The Emerging Evidence Base for Motivational Interviewing: A Meta-Analytic and Qualitative Inquiry

This article offers a meta-analytic, qualitative, and process review of the empirical literature for adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors. AMIs are equivalent to other active treatments and yield moderate effects (from 0.35 to 0.56) compared to no-treatment/placebo for problems involving alcohol, drugs, and diet and exercise. Results do not support the efficacy of AMIs for smoking or HIV-risk behaviors. Conclusions regarding the mechanisms of action for AMIs are limited by methodological problems: confounding motivational interviewing with feedback, unclear definitions of the AMI interventions used, difficulties in therapist training, and limited use of treatment integrity rating scales. Extant research suggests that AMIs are equivalent in efficacy to and briefer than cognitive behavioral skills training (CBST) approaches. Since AMIs focus on readiness to change while CBST targets the change process, AMIs may be useful as preludes or additions to CBST.

[1]  B. Rounsaville,et al.  Motivational interviewing with psychiatrically ill substance abusing patients. , 2000, The American journal on addictions.

[2]  W. Miller,et al.  Assessing drinkers' motivation for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). , 1996 .

[3]  C. N. Mhurchu,et al.  Randomized clinical trial comparing the effectiveness of two dietary interventions for patients with hyperlipidaemia. , 1998, Clinical science.

[4]  G A Marlatt,et al.  Brief intervention for heavy-drinking college students: 4-year follow-up and natural history. , 2001, American journal of public health.

[5]  M. Pantalon,et al.  Motivational interviewing and treatment adherence among psychiatric and dually diagnosed patients. , 1999, The Journal of nervous and mental disease.

[6]  K. Walitzer,et al.  Preparing clients for alcoholism treatment: effects on treatment participation and outcomes. , 2002, Journal of consulting and clinical psychology.

[7]  R. Schneider,et al.  Motivational versus confrontational interviewing: A comparison of substance abuse assessment practices at employee assistance programs , 2000, The journal of behavioral health services & research.

[8]  Brian L. Burke,et al.  The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. , 2003, Journal of consulting and clinical psychology.

[9]  P. Sullivan,et al.  A randomized controlled trial of motivational enhancement therapy (MET) for mild to moderate alcohol dependence. , 2001, Journal of studies on alcohol.

[10]  W. Miller,et al.  Motivational Interviewing with Alcohol Outpatients , 1993, Behavioural and Cognitive Psychotherapy.

[11]  A. Stotts,et al.  Motivational interviewing with cocaine-dependent patients: a pilot study. , 2001, Journal of consulting and clinical psychology.

[12]  A Wodak,et al.  Evaluation of a cognitive‐behavioural intervention for HIV prevention among injecting drug users , 1993, AIDS.

[13]  W. Miller,et al.  Findings of a pilot study of motivational interviewing with pregnant drinkers. , 1999, Journal of studies on alcohol.

[14]  G. Woody,et al.  MET meets the real world: design issues and clinical strategies in the Clinical Trials Network. , 2002, Journal of substance abuse treatment.

[15]  N. Heather,et al.  Controlled evaluation of a brief intervention for HIV prevention among injecting drug users not in treatment. , 1994, AIDS care.

[16]  K. Schmaling,et al.  A Randomized Controlled Pilot Study of Motivational Interviewing to Change Attitudes about Adherence to Medications for Asthma , 2001, Journal of Clinical Psychology in Medical Settings.

[17]  J. Treasure,et al.  Engagement and outcome in the treatment of bulimia nervosa: first phase of a sequential design comparing motivation enhancement therapy and cognitive behavioural therapy. , 1999, Behaviour research and therapy.

[18]  M. Copass,et al.  Behavior change counseling in the emergency department to reduce injury risk: a randomized, controlled trial. , 2002, Pediatrics.

[19]  David C. Atkins,et al.  Is Professional Training Worth the Bother? A Review of the Impact of Psychotherapy Training on Client Outcome , 2001 .

[20]  Comparison of extended versus brief treatments for marijuana use. , 2000 .

