Motivational Interviewing at Intake vs Intake as Usual on Client Engagement in Addiction Treatment

Adapting Intake Procedures to Improve Treatment Delivery in Addiction Treatment

This K23 study is an effectiveness-implementation hybrid type I design to determine the effectiveness of Motivational Interviewing at Intake (MII), relative to intake-as-usual on client engagement and mechanisms of engagement among adults seeking outpatient addiction treatment. We also will obtain personnel feedback on the feasibility of implementing MII into standard practice by having personnel from the addiction treatment study sites complete implementation climate measures before Motivational Interviewing (MI) training and post-clinical trial, as well as an individual interview on implementation feasibility post-trial.

Study Overview

• Status: Recruiting
• Conditions: Substance-Related Disorders; Treatment Adherence
• Intervention / Treatment: Behavioral: Motivational Interviewing at Intake (MII); Behavioral: Intake as Usual (IAU)

• Study Type: Interventional
• Enrollment (Anticipated): 150
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Margo Hurlocker, PhD; Phone Number: (505) 596-0578; Email: mhurlocker@unm.edu

Study Locations

• United States
  • New Mexico
    • Albuquerque, New Mexico, United States, 87111
      • Recruiting
      • Turning Point Recovery Center
      • Contact: Alaina Geoff; Phone Number: 505-217-1717; Email: alaina@turningpointrc.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria (client participants):

• English-speaking adults seeking treatment for alcohol or other drug use at one of two outpatient addiction treatment programs
• Provision of signed and dated informed consent form
• Stated willingness to comply with all study procedures
• Physically withdrawn from alcohol or other drugs

Inclusion Criteria (personnel participants):

• English-speaking adults currently employed at one of the two outpatient addiction treatment programs
• Provision of electronic informed consent

Exclusion Criteria (client participants):

• Experiencing severe withdrawal symptoms
• Actively psychotic, manic, and/or suicidal

Exclusion Criteria (personnel participants):

• current position: facility owner or clinical director

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Motivational Interviewing at Intake (MII); Clients allocated to the MII condition will receive a 90-minute pure Motivational Interviewing (MI) session.	Behavioral: Motivational Interviewing at Intake (MII); The MII will involve a goal-oriented and collaborative conversation about why the client wants treatment now, and how treatment might fit with his/her most important values. The provider will use open questions, reflective listening and autonomy support in a flexible, non-authoritative manner. Rather than asking specific questions in different life domains, the provider will explore with the client their desires, abilities, reasons, and needs for treatment, how treatment fits with their values, and what successful treatment looks like to them. The client's language about change will be strategically reinforced to increase its frequency and strength across the session.
Active Comparator: Intake as Usual (IAU); Clients allocated to the IAU condition will receive the 90-minute standard assessment that is delivered to all clients entering intensive outpatient program (IOP)/outpatient program (OP).	Behavioral: Intake as Usual (IAU); In line with the American Society of Addiction Medicine (ASAM) guidelines, the IAU condition involves a semi-structured interview of the client's psychosocial history and clients answer a series of questions in the following domains: support system, living situation, educational, occupational, family, and medical history.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants who attended the first outpatient treatment program session based on electronic medical record review	Treatment entry is determined by review of electronic medical record of whether clients attended their first scheduled treatment session	up to 36 weeks
Number of treatment sessions attended during the three-month outpatient treatment program based on electronic medical record review	Number of treatment sessions that clients attend is determined by review of electronic medical record and calculating number of treatment sessions attended.	up to 36 weeks
Number of participants who completed the three-month outpatient treatment program based on electronic medical record review	Completion of the three-month outpatient treatment program is determined by review of electronic medical record	up to 36 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in client readiness to enter treatment on the University of Rhode Island Change Assessment Scale (URICA) at 1 hour post-intake	The URICA is a validated, self-report measure of client readiness for treatment engagement. Possible scores range from 32 to 160 with higher scores indicative greater readiness to enter treatment. Change = (Hour 1 score - Baseline Score).	baseline and 1 hour post-intake
Score on therapeutic alliance on the Working Alliance Inventory (WAI) at 1-hour post-intake	The WAI is a validated, self-report measure of client perceptions of the therapeutic process by assessing three sub scales: Goals, Bond, and Tasks. Possible scores on sub scales range from 12 to 84 with higher scores indicative of better therapeutic alliance.	1 hour post-intake

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in organizational readiness to change on the Texas Christian University-Organizational Readiness to Change (TCU-ORC) at 1 year	The TCU-ORC is a validated, self-report measure of personnel perceptions of their organization's readiness and willingness to make changes. Possible scores range from 125 to 625 with higher scores indicative of more readiness to change. Change = (Year 1 score - Baseline Score).	baseline and 1 year
Change from baseline in organizational readiness to change on the Readiness for Organizational Change (ROC) at 1 year	The ROC is a validated, self-report measure of personnel perceptions of their organization's readiness to change. Possible scores range from 25 to 155 with higher scores indicative of more readiness to change. Change = (Year 1 score - Baseline Score).	baseline and 1 year
Change from baseline in organizational capability to change on the Change Process Capability Questionnaire (CPCQ) at Year 1	The CPCQ is a validated, self-report measure of personnel perceptions of of their organization's capability to change. Possible scores range from 1 to 132 with higher scores indicative of more capability to make changes in the organization. Change = (Year 1 score - Baseline Score).	baseline and 1 year

Collaborators and Investigators

• Sponsor: University of New Mexico
• Collaborators: National Institute on Drug Abuse (NIDA)
• Investigators: Principal Investigator: Margo Hurlocker, PhD, University of New Mexico

Study record dates

Study Major Dates

• Study Start (Actual): March 16, 2022
• Primary Completion (Anticipated): October 1, 2024
• Study Completion (Anticipated): December 1, 2024

Study Registration Dates

• First Submitted: July 26, 2022
• First Submitted That Met QC Criteria: August 2, 2022
• First Posted (Actual): August 5, 2022

Study Record Updates

• Last Update Posted (Actual): May 9, 2023
• Last Update Submitted That Met QC Criteria: May 8, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders
• Other Study ID Numbers: A22-0014; K23DA052646 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data that underlie results reported in a peer-reviewed publication, after deidentification (text, tables, figures, and appendices). Session audio recordings will not be shared.
• IPD Sharing Time Frame: Data will become available starting in January 2025
• IPD Sharing Access Criteria: Researchers who provide a methodologically sound proposal will have access to the data. A data use agreement will be required, signed by the requesting investigator and their Authorized Organization Representation (AOR)/Signing Official (SO)
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No