Individuals’ readiness to make changes in their substance use tends to wax and wane over time, often depending on the consequences of use.
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Individuals’ readiness to make changes in their substance use tends to wax and wane over time, often depending on the consequences of use.
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Thus far, results from studies of these types of interventions have shown promise though with somewhat mixed, and relatively modest, effects. Separately, research highlights the importance of recovery social support, and of pro-recovery versus pro-drinking individuals in one’s social network, in predicting who will cut back or stop drinking.
Participants (N = 414) who were admitted to the emergency department or trauma unit at a Level I trauma unit in the United States, were randomized to receive either an individual brief motivational intervention (IMI; n = 193) or a significant “other-enhanced” brief motivational intervention (SOMI; n = 210), and assessed at admission (i.e., baseline) as well as 6-month and 12-month follow-ups. A control group was not included because it was deemed unethical to withhold treatment to a group of patients requiring acute medical care.
To be included, participants needed to either a) meet the clinical cutoff for the Alcohol Use Disorders Identification test (8 or more; M AUDIT score for the sample = 15), b) have a blood alcohol level of .01 or higher at admission, or c) report alcohol use no more than 6 hours before the event leading to their admission, and be able to identify a significant other to participate in the study (46 were excluded due to this final criterion). Participants were about 70% male and 33 years old on average, mostly high-school educated, and were diverse with respect to ethnicity (68% Caucasian, 19% African American, 16% Hispanic, and 14% other or multiracial).
Significant others were 70% female, and typically a romantic partner (39%), family member (30%), or friend (30%). All significant others completed study measures irrespective of whether they were involved in the intervention. Note that due to challenges of providing addiction treatment in a real-world clinical setting, the sample on which the authors conducted analyses was lower than this initial sample of 414, ranging from 370 to 375.
Both interventions consisted of a single session (lasting about 50 minutes), where a masters or doctoral level clinician used a motivational interviewing approach to facilitate discussion of pros/cons of drinking, personalized feedback on the participant’s current drinking behaviors relative to other individuals in the United States, and risky activities associated with their drinking.
Significant “other-enhanced” brief motivational intervention (SOMI) was different from individual brief motivational intervention (IMI) in that the significant other was present, their perspectives on the patient’s drinking were elicited, and they were involved in the motivational exercises. Review of session audio tapes showed that clinician’s faithfulness to the intervention as planned was strong. Primary outcomes examined were drinks per week, heavy drinking days (5+ or 4+ drinks in one day for men and women, respectively), and drinking related consequences and how significant others responded to participants’ drinking or abstinence over time.
Those receiving Significant “other-enhanced” brief motivational intervention (SOMI) in the trauma unit had even greater reductions than those in the emergency department, likely explained by more severe consequences requiring a trauma-unit admission as observed in their greater motivation to reduce drinking on admission.
Authors also ran analyses to examine the clinical (or practical) significance of findings, using the National Institute on Alcohol Abuse and Alcoholism guidelines of 14 or fewer and 7 or fewer drinks for men and women, respectively, as a proxy for “low risk” drinking.
Specifically, results showed that for every 11 patients treated, using SOMI versus IMI would result in 1 more participant who experiences a meaningful improvement in drinking. Although all participants improved heavy drinking days and drinking related consequences, there was no advantage for either intervention. Interestingly, all participants and their significant others generally reported improvements in significant other’s response to participant drinking (e.g., decrease in support for drinking), irrespective of which intervention the participant received.
This study is an important addition to the literature on brief interventions in examining whether involving a significant other can enhance treatment outcomes.
This adds to several other interventions that show benefit of leveraging the role of a significant other (see here) or including a significant other in treatment (see here).
Note that observed reductions in drinking, even in the SOMI, trauma-unit participants were considered relatively modest. In addition, all participants had an involved significant other in the study (though they only completed assessments in the IMI condition), which may have positively influenced even the IMI participants, ultimately muting the benefit for SOMI. Finally, the study used specially trained doctoral and masters level clinicians, which may not be feasible in all hospital settings.
