Motivational Interviewing in Recovery

Editor’s note: It’s graduation season, which means a slew of new dissertations! In today’s post, we feature two recent projects on the use of motivational interviewing techniques in recovery settings. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Motivational Interviewing Treatment Integrity and Client Change: Using ROC Analysis to Explore the Relationship Between MI Fidelity Level and Drinking Outcome

Author: Fischer, Daniel J.

Abstract: Those engaged in the research and practice of MI have shown interest in treatment adherence as an indicator of effective MI and have expressed curiosity in the threshold at which MI practice could be viewed as “good enough”. The most widely used and often cited of MI integrity measures are the Motivational Interviewing Skills Code (MISC) and the Motivational Interviewing Treatment Integrity code (MITI). These adherence tools share similar descriptive coding systems for therapist in-session behavior. MI fidelity standards are often used as reference points for therapist performance, yet practitioners rarely meet full criteria. Further, substandard ratings have been associated with positive client change. These findings have elicited questions about the necessary levels of therapist treatment adherence to promote client change and suggested the need for empirically-derived fidelity standards. This study analyzed existing data from a sample of Motivational Enhancement Therapy (MET) sessions from Project MATCH (Matching Alcohol Treatments to Client Heterogeneity) that were audio recorded and previously coded with the MISC. MI adherence variables were analyzed along with client drinking outcomes to test the relationship between therapist fidelity and client change. Therapist adherence was determined using behavioral codes common to the MITI and MISC. Client change thresholds were determined using clinically significant change standards developed by Jacobson and Truax. The relationships between therapist adherence level and client change thresholds were examined using Receiver Operating Characteristic (ROC) analysis. Findings showed mixed support for the relationship between therapist adherence level and client drinking outcomes, but yielded levels of therapist MI adherence associated with client changes in drinking outcomes.

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Problem Drug Use in Social Context: New Research

Editor’s note: It’s graduation season, which means a slew of new dissertations! In today’s post, we include a few recent projects concerning technological interventions in problematic drug use. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Illness Representation, Coping, and Treatment Outcomes in Substance Use Disorders

Author: Prater, Kimberly A.

Abstract: This study examined the relationship between illness representation, coping, and treatment adherence in substance use disorders (SUDs). Illness representation refers to the way in which an individual cognitively understands his or her illness. Leventhal, Meyer, and Nerenz’s (1980) Self-Regulation Model (SRM) is one theoretical model of illness representation that addresses how cognitive factors influence illness coping behaviors and outcome. The SRM has been applied extensively to understanding patient perspectives of physical illness. More recently, the model has been applied to individuals with psychological disorders, including psychotic disorders, mood disorders, and eating disorders. In the mental health literature, illness representation has been found to be related to, and at times predictive of, behavioral outcomes, such as treatment adherence. The present study is notable because it is the first to examine the SRM in substance use disorders (SUDs). Moreover, this is one of the first longitudinal studies examining the relationship between the SRM and outcome in a mental health population. The sample was comprised of 70 patients with SUDs who were receiving outpatient treatment at the St. Luke-Roosevelt Hospital’s Addiction Institute of New York. The findings provided partial support for the study’s hypotheses. Specifically (a) patients who identified a psychological or behavioral cause of their SUD were more likely to be treatment adherent, (b) patients who perceived some personal control over their SUD were more likely to be treatment adherent, and (c) several illness representation dimensions were associated with various coping styles in SUD patients. The SRM appears to be a valid model for understanding SUDs, and the Brief IPQ a reliable and valid tool for assessing illness representation in SUDs. The current results underscore the necessity and value of conducting further research to inform the further development of empirically supported SUD treatment approaches.Read More »

Archive Report: The Psychoactive Substances Research Collection at Purdue University

Today’s post is by contributing editor David Korostyshevsky, a history PhD candidate at the University of Minnesota. 

It was a cloudy, rainy, late-March week in West Lafayette, Indiana when I first encountered Purdue University’s Psychoactive Substances Research Collection (PSRC). Maintained by the university library’s Archives and Special Collections, the PSRC offers the papers of important figures in American psychedelic research, from American LSD studies during the 1960s to the resurgence of international medical and scientific research about psychedelic substances during the 1990s. The collection also boasts an incredible shelf list of psychedelic science literature dating to the 1950s, including books, periodicals, and newsletters.Read More »

Technology Use and Drug Using Outcomes: New Research

Editor’s note: It’s graduation season, which means a slew of new dissertations! In today’s post, we include a few recent projects concerning technological interventions in problematic drug use. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

A New Kind of Therapeutic Relationship: Exploring Factors that Influence the Effectiveness of Computer-Delivered Interventions for Alcohol Use Disorders

Author: Campbell, William P., IV

Abstract: Computer-delivered interventions (CDI) for alcohol use comprise a relatively new treatment for individuals struggling with problematic drinking. While CDIs for alcohol misuse have proliferated over the last decade, much remains unknown about factors that influence their effectiveness. This study evaluated the performance of Overcoming Addictions (OA), a CDI based on the principles of SMART Recovery (SR). Subjects were drawn from a sample of 189 participants enrolled in a randomized clinical trial (RCT) that compared three and six-month outcomes for two interventions for problematic alcohol use: control participants were enrolled in SR meetings (face to face and/or online); experimental participants also had access to OA. Primary analyses of between group differences were conducted to detect an additive effect of OA. Further, this study explored variables thought to mediate the effectiveness of OA, and CDIs for problematic alcohol use more generally. Within the experimental group, analyses were conducted to examine whether participants’ amount of experience navigating the Internet accounted for any variance associated with positive outcomes; also, the study examined the mediating effect of two other closely related variables: participants’ sense of how easy the website was to use, and whether participants were satisfied with the amount of content on the website. Primary analysis indicated that both the control and experimental groups showed significant improvement across outcome variables, although no additional benefit of OA was detected. Finally, no evidence was found to support the hypotheses for the identified variables thought to mediate the effectiveness of OA. Implications of this null finding are discussed.

 

Publication year: 2015

 

Advisor: Dougher, Michael J.

Committee member: Gangestad, Steven W.; Moyers, Theresa B.; Witherington, David C.; Woodall, William G.

University/institution: The University of New Mexico

Department: Psychology

 

Designing and Evaluating a Self-Help Website to Reduce Teen Alcohol Use

Author: Current, Brittany

Abstract: Teen substance use is an issue of major concern. Increasing numbers of teens are using alcohol and at earlier ages, resulting in severe and lasting consequences. Given teenagers’ developmental predispositions for risk-taking, illusions of invincibility, and limited attention to long-term consequences, it is critical for parents and other concerned adults to help teenagers think about and realistically evaluate the consequences of their actions in age-appropriate ways. Teens and young adults have been noted for being highly technically savvy, being regular online users, and obtaining much of their information online. Therefore, it would be helpful to leverage technical and online solutions for supporting teens in resisting pressures to drink. However, existing self-help websites are created and run by mental health professionals, generally without help or feedback from teens. The present action research project contributed to existing literature by inviting teens to participate in the design of a new self-help website by providing evaluative feedback through group interviews. This is the only research project involving focus group evaluations of teen self-help websites known to date. The present project involved designing, evaluating, and modifying a new self-help website for teenagers who are using alcohol or considering using alcohol, with the purpose of helping them avoid underage drinking and its consequences. First, a website was created based on an extensive literature review. Second, a 2-hour workshop of 15 college students was convened to present and evaluate the website. Focus group notes were transcribed and emerging topics for each question were summarized. Third, the website was redesigned based on participant feedback. Recommendations based on the results on the present study are to continue creating and maintaining alcohol and substance abuse self-help websites for teens and to create awareness about these sites so the target population may make use of them. Suggestions for continued research are to repeat the study with a larger sample and improved data collection tools. Another suggestion for continued research is to explore additional self-help options for teens to avoid underage drinking.

 

Publication year: 2016

 

Advisor: Willmarth, Eric

Committee member: Hoffman, Louis; Schmitt, Robert

University/institution: Saybrook University

Department: Psychology

Where Does Addiction Come From? Perspectives from the Past and Present

Editor’s note: It’s graduation season, which means a slew of new dissertations have been published. In today’s post, we include a few recent summaries of historical, psychological, and neurological perspectives on the etiology of addiction. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Intoxication and Empire: Distilled Spirits and the Creation of Addiction in the Early Modern British Atlantic
Author: Burton, Kristen D.
Abstract: This dissertation exams how the spread of imperialism in the British Atlantic led to the mass production and consumption of distilled spirits during the seventeenth and eighteenth centuries. Through transatlantic colonization, distilled liquors, once produced as medicinal remedies, developed into a thriving industry by the beginning of the eighteenth century. This change in the purpose and use of distilled spirits prompted political, religious, and medical leaders to ask new questions about the effects and possible threats of consuming such spirits. This dissertation is a study of perceptions; it examines how spirits became the means through which people evaluated the place and proper behavior of women, the working poor, indigenous peoples, enslaved laborers, and backcountry famers, among others. While alcohol was thought by many to be spiritually and physically nourishing, mass production and distribution of rum in the mid-seventeenth century created new questions and concerns among elites about intoxication, bodily health, and the perceived threat of lost control over the laboring poor in England, and over indigenous communities and enslaved peoples throughout the empire. Social elites constructed narratives around new notions of inebriation based upon the loss of physical, as well as moral, control. Through these narratives, physicians came to create new theories of habitual drinking as a compulsive act. Altered perceptions, constructed from unprecedented eighteenth-century drinking practices, redefined alcohol as an intoxicant. This established the framework of what became early addiction theory, which emerged during the initial decades of the modern era. Eighteenth-century imperial, medical, and religious debates over distilled spirits, in turn, established the foundation for early ideas of alcoholism and transatlantic movements advocating temperance.

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