Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, 109 Bee St., Charleston, SC, 29401, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St., Charleston, SC, 29425, USA.
Mental Health Service Line, James H. Quillen VAMC, 53 Memorial Ave, Johnson City, TN, 37684, USA.
Drug Alcohol Depend. 2021 Jun 1;223:108716. doi: 10.1016/j.drugalcdep.2021.108716. Epub 2021 Apr 20.
Motivational interviewing delivered in a group format is understudied yet promising as a treatment for substance use disorders (SUD). We evaluated the efficacy of group motivational interviewing (GMI) relative to a treatment-control (TCC) for enhancing treatment and self-help engagement and decreasing alcohol and drug use among veterans with SUD and co-existing psychiatric disorders.
Veterans (n = 118) with alcohol use disorder were recruited within an outpatient SUD treatment program and randomized to GMI or TCC upon program entry. Alcohol use, SUD treatment, and 12-step session attendance were primary outcomes. Drug use days was the secondary outcome. Participants were assessed at baseline and at one-and three-month follow-up.
Significant differences were observed between GMI and TCC for binge drinking at both one (RR = .74; 95 % CI [.58, .94]) and three-month follow-up (RR = .74; 95 % CI [.59, .91]). At three-month follow-up, significant differences between treatment conditions were observed for alcohol use days (RR = .79; 95 % CI [.67, .94]), number of SUD treatment sessions (RR = 2.53; 95 % CI [1.99, 3.22]), and 12-step sessions attended (RR = 1.64; 95 % CI [1.35-1.98]). Similarly, we observed significant effects for GMI on reducing alcohol consumption in standard drinks (RR = .49; 95 % CI [.25, .95]). Drug use days declined at each follow-up, with no significant differences between treatment conditions.
GMI delivered at SUD treatment program entry enhanced treatment session and 12-step group attendance and lowered alcohol consumption among outpatient Veterans. Future research should study how GMI works and its effectiveness in SUD treatment settings.
以团体形式进行的动机性访谈作为治疗物质使用障碍（SUD）的方法研究较少，但前景广阔。我们评估了团体动机性访谈（GMI）相对于治疗对照（TCC）在增强治疗和自助参与、减少患有 SUD 和并存精神障碍的退伍军人的酒精和药物使用方面的疗效。
在一个门诊 SUD 治疗项目中招募了患有酒精使用障碍的退伍军人（n = 118），并在项目开始时根据 GMI 或 TCC 进行随机分组。酒精使用、SUD 治疗和 12 步会议出勤率是主要结果。药物使用天数是次要结果。参与者在基线和一个月和三个月随访时进行评估。
在一个月和三个月的随访中，GMI 和 TCC 之间在 binge drinking 方面观察到显著差异（RR =.74；95 % CI [.58,.94]）和三个月随访（RR =.74；95 % CI [.59,.91]）。在三个月的随访中，治疗条件之间观察到显著差异，包括酒精使用天数（RR =.79；95 % CI [.67,.94]）、SUD 治疗次数（RR = 2.53；95 % CI [1.99, 3.22]）和 12 步会议出席率（RR = 1.64；95 % CI [1.35-1.98]）。同样，我们观察到 GMI 对减少标准饮酒量的酒精消耗有显著效果（RR =.49；95 % CI [.25,.95]）。药物使用天数在每次随访时都有所下降，但治疗条件之间没有显著差异。
在 SUD 治疗项目开始时提供 GMI 增强了门诊退伍军人的治疗会议和 12 步小组参与度，并降低了他们的酒精摄入量。未来的研究应研究 GMI 的工作原理及其在 SUD 治疗环境中的有效性。