Monti, P. M., Colby, S. M., Mastroleo, N. R., Barnett, N. P., Gwaltney, C. J., Apodaca, T. R., … & Biffl, W. L. (2014). Individual versus significant-other-enhanced brief motivational intervention for alcohol in emergency care. Journal of consulting and clinical psychology, 82(6), 936.
l
Thus far, results from studies of these types of interventions have shown promise though with somewhat mixed, and relatively modest, effects. Separately, research highlights the importance of recovery social support, and of pro-recovery versus pro-drinking individuals in one’s social network, in predicting who will cut back or stop drinking.
Participants (N = 414) who were admitted to the emergency department or trauma unit at a Level I trauma unit in the United States, were randomized to receive either an individual brief motivational intervention (IMI; n = 193) or a significant “other-enhanced” brief motivational intervention (SOMI; n = 210), and assessed at admission (i.e., baseline) as well as 6-month and 12-month follow-ups. A control group was not included because it was deemed unethical to withhold treatment to a group of patients requiring acute medical care.
To be included, participants needed to either a) meet the clinical cutoff for the Alcohol Use Disorders Identification test (8 or more; M AUDIT score for the sample = 15), b) have a blood alcohol level of .01 or higher at admission, or c) report alcohol use no more than 6 hours before the event leading to their admission, and be able to identify a significant other to participate in the study (46 were excluded due to this final criterion). Participants were about 70% male and 33 years old on average, mostly high-school educated, and were diverse with respect to ethnicity (68% Caucasian, 19% African American, 16% Hispanic, and 14% other or multiracial).
Significant others were 70% female, and typically a romantic partner (39%), family member (30%), or friend (30%). All significant others completed study measures irrespective of whether they were involved in the intervention. Note that due to challenges of providing addiction treatment in a real-world clinical setting, the sample on which the authors conducted analyses was lower than this initial sample of 414, ranging from 370 to 375.
Both interventions consisted of a single session (lasting about 50 minutes), where a masters or doctoral level clinician used a motivational interviewing approach to facilitate discussion of pros/cons of drinking, personalized feedback on the participant’s current drinking behaviors relative to other individuals in the United States, and risky activities associated with their drinking.
Significant “other-enhanced” brief motivational intervention (SOMI) was different from individual brief motivational intervention (IMI) in that the significant other was present, their perspectives on the patient’s drinking were elicited, and they were involved in the motivational exercises. Review of session audio tapes showed that clinician’s faithfulness to the intervention as planned was strong. Primary outcomes examined were drinks per week, heavy drinking days (5+ or 4+ drinks in one day for men and women, respectively), and drinking related consequences and how significant others responded to participants’ drinking or abstinence over time.
Those receiving Significant “other-enhanced” brief motivational intervention (SOMI) in the trauma unit had even greater reductions than those in the emergency department, likely explained by more severe consequences requiring a trauma-unit admission as observed in their greater motivation to reduce drinking on admission.
Authors also ran analyses to examine the clinical (or practical) significance of findings, using the National Institute on Alcohol Abuse and Alcoholism guidelines of 14 or fewer and 7 or fewer drinks for men and women, respectively, as a proxy for “low risk” drinking.
Specifically, results showed that for every 11 patients treated, using SOMI versus IMI would result in 1 more participant who experiences a meaningful improvement in drinking. Although all participants improved heavy drinking days and drinking related consequences, there was no advantage for either intervention. Interestingly, all participants and their significant others generally reported improvements in significant other’s response to participant drinking (e.g., decrease in support for drinking), irrespective of which intervention the participant received.
This study is an important addition to the literature on brief interventions in examining whether involving a significant other can enhance treatment outcomes.
This adds to several other interventions that show benefit of leveraging the role of a significant other (see here) or including a significant other in treatment (see here).
Note that observed reductions in drinking, even in the SOMI, trauma-unit participants were considered relatively modest. In addition, all participants had an involved significant other in the study (though they only completed assessments in the IMI condition), which may have positively influenced even the IMI participants, ultimately muting the benefit for SOMI. Finally, the study used specially trained doctoral and masters level clinicians, which may not be feasible in all hospital settings.