[21]  W. Miller,et al.  A SMALL STUDY OF TRAINING IN MOTIVATIONAL INTERVIEWING: DOES ONE WORKSHOP CHANGE CLINICIAN AND CLIENT BEHAVIOR? , 2001 .

[22]  K. Radonovich,et al.  Adding voucher-based incentives to coping skills and motivational enhancement improves outcomes during treatment for marijuana dependence. , 2000, Journal of consulting and clinical psychology.

[23]  L. Aubrey.  Motivational interviewing with adolescents presenting for outpatient substance abuse treatment. , 1998 .

[24]  R. Longabaugh,et al.  Cognitive-behavioral treatment for alcohol dependence: a review of evidence for its hypothesized mechanisms of action. , 2000, Addiction.

[25]  Delia E. Smith,et al.  Motivational Interviewing to Improve Adherence to a Behavioral Weight-Control Program for Older Obese Women With NIDDM: A pilot study , 1997, Diabetes Care.

[26]  M. Larimer,et al.  Screening and brief intervention for high-risk college student drinkers , 1998 .

[27]  R. Booth,et al.  Facilitating treatment entry among out-of-treatment injection drug users. , 1998, Public health reports.

[28]  R. Woolard,et al.  Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department. , 1999, Journal of consulting and clinical psychology.

[29]  G A Marlatt,et al.  Screening and brief intervention for high-risk college student drinkers: results from a 2-year follow-up assessment. , 1998, Journal of consulting and clinical psychology.

[30]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[31]  Wayne F. Velicer,et al.  Stages of change in psychotherapy: A follow-up report. , 1989 .

[32]  K. Kraemer,et al.  Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers. , 2001, Journal of studies on alcohol.

[33]  The impact of a brief motivational intervention with opiate users attending a methadone programme. , 1995 .

[34]  F P Rivara,et al.  The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. , 2001, Addiction.

[35]  M. Carey,et al.  Interpersonal communication and sexual adjustment: the roles of understanding and agreement. , 1997, Journal of consulting and clinical psychology.

[36]  M. Stein,et al.  A randomized trial of a brief alcohol intervention for needle exchangers (BRAINE). , 2002, Addiction.

[37]  Chris Drinkwater,et al.  The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care , 1999, BMJ.

[38]  W. Miller,et al.  Motivational Interviewing with Problem Drinkers: II. The Drinker's Check-up as a Preventive Intervention , 1988, Behavioural and Cognitive Psychotherapy.

[39]  M. Copass,et al.  Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. , 1999, Annals of surgery.

[40]  W. Miller,et al.  The Effectiveness of Alcoholism Treatment , 1986 .

[41]  W. Miller,et al.  Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles. , 1993, Journal of consulting and clinical psychology.

[42]  G. Bennett,et al.  THE IMPACT OF BRIEF MOTIVATIONAL INTERVENTION AT THE START OF AN OUTPATIENT DAY PROGRAMME FOR ALCOHOL DEPENDENCE , 2000, Behavioural and Cognitive Psychotherapy.

[43]  Licsw,et al.  Evaluating the effects of a brief motivational intervention for injured drinkers in the emergency department. , 2001, Journal of studies on alcohol.

[44]  R. Woolard,et al.  Brief motivational interviewing in a hospital setting for adolescent smoking: a preliminary study. , 1998, Journal of consulting and clinical psychology.

[45]  W. Miller,et al.  Impact of motivational interviewing on participation and outcome in residential alcoholism treatment. , 1993 .

[46]  W. Miller,et al.  Do Continuing Education Workshops Improve Participants' Skills? Effects of a Motivational Interviewing Workshop on Substance-Abuse Counselors' Skills and Knowledge. , 2000 .

[47]  K. Carey,et al.  Effects of a brief motivational intervention with college student drinkers. , 2000, Journal of consulting and clinical psychology.

[48]  M. Bachmann,et al.  Motivational consulting versus brief advice for smokers in general practice: a randomized trial , 1999 .

[49]  N. Heather,et al.  Effects of brief counselling among male heavy drinkers identified on general hospital wards. , 1996, Drug and alcohol review.