Quality of Research
Documents Reviewed
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted.
Study 1Ball, S. A., Martino, S., Nich, C., Frankforter, T. L., van Horn, D., Crits-Christoph, P., et al. Site matters: Multisite randomized trial of motivational enhancement therapy in community drug abuse clinics. Journal of Consulting and Clinical Psychology, 75(4), 556-567. Study 2Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58(1), 7-29. Study 3Miller, W. R., Benefield, G., & Tonigan, J. S. Enhancing motivation for change in problem drinking: A controlled comparison of two therapist styles. Journal of Consulting and Clinical Psychology, 61(3), 455-461. Study 4Stephens, R. S., Roffman, R. A., & Curtin, L. Comparison of extended versus brief treatments for marijuana use. Journal of Consulting and Clinical Psychology, 68(5), 898-908. Study 5Borsari, B., & Carey, K. B. Effects of a brief motivational intervention with college student drinkers. Journal of Consulting and Clinical Psychology, 68(4), 728-733. Study 6Brown, J. M., & Miller, W. R. Impact of motivational interviewing on participation and outcome in residential alcoholism treatment. Psychology of Addictive Behaviors, 7, 211-218.
Outcomes
| Outcome 1: Substance use |
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Description of Measures
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Substance use was defined as the self-reported number of days per week that the client used substances (marijuana, cocaine, alcohol, methamphetamine, benzodiazepines, opioids, or other drugs) using the Substance Use Calendar (SUC). The SUC is an interview assessment completed by a research assistant at each contact with the client. The SUC is adapted from Timeline Followback (TLFB) interview methods.
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Key Findings
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MET and the counseling as usual (CAU) therapy sessions (three 50-minute sessions in each condition) both resulted in reductions in substance use during the 4-week therapy phase (p < .001). MET participants, however, sustained these reductions in substance use for the subsequent 12 weeks of follow-up, whereas CAU participants increased their use to their original, pretreatment levels.
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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3.5
(0.0-4.0 scale)
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| Outcome 2: Alcohol consumption |
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Description of Measures
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Alcohol consumption was defined as the self-reported number of alcoholic drinks consumed per week by the study participant. The Drinker Profile structured interview employed by the investigators expresses participants' average weekly consumption in standard ethanol content (SEC) units. One SEC is equivalent to 0.5 ounces of pure ethyl alcohol.
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Key Findings
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In one study, compared with wait-list control group participants, MET participants reported substantially lower alcohol consumption 7 weeks after treatment. These treatment effect sizes were of medium magnitude (Cohen's d = 0.54).
In another study, motivational interviewing with feedback (MET) was associated with greater reductions in client-reported alcohol consumption compared with a standard treatment approach (p < .001). The average number of weekly drinks (in SEC units) for the clients in the MET group was reduced from 95 before treatment to 19 following 3 months of treatment. In contrast, for clients who received standard treatment, the number of weekly drinks consumed dropped from 85 to 61.
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Studies Measuring Outcome
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Study 3, Study 5, Study 6
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Study Designs
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Experimental, Quasi-experimental
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Quality of Research Rating
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3.3
(0.0-4.0 scale)
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| Outcome 3: Drinking intensity |
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Description of Measures
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In one study, drinking intensity was defined as the number of drinks consumed per drinking day (DDD). The DDD measure was obtained through periodic interviews in which the client retrospectively examined his or her last month of drinking. These estimates of alcohol use were obtained by means of the Form 90 interview procedure that combines calendar memory cues within a Timeline Followback methodology. In other studies, weekly peak blood alcohol concentration (BAC) was used as the measure of drinking severity/intensity. Using the Drinker Profile structured interview, estimates of weekly peak BAC were derived by computer projection to estimate the client's regular levels of intoxication.
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Key Findings
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Each of the studies reviewed clearly demonstrated that MET reduced the intensity of client drinking behavior over the course of outpatient treatment. Among three treatment interventions investigated as part of a large, National Institute on Alcohol Abuse and Alcoholism (NIAAA)-funded, randomized multisite evaluation of alcohol treatment (Project MATCH), MET substantially reduced heavy drinking across the 1-year posttreatment period. This study, however, revealed few differences in main drinking outcomes by the type of treatment intervention employed (i.e., MET compared with Cognitive Behavioral Coping Skills Therapy [CBT] and Twelve-Step Facilitation Therapy [TSF]). In Project MATCH, it was noted that MET produced equally effective drinking outcomes using only 4 sessions (over the course of 12 weeks) compared with the 12 sessions employed by the other 2 comparison treatments (CBT and TSF).
In another study that examined MET versus usual treatment in a residential alcohol treatment setting, weekly peak BAC decreased significantly (p < .001), and clients increased their participation in treatment; however, the positive changes in drinking intensity were not specific to the MET treatment group.
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Studies Measuring Outcome
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Study 2, Study 3, Study 6
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Study Designs
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Experimental, Quasi-experimental
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Quality of Research Rating
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3.5
(0.0-4.0 scale)
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| Outcome 4: Marijuana use |
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Description of Measures
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Marijuana use was defined as the number of times the client used marijuana on a typical day of use in the past 90 days. Clients reported their use on a 4-point scale: 0 = not at all; 1 = once; 2 = 2-3 times; 3 = 4-5 times; 4 = 6 or more times per day.