Monti, P. M., Colby, S. M., Mastroleo, N. R., Barnett, N. P., Gwaltney, C. J., Apodaca, T. R., … & Biffl, W. L. (2014). Individual versus significant-other-enhanced brief motivational intervention for alcohol in emergency care. Journal of consulting and clinical psychology, 82(6), 936.
l
Thus far, results from studies of these types of interventions have shown promise though with somewhat mixed, and relatively modest, effects. Separately, research highlights the importance of recovery social support, and of pro-recovery versus pro-drinking individuals in one’s social network, in predicting who will cut back or stop drinking.
Participants (N = 414) who were admitted to the emergency department or trauma unit at a Level I trauma unit in the United States, were randomized to receive either an individual brief motivational intervention (IMI; n = 193) or a significant “other-enhanced” brief motivational intervention (SOMI; n = 210), and assessed at admission (i.e., baseline) as well as 6-month and 12-month follow-ups. A control group was not included because it was deemed unethical to withhold treatment to a group of patients requiring acute medical care.
To be included, participants needed to either a) meet the clinical cutoff for the Alcohol Use Disorders Identification test (8 or more; M AUDIT score for the sample = 15), b) have a blood alcohol level of .01 or higher at admission, or c) report alcohol use no more than 6 hours before the event leading to their admission, and be able to identify a significant other to participate in the study (46 were excluded due to this final criterion). Participants were about 70% male and 33 years old on average, mostly high-school educated, and were diverse with respect to ethnicity (68% Caucasian, 19% African American, 16% Hispanic, and 14% other or multiracial).
Significant others were 70% female, and typically a romantic partner (39%), family member (30%), or friend (30%). All significant others completed study measures irrespective of whether they were involved in the intervention. Note that due to challenges of providing addiction treatment in a real-world clinical setting, the sample on which the authors conducted analyses was lower than this initial sample of 414, ranging from 370 to 375.
Both interventions consisted of a single session (lasting about 50 minutes), where a masters or doctoral level clinician used a motivational interviewing approach to facilitate discussion of pros/cons of drinking, personalized feedback on the participant’s current drinking behaviors relative to other individuals in the United States, and risky activities associated with their drinking.
Significant “other-enhanced” brief motivational intervention (SOMI) was different from individual brief motivational intervention (IMI) in that the significant other was present, their perspectives on the patient’s drinking were elicited, and they were involved in the motivational exercises. Review of session audio tapes showed that clinician’s faithfulness to the intervention as planned was strong. Primary outcomes examined were drinks per week, heavy drinking days (5+ or 4+ drinks in one day for men and women, respectively), and drinking related consequences and how significant others responded to participants’ drinking or abstinence over time.
Those receiving Significant “other-enhanced” brief motivational intervention (SOMI) in the trauma unit had even greater reductions than those in the emergency department, likely explained by more severe consequences requiring a trauma-unit admission as observed in their greater motivation to reduce drinking on admission.
Authors also ran analyses to examine the clinical (or practical) significance of findings, using the National Institute on Alcohol Abuse and Alcoholism guidelines of 14 or fewer and 7 or fewer drinks for men and women, respectively, as a proxy for “low risk” drinking.
Specifically, results showed that for every 11 patients treated, using SOMI versus IMI would result in 1 more participant who experiences a meaningful improvement in drinking. Although all participants improved heavy drinking days and drinking related consequences, there was no advantage for either intervention. Interestingly, all participants and their significant others generally reported improvements in significant other’s response to participant drinking (e.g., decrease in support for drinking), irrespective of which intervention the participant received.
This study is an important addition to the literature on brief interventions in examining whether involving a significant other can enhance treatment outcomes.
This adds to several other interventions that show benefit of leveraging the role of a significant other (see here) or including a significant other in treatment (see here).
Note that observed reductions in drinking, even in the SOMI, trauma-unit participants were considered relatively modest. In addition, all participants had an involved significant other in the study (though they only completed assessments in the IMI condition), which may have positively influenced even the IMI participants, ultimately muting the benefit for SOMI. Finally, the study used specially trained doctoral and masters level clinicians, which may not be feasible in all hospital settings.
Monti, P. M., Colby, S. M., Mastroleo, N. R., Barnett, N. P., Gwaltney, C. J., Apodaca, T. R., … & Biffl, W. L. (2014). Individual versus significant-other-enhanced brief motivational intervention for alcohol in emergency care. Journal of consulting and clinical psychology, 82(6), 936.
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