Randomized controlled trial of MICBT for co-existing alcohol misuse and depression: Outcomes to 36-months

Integrated psychological treatment addressing co-existing alcohol misuse and depression has not been compared with single-focused treatment. This trial evaluates changes over 36 months following randomization of 284 outpatients to one of four motivational interviewing and cognitive–behavior therapy (MICBT) based interventions: (1) brief integrated intervention (BI); or BI plus 9 further sessions with (2) an integrated-, (3) alcohol-, or (4) depression-focus. Outcome measures included changes in alcohol consumption, depression (BDI-II: Beck Depression Inventory) and functioning (GAF: Global Assessment of Functioning), with average improvements from baseline of 21.8 drinks per week, 12.6 BDI-II units and 8.2 GAF units. Longer interventions tended to be more effective in reducing depression and improving functioning in the long-term, and in improving alcohol consumption in the short-term. Integrated treatment was at least as good as single-focused MICBT. Alcohol-focused treatment was as effective as depression-focused treatment at reducing depression and more effective in reducing alcohol misuse. The best approach seems to be an initial focus on both conditions followed by additional integrated- or alcohol-focused sessions.     

Motivational Interviewing in Improving Oral Health: A Systematic Review of Randomized Controlled Trials

Background: The control and management of many oral health conditions highly depend on one's daily self‐care practice and compliance to preventive and curative measures. Conventional (health) education (CE), focusing on disseminating information and giving normative advice, is insufficient to achieve sustained behavioral changes. A counseling approach, motivational interviewing (MI), is potentially useful in changing oral health behaviors. This systematic review aims to synthesize the evidence on the effectiveness of MI compared with CE in improving oral health. Methods: Four databases (PubMed MEDLINE, Web of Science, Cochrane Library, and PsycINFO) were searched to identify randomized controlled trials that evaluated the effectiveness of MI compared with CE in changing oral health behaviors and improving oral health of dental patients and the public. The scientific quality of the studies was rated, and their key findings were qualitatively synthesized. Results: The search yielded 221 potentially relevant papers, among which 20 papers (on 16 studies) met the eligibility criteria. The quality of the studies varied from 10 to 18 out of a highest possible score of 21. Concerning periodontal health, superior effect of MI on oral hygiene was found in five trials and was absent in two trials. Two trials targeting smoking cessation in adolescents failed to generate a positive effect. MI outperformed CE in improving at least one outcome in four studies on preventing early childhood caries, one study on adherence to dental appointments, and two studies on abstinence of illicit drugs and alcohol use to prevent the reoccurrence of facial injury. Conclusions: Reviewed randomized controlled trials showed varied success of MI in improving oral health. The potential of MI in dental health care, especially on improving periodontal health, remains controversial. Additional studies with methodologic rigor are needed for a better understanding of the roles of MI in dental practice.     

动机性访谈对恶性肿瘤患者配偶心理健康的影响

目的探讨动机性访谈对恶性肿瘤患者配偶心理健康的影响。方法对33名恶性肿瘤患者配偶进行3次动机性访谈,访谈前及第3次访谈后用症状自评量表测评。结果恶性肿瘤患者配偶的症状自评量表评分访谈前明显高于常模;访谈后评分降低,但抑郁、焦虑因子分仍高于常模;访谈前后的评分比较,差异有统计学意义。结论动机性访谈能促进恶性肿瘤患者配偶的心理健康。     

动机性访谈对脑卒中患者日常生活活动能力的影响

目的 ：探讨动机性访谈对脑卒中患者日常生活活动能力康复进程的影响。方法 ：选取天津市某三级甲等医院的脑卒中患者60例,按照时间先后顺序分为实验组及对照组,各组均30例。在科室常规护理的基础上,对实验组进行一对一的为时30-40min的动机性访谈干预,并发放《卒中后日常生活活动锻炼手册》以及为期3个月的电话随访。对照组接受针灸科常规护理及健康教育。采用Barthel指数量表对干预前、出院前2天、出院后1个月、出院后3个月的干预效果进行评价。结果 ：实验组干预后日常生活活动能力得分高于对照组,差异有统计学意义（P〈0.05）。其中,实验组日常生活活动能力得分随时间变化幅度不同,表现为出院前2天得分涨幅达到较高水平,而3个月时得分逐渐趋于平稳。结论 ：动机性访谈可以提高患者的日常生活活动能力,加快患者的康复进程。而3个月时干预的正向效果随着时间发展逐渐削弱,应警惕出现故态复萌现象。     

Training and maintaining motivational interviewing skills in a clinical trial

Motivational interviewing (MI) is an evidence-based practice that is being implemented in a wide range of settings. Research supports the importance of ongoing coaching and feedback sessions following initial training in MI to implement and sustain MI-adherent competencies. This article describes the development and preliminary testing of a group feedback and consultation process where clinicians code each others’ clinical samples of MI sessions and provide feedback to each other regarding the level of adherence to MI fidelity measures. Preliminary results suggest that group feedback may help clinicians develop and sustain MI skills.     

Randomized Controlled Trial of Motivational Interviewing to Support Breastfeeding Among Appalachian Women

ObjectiveTo determine the effectiveness of a single session of prenatal motivational interviewing (MI) to enhance breastfeeding outcomes.DesignA randomized controlled trial with two groups (MI and psychoeducation) with repeated measures: preintervention, postintervention, and at 1 month postpartum.SettingThe intervention was conducted at a university-associated clinic, community locations, and participants’ homes. Postpartum follow-up was conducted by telephone.ParticipantsA total of 81 women with low-risk pregnancies enrolled at 28 to 39 weeks gestation who lived in Appalachia.MethodsParticipants were randomly assigned to MI or psychoeducation on infant development. Pre- and postintervention outcome measures included intention to breastfeed, confidence in and importance of breastfeeding plan, and breastfeeding attitudes. At 1 month postpartum, participants completed a telephone interview to assess actual breastfeeding initiation, exclusivity, and plans to continue breastfeeding.ResultsAt 1 month postpartum, women in the MI group were more likely to report any current breastfeeding than women in the psychoeducation group, regardless of parity, χ²(1, N = 79) = 4.30, p = .040, Φ = .233. At the postintervention time point, the MI intervention had a significant effect on improving attitudes about breastfeeding among primiparous women only (p < .05).ConclusionOne session of MI was effective to promote breastfeeding at 1 month postpartum and to enhance positive attitudes toward breastfeeding among primiparous women in Appalachia.