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Motivational interviewing for adolescent substance use a review of the literature

Motivational interviewing for adolescent substance use: Further study was needed. Authors' objectives To evaluate the effectiveness of motivational interviewing, to treat adolescent substance use, and to explore the impact of different intervention formats and designs, as well as the mechanisms of change, based on theory.

  • Twenty-six studies reported statistically significant reductions in some type of substance use, at follow-up, including alcohol seven studies , tobacco six studies , marijuana seven studies , and various combinations of substance use eight studies;
  • Most of the data were combined in a narrative synthesis, which was appropriate given the variation between studies;
  • The authors stated the need for further research into the relationship between design, format and other intervention characteristics;
  • The authors did not state how many reviewers selected studies for inclusion;
  • Study selection Experimental and quasi-experimental studies of interventions, based on motivational interviewing techniques, aimed at improving substance use outcomes in participants, with a mean age of less than 18.

Search terms were reported. A motivational interviewing website and the Internet, using Google Scholar, were searched, as were the reference lists of the articles from the website. Study selection Experimental and quasi-experimental studies of interventions, based on motivational interviewing techniques, aimed at improving substance use outcomes in participants, with a mean age of less than 18.

  • Data extraction Data were extracted and categorised by intervention design and delivery mode, and whether the effect of the intervention was positive, negative or none, at follow-up;
  • Two reviewers independently assessed study quality;
  • Search terms were reported.

The included studies were categorised as motivational interviewing only, motivational interviewing with feedback, motivational interviewing with another intervention, and motivational interviewing with feedback and another intervention.

Programmes were delivered to groups or individuals, or a combination of these. Formats included face-to-face, telephone, and computer or Internet, alone or in various combinations. Most studies measured substance use by self report; some used a combination of self report and biochemical measures or medical records.

The authors did not state how many reviewers selected studies for inclusion.

  • Follow-up ranged from one month to two years;
  • Authors' conclusions Two thirds of the included studies reported statistically significant reductions in adolescent substance use, at follow-up, with no significant differences between motivational interviewing with feedback and interviewing without, and interviewing with other treatments and interviewing without;
  • Disagreements were resolved through discussion;
  • Programmes were delivered to groups or individuals, or a combination of these;
  • Methods of synthesis Differences between baseline and follow-up were examined by tabulating the data from each study and counting how many studies showed a beneficial effect.

Assessment of study quality The quality assessment criteria included the use of a manual for the intervention; motivational interviewing training or supervision; and coding for how well the intervention was applied. The maximum score was 3 points.

Two reviewers independently assessed study quality. Disagreements were resolved through discussion. Data extraction Data were extracted and categorised by intervention design and delivery mode, and whether the effect of the intervention was positive, negative or none, at follow-up. Two reviewers independently extracted the data.

Methods of synthesis Differences between baseline and follow-up were examined by tabulating the data from each study and counting how many studies showed a beneficial effect.

Subgroup analyses were conducted by intervention format, treatment modality, intervention adaptation, and theory-based mechanisms. Results of the review Thirty-nine studies were included in the review 13,107 participants. Thirty-seven were randomised controlled trials RCTs and two were quasi-experimental trials. Sample sizes ranged from 18 to 2,524. Twenty-one studies reported an intention-to-treat analysis.

Three reported all three quality indicators, 15 reported two, 19 reported one, and two reported none.

  1. CRD commentary The research question was clear, with broadly defined inclusion criteria.
  2. Search terms were reported.
  3. CRD commentary The research question was clear, with broadly defined inclusion criteria.
  4. Most studies measured substance use by self report; some used a combination of self report and biochemical measures or medical records. A motivational interviewing website and the Internet, using Google Scholar, were searched, as were the reference lists of the articles from the website.
  5. Two reviewers independently extracted the data.

Follow-up ranged from one month to two years. Twenty-six studies reported statistically significant reductions in some type of substance use, at follow-up, including alcohol seven studiestobacco six studiesmarijuana seven studiesand various combinations of substance use eight studies.

Motivational Interviewing for adolescent substance use: a review of the literature.

In the subgroup analyses, there were no significant differences in substance use outcomes, between motivational interviewing with feedback with or without other interventionscompared with interviewing without feedback with or without other interventionsand between interviewing with other interventions with or without feedbackcompared with stand-alone interviewing with or without feedback.

The results comparing different intervention formats, treatment modalities, adaptations, and theory-based mechanisms were reported. Authors' conclusions Two thirds of the included studies reported statistically significant reductions in adolescent substance use, at follow-up, with no significant differences between motivational interviewing with feedback and interviewing without, and interviewing with other treatments and interviewing without.

CRD commentary The research question was clear, with broadly defined inclusion criteria. Some relevant sources were searched, but inclusion was limited to trials published in English, so some trials may have been missed. The authors conducted a quality assessment, but this was assessed the quality of the intervention process, rather than the study design. Appropriate methods to reduce reviewer error and bias were reported for data extraction and quality assessment, but not for study selection.

  1. Assessment of study quality The quality assessment criteria included the use of a manual for the intervention; motivational interviewing training or supervision; and coding for how well the intervention was applied. Subgroup analyses were conducted by intervention format, treatment modality, intervention adaptation, and theory-based mechanisms.
  2. Addictive Behaviors 2012; 37 12. The results were largely reported as a count of studies with significant results, which did not take account of differences between studies and the size of the effects.
  3. Some relevant sources were searched, but inclusion was limited to trials published in English, so some trials may have been missed.
  4. The results were largely reported as a count of studies with significant results, which did not take account of differences between studies and the size of the effects. Appropriate methods to reduce reviewer error and bias were reported for data extraction and quality assessment, but not for study selection.

Most of the data were combined in a narrative synthesis, which was appropriate given the variation between studies. The results were largely reported as a count of studies with significant results, which did not take account of differences between studies and the size of the effects. The review included controlled studies, but it appears that only the motivational interviewing groups were included for most analyses.

Implications of the review for practice and research Practice: The authors did not state any implications for practice. The authors stated the need for further research into the relationship between design, format and other intervention characteristics.

Further development and testing of theory-based models was needed to enhance their effects. Addictive Behaviors 2012; 37 12: