Saturday, December 13, 2014

Motivational interviewing may not curb drinking among young adults

By Andrew M. Seaman

NEW YORK, Thu Aug 21, 2014 12:11pm EDT

NEW YORK, (Reuters) - Young people may not see meaningful benefits from a counseling approach designed to curb their alcohol use, according to a new analysis of previous research.

Teens and young adults who took part in so-called motivational interviewing targeted to their risky drinking behaviors ended up drinking less alcohol and drinking less often, but the differences were not meaningful, researchers found.

“These programs aren’t working or aren’t working as well as we thought they should and we as society, policymakers and practitioners need to think of what we can do instead,” said David Foxcroft, the study’s lead author, from Oxford Brookes University in the UK.

Counselors who practice motivational interviewing interact with their patients in a non-judgmental way to highlight the dangers of an activity in the hope of coaxing a person past their ambivalence about changing their behavior.

In a report released August 20 by The Cochrane Library, Foxcroft and his colleagues say motivational interviewing is a popular technique used to target excessive drinking among teens, but until now it has not been examined by the Cochrane Collaboration, an international organization that evaluates medical evidence.

For this review, the researchers pooled data from clinical trials of motivational interviewing targeted to drinking among young people between 15 and 26 years old and comparing the method to no counseling or to some other intervention or therapy.

Overall, they found 66 trials involving 17,901 people. Most were conducted on college campuses. The rest were in other settings such as youth prisons and centers.

Foxcroft said a typical person included in these trials would be a college student deemed to be at risk for alcohol abuse through behavior caught by campus officials or through some sort of screening tool or test.

Most participants attended one individual session with a counselor while the rest attended either group sessions or a mix of individual and group sessions.

The researchers found that after four months, those who went through the counseling reported drinking an average of about 12.2 alcoholic drinks per week, compared to about 13.7 drinks per week among people who didn’t go through motivational interviewing.

Those who went through motivational interviewing also reported drinking an average 2.5 days during the week four months later, compared to about 2.7 days per week among those who didn’t go through the counseling.

The counseling group also saw a slight decrease in their maximum blood alcohol levels, but the average blood alcohol level did not change. Risky behaviors like binge drinking or driving drunk did not change at all among the young counseling participants.

Although some of the differences were greater than could be attributed to chance, the size of the effects overall are too small “to be of relevance to policy or practice,” the study authors conclude.

“This review challenges what has been previously thought or concluded in previous research on motivational interviewing,” Foxcroft said.

While the study casts doubts on the effectiveness of the counseling, the researchers cannot say it doesn’t work for certain subgroups of young adults or that it’s not effective for older populations like the elderly, he added.

For example, the new study included many college students who went to counseling as punishment for drinking in college and who may not be ready to make a meaningful behavior change.

Dr. Ken Carpenter, clinical director of the Substance and Treatment Research Service at Columbia Psychiatry/NY State Psychiatric Institute in New York, said the study’s findings are limited by the quality of the research and data included in the analysis.

“A lot of these studies say they do (motivational interviewing) but a lot of them don’t show how well it’s being done,” said Carpenter, who has been a motivational interviewing trainer and practitioner for the past 10 years.

He said the new findings won’t change how he practices other than to look for other ways to support his patients.

“Certainly we should think through learning the boundaries and that these brief interventions may not be as helpful as we hoped they would be,” he said.


Cochrane Library 2014.

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