Date of Award

1-2011

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Dr. Scott T. Gaynor

Second Advisor

Dr. Lester W. Wright Jr.

Third Advisor

Dr. Amy Naugle

Fourth Advisor

Dr. C. Dennis Simpson

Abstract

Motivational interviewing (MI) is a directive, client-centered intervention to elicit behavior change by assisting clients in the exploration and resolution of ambivalence toward change. MI-inspired approaches have been used in an attempt to facilitate change in a wide variety of domains including alcohol and drug abuse, safe water handling practices, dual diagnoses, gambling, spousal abuse, health related areas, mood and anxiety disorders, and parental engagement. MI seeks to resolve ambivalence in the direction of change by increasing the client's self-efficacy. This is accomplished by combining clientcentered (e.g., reflective listening) and directive strategies (e.g., attending selectively to change statements). The origins of MI are in the substance abuse field where it provided an alternative to harsher strategies among a population that is often described as treatment resistant.

The goal of the current study was to assess the effectiveness of motivational enhancement therapy applied in a group setting in a community substance abuse treatment agency. Group treatment involved eight sessions, each lasting 90 minutes, focused on the following topics: lifestyles, stages of change, ambivalence surrounding change, developing discrepancy, pros and cons of changing, values, self-efficacy, and planning for change. Self-report measures from 82 individuals (70.7% male, mean age of 31) who received treatment were analyzed to determine what impact the treatment had on current substance use, self-efficacy, ambivalence toward a change in use, and the presence of change talk.

Participants did not report a significant decrease in their substance use during the treatment, but the results approached a significant trend suggestive of decreased use. In addition, no statistically significant changes in participants' self-reported readiness to change or in their self-efficacy were observed. However, a statistically significant increase in change oriented talk was observed. Specifically, results suggested an increase in statements indicating a desire and intention to decrease substance use.

This uncontrolled effectiveness study of a motivational enhancement intervention in a community substance abuse clinic produced mixed results. The implications for the practice of motivational enhancement interventions in the community, the place of these data in the empirical literature, and how the findings fit with the theorized mechanisms of action are discussed.

Access Setting

Dissertation-Open Access

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