Effectiveness of a brief motivation enhancing intervention on treatment initiation, treatment retention and abstinence: Results from a multi-site cluster-randomized trial

Effectiveness of Motivational Interviewing with Justice-involved People: A Systematic Review and Meta-analysis

Objective: Motivational interviewing (MI) is increasingly recognized as an effective approach in forensic settings, particularly for overcoming resistance by avoiding confrontation and fostering intrinsic motivation. Research shows that interventions incorporating MI are more effective than other approaches in preventing and reducing offending behavior, highlighting its importance in improving intervention outcomes. Given this evidence, advocating for the integration of MI is crucial to enhance the effectiveness of interventions. Method: This systematic review and meta-analysis aimed to systematize knowledge and assess the effectiveness of interventions incorporating MI for justice-involved people who have been sentenced to custodial or non-custodial measures. Twenty-two studies were included. The total sample size of the studies ranged from 25 to 528 individuals convicted of various offences, including intimate partner violence, violent crimes, sexual offences, property crimes, driving offences, and drug offences. Results: Results indicated that MI is more effective in increasing session attendance and reducing dropout than interventions without MI. For official recidivism, evidence favored MI with a statistically significant reduction in recidivism rates. Conclusions: These findings highlight the importance of integrating MI into forensic settings, establishing its positive impact on numerous outcomes.

Social Factors Predict Treatment Engagement in Veterans with PTSD or SUD

Veterans with PTSD and SUDs often fail to initiate, or prematurely discontinue, mental health treatment in Veteran Affairs Medical Centers (VAMC). While much is known about clinical characteristics and demographic factors impacting treatment engagement in this population, less is known about the role of social factors. This retrospective study examines primary care-based screening assessment and specialty mental healthcare appointment data in a VAMC, to test whether social factors predict treatment initiation and appointment attendance. Findings reveal veterans were more likely to initiate treatment when (a) those with SUDs (n = 235) reported more frequent negative exchanges with others and (b) those with PTSD (n = 2107) reported more perceived support or being partnered. Those with PTSD who were partnered had higher appointment attendance rates. Findings suggest social factors are relevant to treatment initiation among veterans with PTSD and SUDs and that close others may be helpful in facilitating referrals.

Correlates of motivation for treatment among alcohol service users in Uganda

Purpose

Given the scarce literature on alcohol use disorders (AUD) and their treatment in developing countries, this paper aims to explore motivation levels and their correlates among alcohol service users in two residential treatment centres in Kampala, Uganda. This study how motivation levels of Ugandan alcohol service users compare with those from American studies; and the specific factors affecting internal and external motivation in the Ugandan context.

Design/methodology/approach

The motivation for treatment was measured among 100 individuals entering AUD treatment using the Texas Christian University (TCU) Treatment needs and Motivation scale. The WHOQoL–BREF, Addiction Severity Index–6 and Hopkins Symptoms Check List–37 were used to measure addiction severity, quality of life (QoL) and psychopathology, respectively. Correlates of motivation were identified using linear regression analyses.

Findings

Ugandan service users demonstrated low treatment motivation in the treatment needs a domain. While addiction severity (recent heavy alcohol use) and participating in private treatment were associated with higher internal and external motivation, deterioration in physical and environmental QoL, depressive symptoms and lower education were linked with higher internal motivation.

Research limitations/implications

Different elements affect domains of treatment motivation, requiring attention for clients’ unique needs as influenced by their background, addiction severity, QoL, psychological needs and contextual factors (e.g. treatment setting). Further studies are needed to explore additional correlates of motivation for treatment among alcohol service users in Uganda and to assess the longitudinal impact of motivation on treatment outcomes.

Originality/value

Although motivation has been extensively studied, clinicians are challenged in understanding and explaining motivational dynamics given the multiplicity of factors influencing change-related decisions and behaviours and the diversity in substance-using populations. This need is even bigger in non-Western societies as cultural differences may require differential therapeutic management. This is one of the first studies measuring motivation for AUD treatment in a low-income country and offers insight for understanding motivation dynamics in similar settings.