Intensive Motivational Interviewing for Women with Alcohol Problems.

Motivational interviewing (MI) for the treatment of alcohol and drug problems is typically conducted over 1 to 3 sessions. This paper reports on an evaluation of an intensive 9-session version of MI (IMI) compared to a standard single MI session (SMI). Although no differences between IMI and SMI were found for methamphetamine use, there was an unexpected finding that women but not men with co-occurring alcohol problems in the IMI condition reduced the severity of their alcohol problems significantly more than those in the SMI condition at 4- and 6-month follow-up. Stronger perceived alliance with the therapist was associated with better outcome. Findings indicate that alcohol outcomes for women might be improved with the addition of more MI sessions. A current study is assessing the impact of IMI for women with more serious alcohol problems. Qualitative interviews are being conducted with women to better understand how IMI is helpful and why it appears to add benefit for women but not men.

Randomized trial of intensive motivational interviewing for methamphetamine dependence.

An intensive, 9-session motivational interviewing (IMI) intervention was assessed using a randomized clinical trial of 217 methamphetamine (MA) dependent individuals. Intensive motivational interviewing (IMI) was compared with a single standard session of MI (SMI) combined with eight nutrition education sessions. Interventions were delivered weekly over 2 months. All study participants also received standard outpatient group treatment three times per week. Both study groups showed significant decreases in MA use and Addiction Severity Index drug scores, but there were no significant differences between the two groups. However, reductions in Addiction Severity Index psychiatric severity scores and days of psychiatric problems during the past 30 days were found for clients in the IMI group but not the SMI group. SMI may be equally beneficial to IMI in reducing MA use and problem severity, but IMI may help alleviate co-occurring psychiatric problems that are unaffected by shorter MI interventions. Additional studies are needed to assess the problems, populations, and contexts for which IMI is effective.

Intensive motivational interviewing for women with concurrent alcohol problems and methamphetamine dependence.

Motivational interviewing (MI) for the treatment of alcohol and drug problems is typically conducted over 1 to 3 sessions. The current work evaluates an intensive 9-session version of MI (Intensive MI) compared to a standard single MI session (Standard MI) using 163 methamphetamine (MA) dependent individuals. The primary purpose of this paper is to report the unexpected finding that women with co-occurring alcohol problems in the Intensive MI condition reduced the severity of their alcohol problems significantly more than women in the Standard MI condition at the 6-month follow-up. Stronger perceived alliance with the therapist was inversely associated with alcohol problem severity scores. Findings indicate that Intensive MI is a beneficial treatment for alcohol problems among women with MA dependence.

Perceptions of sober living houses among addiction counselors and mental health therapists: knowledge, views and perceived barriers.

Affordable alcohol- and drug-free housing that supports recovery is limited in many areas. Sober living houses (SLHs) offer a unique living environment that supports abstinence and maintenance of a recovery lifestyle. Previous studies show that SLH residents make improvements on alcohol, drug and other problems that are maintained at 18-month follow-up (Polcin et al. 2010). However, for SLHs to maximize their impact they must recognize how they are viewed by community stakeholders and successfully address barriers. This pilot study recruited a convenience sample of two stakeholder groups, certified alcohol and drug counselors (N = 85) and licensed mental health therapists (N = 49), to explore knowledge and views about SLHs using an online survey. Therapists and counselors had similar views about SLHs, although counselors had more direct experience with them and were more knowledgeable. Both groups were highly supportive of increasing the role of SLHs to address addiction problems in their communities. Those who were most supportive had more knowledge about SLHs, agreed that alcohol and drug problems were caused by a physical disease, and agreed that successful recovery required an abstinent living environment. Both groups identified a variety of barriers, particularly social stigma. Recommendations are made for knowledge dissemination and decreasing barriers.

Community Context of Sober Living Houses.

The success or failure of programs designed to address alcohol and drug problems can be profoundly influenced by the communities where they are located. Support from the community is vital for long term stability and conflict with the community can harm a program's reputation or even result in closure. This study examined the community context of sober living houses (SLHs) in one Northern California community by interviewing key stakeholder groups. SLHs are alcohol and drug free living environments for individuals attempting to abstain from substance use. Previous research on residents of SLHs showed they make long-term improvements on measures of substance use, psychiatric symptoms, arrests, and employment. Interviews were completed with house managers, neighbors, and key informants from local government and community organizations. Overall, stakeholders felt SLHs were necessary and had a positive impact on the community. It was emphasized that SLHs needed to practice a "good neighbor" policy that prohibited substance use and encouraged community service. Size and density of SLHs appeared to influence neighbor perceptions. For small (six residents or less), sparsely populated houses, a strategy of blending in with the neighborhood seemed to work. However, it was clear that larger, densely populated houses need to actively manage relationships with community stakeholders. Strategies for improving relationships with immediate neighbors, decreasing stigma, and broadening the leadership structure are discussed. Implications for a broad array of community based programs are discussed.