This K23 study is an effectiveness-implementation hybrid type I design to determine the effectiveness of Motivational Interviewing at Intake (MII), relative to intake-as-usual on client engagement and mechanisms of engagement among adults seeking outpatient addiction treatment. We also will obtain personnel feedback on the feasibility of implementing MII into standard practice by having personnel from the addiction treatment study sites complete implementation climate measures before Motivational Interviewing (MI) training and post-clinical trial, as well as an individual interview on implementation feasibility post-trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
TRIPLE
Enrollment
150
The MII will involve a goal-oriented and collaborative conversation about why the client wants treatment now, and how treatment might fit with his/her most important values. The provider will use open questions, reflective listening and autonomy support in a flexible, non-authoritative manner. Rather than asking specific questions in different life domains, the provider will explore with the client their desires, abilities, reasons, and needs for treatment, how treatment fits with their values, and what successful treatment looks like to them. The client's language about change will be strategically reinforced to increase its frequency and strength across the session.
In line with the American Society of Addiction Medicine (ASAM) guidelines, the IAU condition involves a semi-structured interview of the client's psychosocial history and clients answer a series of questions in the following domains: support system, living situation, educational, occupational, family, and medical history.
UNM Psychology Clinic
Albuquerque, New Mexico, United States
RECRUITINGNumber of participants who attended the first outpatient treatment program session based on electronic medical record review
Treatment entry is determined by review of electronic medical record of whether clients attended their first scheduled treatment session
Time frame: up to 36 weeks
Number of treatment sessions attended during the three-month outpatient treatment program based on electronic medical record review
Number of treatment sessions that clients attend is determined by review of electronic medical record and calculating number of treatment sessions attended.
Time frame: up to 36 weeks
Number of participants who completed the three-month outpatient treatment program based on electronic medical record review
Completion of the three-month outpatient treatment program is determined by review of electronic medical record
Time frame: up to 36 weeks
Change from baseline in client readiness to enter treatment on the University of Rhode Island Change Assessment Scale (URICA) at 1 hour post-intake
The URICA is a validated, self-report measure of client readiness for treatment engagement. Possible scores range from 32 to 160 with higher scores indicative greater readiness to enter treatment. Change = (Hour 1 score - Baseline Score).
Time frame: baseline and 1 hour post-intake
Score on therapeutic alliance on the Working Alliance Inventory (WAI) at 1-hour post-intake
The WAI is a validated, self-report measure of client perceptions of the therapeutic process by assessing three sub scales: Goals, Bond, and Tasks. Possible scores on sub scales range from 12 to 84 with higher scores indicative of better therapeutic alliance.
Time frame: 1 hour post-intake
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