 35 Enhancing Motivation for Change in ... Motivation for change is a key component in addressing substance misuse. This Treatment Improvement. Protocol (TIP) reflects a fundamental rethinking of the ...