Evaluation of a motivational interview for substance use within psychiatric in-patient services.

AIMS: To assess the effectiveness of a motivational interview among hospitalized psychiatric patients with comorbid substance use disorder in reducing alcohol and other drug (AOD) use. DESIGN: Subjects were assigned randomly to receive an individual motivational interview (n=79) or a self-help booklet (control condition; n=81). SETTING: Subjects were volunteers recruited from a major public psychiatric hospital. PARTICIPANTS: Subjects met abuse or dependence criteria on the structured clinical interview for diagnosis (SCID) for alcohol, cannabis or amphetamine or they reported hazardous use during the last month of one or more of these drug types on the opiate treatment index (OTI). INTERVENTION: Either one 30-45-minute motivational interview or brief advice. MEASUREMENTS: The SCID and OTI were the main measures. FINDINGS: There was a modest short-term effect of the motivational interview on an aggregate index of alcohol and other drug use (polydrug use on the OTI). Cannabis use remained high among the sample over the 12-month follow-up period. CONCLUSION: Although motivational interviewing appears feasible among in-patients in psychiatric hospital with comorbid substance use disorders, more extensive interventions are recommended, continuing on an out-patient basis, particularly for cannabis use.

Motivational interviewing among psychiatric in-patients with substance use disorders.

OBJECTIVE: There were three aims of the present study: 1) to document patterns of substance misuse among psychiatric in-patients with comorbid alcohol and other drug (AOD) use; 2) to examine associations among psychiatric and substance use diagnoses and readiness to change; and 3) to evaluate the effectiveness of an opportunistic motivational interview on engagement in a Specialist Substance Misuse Service (SSMS). METHOD: One hundred and sixty subjects were randomly assigned to receive either a motivational interview or no intervention. RESULTS: Overall, 66.3% of subjects met intervention threshold for cannabis, 60.6% for alcohol and 22.5% for amphetamines. There was a bimodal distribution of stage of change for cannabis use which was associated with age, with precontemplation being associated with older age and less frequent use. Attendance at the SSMS was low and unrelated to intervention status. CONCLUSION: A different approach to treatment is recommended, including early intervention among cannabis users.