Largest analysis to date offers practice insights in to motivational interviewing

Better than ‘treatment as usual’ but not than other specific therapies are the headlines from the most comprehensive synthesis of motivational interviewing studies to date. Along the way are insights in to the equivocal value of manuals and of feeding back assessment results to patients.

Extract

A team of authors from the USA has produced the most comprehensive synthesis yet of studies of the influential counselling approach, motivational interviewing. The breadth of the analysis has enabled them to conduct detailed sub-analyses of relevance to practitioners and service planners.

Across all 132 comparisons, motivational interventions were associated with a statistically significant improvement in outcomes whose effect size at 0.22 is conventionally considered to represent a small impact. In a quarter of cases, the motivational intervention was roughly equivalent to the comparator, in another quarter it was associated with small positive improvements, and in a half with substantial improvements. The added benefits showed no signs of fading up to two years or more after intervention, though few studies tested this beyond a year.

The review adds its considerable weight to the common conclusion that any well structured therapy is as good as any other. However, this may be partly because studies inappropriately standardise the treatment of individuals seeking help, and equivalence of impact applies only on average across the entire caseload. It remains the case that different therapeutic styles are more or less suited to different people or people at different stages in their commitment to change.

Read the full story at our partner site Drug and Alcohol Findings

About Mike Ashton

Mike Ashton is the editor of Drug and Alcohol Findings, a collaborative project involving the National Addiction Centre, DrugScope and Alcohol Concern.

It produced the world’s only magazine devoted to evaluations of the effectiveness of alcohol and drug interventions and now offers a similar service from its web site Findings.

Previously he produced the first two Annual Reports on the State of the Drugs Problem in the European Union for the European Monitoring Centre for Drugs and Drug Addiction and Juice, a magazine for drug users in the UK. His background was 20 years at the Institute for the Study of Drug Dependence, then the UK’s information service on the misuse of drugs, where he was became co-responsible for publications and founded the Druglink magazine. He edited the magazine for 10 years until leaving the Institute in 1995.

Until standing down in 2003 he also chaired (and remains a board member for) T3E UK, a charity especially concerned with race and drugs issues on which it provides training, research and consultancy.

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