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Key Findings
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Compared with clients receiving delayed treatment (i.e., the control group), participants in the MET group (in this study referred to as individualized assessment and advice [IAI]) and the relapse prevention support group (RPSG) reported fewer days of use and number of times using marijuana per day. This finding was observed at the 1-, 4-, 7-, 13-, and 16-month follow-ups when compared with pretreatment levels (p < .001 for all five follow-up points). There were no significant differences in outcomes between the RPSG and the MET groups at any follow-up point.
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Studies Measuring Outcome
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Study 4
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Study Designs
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Experimental
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Quality of Research Rating
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2.6
(0.0-4.0 scale)
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| Outcome 5: Marijuana problems |
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Description of Measures
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Marijuana problems were measured with a 19-item list of negative psychological, social, occupational, and legal consequences of use. The list was adapted from other drug use severity indices in common use. Items on the list were rated on a 3-point scale ranging from 0 (no problem) to 2 (a serious problem).
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Key Findings
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Compared with clients receiving delayed treatment (control group), participants in the MET group (in this study referred to as individualized assessment and advice [IAI]) and relapse prevention support group (RPSG) reported fewer problems related to marijuana at 1-, 4-, 7-, 13-, and 16-month follow-ups when compared with pretreatment levels (p < .001 for all five follow-up points). There were no significant differences in outcomes between the RPSG and the MET groups at any follow-up point.
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Studies Measuring Outcome
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Study 4
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Study Designs
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Experimental
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Quality of Research Rating
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2.7
(0.0-4.0 scale)
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Study Populations
The following populations were identified in the studies reviewed for Quality of
Research.
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Study
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Age
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Gender
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Race/Ethnicity
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Study 1
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18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
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63% Female
37% Male
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75% White
12% Black or African American
10% Hispanic or Latino
3% Race/ethnicity unspecified
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Study 2
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18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
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72% Male
28% Female
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80% White
12% Hispanic or Latino
6% Black or African American
2% Race/ethnicity unspecified
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Study 3
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26-55 (Adult)
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57.1% Male
42.9% Female
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Data not reported/available
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Study 4
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26-55 (Adult)
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77% Male
23% Female
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95% White
5% Race/ethnicity unspecified
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Study 5
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18-25 (Young adult)
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55% Female
45% Male
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90% White
10% Race/ethnicity unspecified
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Study 6
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26-55 (Adult)
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75% Male
25% Female
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42.9% Hispanic or Latino
39.3% White
10.7% American Indian or Alaska Native
7.1% Black or African American
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Quality of Research Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
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Outcome
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Reliability
of Measures
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Validity
of Measures
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Fidelity
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Missing
Data/Attrition
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Confounding
Variables
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Data
Analysis
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Overall
Rating
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1: Substance use
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4.0
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4.0
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3.5
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2.5
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3.0
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4.0
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3.5
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2: Alcohol consumption
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3.5
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3.5
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2.9
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4.0
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3.0
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3.0
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3.3
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3: Drinking intensity
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3.3
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3.8
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3.5
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3.9
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2.9
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3.4
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3.5
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4: Marijuana use
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3.0
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2.5
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2.0
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1.5
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3.0
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3.5
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2.6
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5: Marijuana problems
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3.0
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3.0
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2.0
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1.5
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3.0
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3.5
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2.7
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Study Strengths The studies were very rigorous. The majority used random assignment and attended closely to issues related to quality of measurement and fidelity of implementation.
Study Weaknesses Several studies had small samples, which limited conclusions in some instances due to lack of statistical power.
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Readiness for Dissemination
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Materials Reviewed
The materials below were reviewed for Readiness for Dissemination. The implementation
point of contact can provide information regarding implementation of the intervention
and the availability of additional, updated, or new materials.
Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the intervention's Readiness for Dissemination
using three criteria:
- Availability of implementation materials
- Availability of training and support resources
- Availability of quality assurance procedures
For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.
Implementation
Materials
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Training and Support
Resources
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Quality Assurance
Procedures
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Overall
Rating
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3.8
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3.3
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3.5
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3.5
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Dissemination Strengths Extensive, high-quality implementation materials are available to support the development of motivational interviewing skills, an integral component of this intervention. Three early MET implementation manuals are available with detailed descriptions of how the protocols are delivered, along with process forms and assessment instruments. A variety of training tools and resources are available, including the Motivational Interviewing Network of Trainers (MINT), although most of these are MI resources, not specific to MET. An assortment of MI assessment tools is available to support quality assurance.
Dissemination Weaknesses While materials on MI continue to be updated and refined, the standard MET manuals have not been updated. Existing training, support, and quality assurance resources focus primarily on MI, with few specifically designed for MET.
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Materials Reviewed
The materials below were reviewed for Readiness for Dissemination. The implementation
point of contact can provide information regarding implementation of the intervention
and the availability of additional, updated, or new materials.
Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the intervention's Readiness for Dissemination
using three criteria:
- Availability of implementation materials
- Availability of training and support resources
- Availability of quality assurance procedures
For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.
Implementation
Materials
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Training and Support
Resources
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Quality Assurance
Procedures
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Overall
Rating
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4.0
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3.3
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3.8
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3.7
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Dissemination Strengths This program has multiple well-written and easy-to-follow manuals and instructional videos to support implementation. Many comprehensive training and support resources are readily available to interested implementers. The MIA-STEP manual provides training materials, teaching tools, a practitioner self-assessment protocol, rating guides, and forms to support clinical supervision and quality assurance.
Dissemination Weaknesses It is unclear how an interested implementer identifies an MET-specific trainer from the Motivational Interviewing Network of Trainers (MINT) list other than contacting each one individually. Minimal guidance is provided to implementers for measuring posttreatment outcomes.
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