Brief Motivational Enhancement Therapy for Concurrent Disorders

Brief Motivational Enhancement Therapy for Individuals With Psychotic Disorders and Concurrent Substance Use Disorders

The investigators are proposing a project that will examine the effectiveness of brief motivational enhancement therapy in a population with concurrent psychotic disorders and substance use disorders. This study will represent an emerging line of inquiry, as best practice interventions with this concurrent disordered (CD) populations are yet to be established.

Study Overview

• Status: Terminated
• Conditions: Substance Use; Psychosis
• Intervention / Treatment: Behavioral: Brief Motivational Enhancement Therapy; Other: treatment as usual

Detailed Description

Motivational enhancement therapy (MET) is grounded in research that explores the process of change. The MET approach assists individuals to move through increasingly higher levels of change towards action (making change) and maintaining change. The MET approach aims to invoke rapid and internally motivated change.

The Two MET sessions adapted from Sampl and Kadden (2001) are prepared as two individual sessions to reflect the original design of MET, allowing for client's to be met at their respective stage of change. Further, individual sessions allow the treatment to be tailored to client's individual reasons for change and personal coping strategies. The use of the Personalized Feedback Report (PFR) further encourages treatment around client's personal concerns and goals (Ramchand et al., 2011; See appendix 1 for further detail).

In the first treatment session, the therapist provides feedback from the initial CD consultation, using the PFR to stimulate discussion about personal substance use and reasons for change. Rapport building is also a key element to the first session, during which a strong therapeutic alliance is initiated. The second session is aimed at strengthening the commitment to change, exploring goal setting, and preparation for group.

The Centre for Addiction and Mental Health (CAMH) Schizophrenia Division introduced a CD service in 2009. Since the time of its inception, more than 200 consultations have been conducted. Of those consultations, more than 80%recommended attending CD groups offered with the Schizophrenia Program. However, less than 10% have followed those recommendations and attended the CD group.

Based on what is known about challenges surrounding engagement of CD clients in recommended treatments coupled with guidelines for evidence-based treatment with this population (Ledgerwood et al., 2008; Tsuang et al., 2006; Roncero et al., 2011), the purpose of the current study is to explore the ability of MET to increase engagement in CD interventions for clients diagnosed with psychotic and substance use disorders.

• Study Type: Interventional
• Enrollment (Actual): 8
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M5T 1R8
      • Centre for Addiction and Mental Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 65 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Between the ages of 16-65
• DSM-IV Diagnoses of a psychotic disorder and a substance use disorder (tobacco, alcohol and/or drug)
• Fluent English speaker
• Capable of giving written informed consent

Exclusion Criteria:

• Any medical or neuropsychiatric condition, illness or disorder (e.g. unstable angina, severe dementia) that could compromise attendance to outpatient appointments.
• Inability to provide informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Brief Motivational Enhancement Therapy	Behavioral: Brief Motivational Enhancement Therapy; The MET intervention consists of two 45 minute one-to-one sessions with a MET-trained therapist. The MET approach assists individuals to move through increasingly higher levels of change towards action (making change) and maintaining change. The MET approach aims to invoke rapid and internally motivated change with respect to substance use.
Other: treatment as usual	Behavioral: Brief Motivational Enhancement Therapy; The MET intervention consists of two 45 minute one-to-one sessions with a MET-trained therapist. The MET approach assists individuals to move through increasingly higher levels of change towards action (making change) and maintaining change. The MET approach aims to invoke rapid and internally motivated change with respect to substance use.; Other: treatment as usual; Treatment as usual includes case management as well as psychiatric appointments.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
CD group attendance	The primary outcome engagement with outpatient CD service as measured by CD group attendance.	2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Alcohol Use Scale (AUS)/Drug Use Scale (DUS)	The secondary outcome is change in substance use as measured by the AUS and DUS	2 weeks and 3 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Working Alliance Inventory	A measure of alliance between the participant and the clinician conducting the MET sessions.	2 weeks

Collaborators and Investigators

• Sponsor: Centre for Addiction and Mental Health
• Investigators: Principal Investigator: Yarissa Herman, D.Psych, Centre for Addiction and Mental Health

Study record dates

Study Major Dates

• Study Start: June 1, 2013
• Primary Completion (Actual): September 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: August 7, 2013
• First Submitted That Met QC Criteria: August 15, 2013
• First Posted (Estimate): August 16, 2013

Study Record Updates

• Last Update Posted (Estimate): December 17, 2014
• Last Update Submitted That Met QC Criteria: December 16, 2014
• Last Verified: December 1, 2014

More Information

Terms related to this study

• Keywords: Psychosis; Substance Use; Motivational Enhancement Therapy
• Additional Relevant MeSH Terms: Chemically-Induced Disorders; Schizophrenia Spectrum and Other Psychotic Disorders; Substance-Related Disorders; Psychotic Disorders; Mental Disorders
• Other Study ID Numbers: 055/2013

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No