The Efficacy of Motivational Interviewing: A Meta-Analysis of Controlled Clinical Trials

By Brian L. Burke, Hal Arkowitz, and Marisha Menchola

Presented by Jane Canavan

Radford University

Purpose

• To determine if motivational interviewing is an effective form of treatment for problem behaviors involving alcohol, drugs, smoking, HIV-risk-behaviors, and diet/exercise.

Definition of Motivational Interviewing

• A directive, client-centered counseling style for eliciting behavior change by helping clients explore and resolve problem behaviors.– Motivation to change is elicited from the client, and not

imposed by coercion, persuasion, or constructive confrontation from the counselor

– The counselor’s job is to identify and examine the intrinsic values and goals of the client in order to stimulate behavior change (reason it is considered directive)

Issues to Consider

• Type of problem area– Some problem behaviors involve a physiological addiction

(drug and alcohol addiction) while others do not (diet and exercise)

• Format of the MI– Alone

– Along with other services

• Study design– No treatment/placebo

– Active treatment

Literature Review

• Methods– Article Bibliographies– Electronic Source

• PsycINFO

– Electronic Message• To all members of the Motivational Interviewing

Network of Trainers asking for any published or unpublished studies

• Studies– 30 were used

Inclusion Criteria

• The intervention was delivered on an individual (not group) and face-to-face (not telephone) basis

• Studies had to include the following criteria:– Random assignment to groups– At least one comparison group– Adequate measurement targeting pertinent

problem areas

Dependent Measures

• Alcohol

• Smoking cessation

• Drug Addiction

• HIV-risk behaviors

• Diet & exercise

• Social impact

Potential Moderators

• Clinical problem area

• Severity of drug or alcohol problem

• Format of the motivational interview- stand-alone intervention or adjunct to other services

• Dose of treatment- minutes per session/ # of sessions

• Follow- up point

Results Effect Size d over K/N*Significant

Problem Area No-treat./placebo

Active treatment

Alcohol (SEC) 0.25*

12/1,142

0.09

5/826

Drug Addiction 0.56*

3/250

-0.01

2/247

Alcohol (BAC) 0.53*

5/266

----

Results Effect Size d over K/N* Significant

Problem Area No-treatment/

Placebo

Active treatment

Smoking Cessation

0.11

2/574

----

HIV-risk behaviors

0.01

2/173

----

Diet & exercise 0.53*

4/366

----

Social impact 0.47*

7/1,984

----

Factors that may Account for Differences in Effect Sizes

• Drug Addiction– Higher dose of treatment

• Diet and exercise– High dose of treatment– Low quality studies

Conclusion

• Motivational interviews were equivalent to other active treatments and are more effective than placebo and no treatment controls for problems involving alcohol, drugs, and diet and exercise.

• There was no support for the efficacy of MI’s in the areas of smoking and HIV-risk behaviors.