Journal of Substance Abuse Treatment最新文献

{"title":"National trends in buprenorphine prescribing before and during the COVID-19 pandemic","authors":"Mir M. Ali,&nbsp;Timothy B. Creedon,&nbsp;Laura Jacobus-Kantor,&nbsp;Tisamarie B. Sherry","doi":"10.1016/j.jsat.2022.108923","DOIUrl":"10.1016/j.jsat.2022.108923","url":null,"abstract":"<div><h3>Objective</h3><p>Recent studies have shown that early in the COVID-19 pandemic, rates of buprenorphine prescription dispensing for opioid use disorder (OUD) were relatively stable. However, whether that pattern continued later in the pandemic is unclear. This study examines the monthly rate of dispensed buprenorphine prescriptions during the early period and the later period of the pandemic.</p></div><div><h3>Methods</h3><p>The study uses interrupted time series analysis to examine buprenorphine prescription dispensed, average day's supply, payment source, and the number of patients with a dispensed buprenorphine prescription. The study utilized January 2019–April 2021 data from IQVIA National Prescription Audit, PayerTrack and Total Patient Tracker databases.</p></div><div><h3>Results</h3><p>After an initial increase in the number of patients prescribed buprenorphine in the early period of the pandemic, the monthly rate of patients prescribed buprenorphine increased at a lower rate compared to the pre-pandemic period (6100 vs 4600/month). The study observed a decline in the number of buprenorphine prescriptions dispensed both in levels and growth rate during the pandemic, but an increase occurred in the average day's supply of buprenorphine prescriptions (17 days pre-pandemic vs 18.6 day during the pandemic). Medicaid became the primary payer of buprenorphine prescriptions as the pandemic continued, while buprenorphine prescriptions paid for by private insurance declined.</p></div><div><h3>Discussion</h3><p>Expanding and maintaining access to treatment for OUD were key priorities in federal and state responses to the COVID-19 pandemic. The results of our study underscore the importance of policy efforts to help increase buprenorphine prescribing for OUD.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108923"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An intervention pilot to facilitate harm reduction service decentralization in Vietnam","authors":"Chunqing Lin ,&nbsp;Li Li ,&nbsp;Anh Tuan Le ,&nbsp;Hoang My Lien Tran ,&nbsp;Thanh Duyen Pham ,&nbsp;Anh Tuan Nguyen","doi":"10.1016/j.jsat.2022.108927","DOIUrl":"10.1016/j.jsat.2022.108927","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Harm reduction services, including methadone maintenance therapy (MMT), have been decentralized to Vietnam's community </span>health care settings. This study aims to pilot test an intervention to facilitate decentralized harm reduction service delivery in Vietnam.</p></div><div><h3>Methods</h3><p><span>The research team conducted an intervention pilot between August 2020 and May 2021 with six community MMT distribution sites in Thai Nguyen Province of Vietnam. We recruited five commune health workers (CHW) from each center (</span><em>N</em><span> = 30). In-person intervention training included content to correct misconceptions about harm reduction and reduce stigmatizing attitudes toward patients who use drugs and teach CHWs to self-examine and improve their service provision process. The study team developed a web-based platform to streamline CHW's patient monitoring and referral efforts. The team assessed intervention outcomes at baseline, 3-, and 6-months. CHWs in the intervention group provided acceptability ratings and feedback on the intervention at 6-months.</span></p></div><div><h3>Results</h3><p>CHWs in both intervention and control groups had similar background characteristics and outcome measures at baseline. CHWs in the intervention group, compared to those in the control group, showed a significantly higher level of improvement in adherence to service delivery protocol at 3-months. CHW in the intervention group had a significantly lower level of management-related stress compared to the control group at 6-months, although the intervention effect measured by the difference in change from baseline was not statistically significant. CHWs who participated in the final focus group reported high acceptability of the intervention.</p></div><div><h3>Conclusion</h3><p>This intervention pilot demonstrated acceptability and promising outcomes on community-based harm reduction service delivery. Similar intervention strategies can be applied to enhance the decentralization of other chronic disease treatment services.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108927"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9759177/pdf/nihms-1851647.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing clinical guidelines for co-occurring substance use and major mental disorders in Swedish forensic psychiatry: An exploratory, qualitative interview study with mental health care staff","authors":"J. Green ,&nbsp;A.S. Lindqvist Bagge ,&nbsp;S. Olausson ,&nbsp;P. Andiné ,&nbsp;M. Wallinius ,&nbsp;M. Hildebrand Karlén","doi":"10.1016/j.jsat.2022.108899","DOIUrl":"10.1016/j.jsat.2022.108899","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with substance use disorders (SUD) and co-occurring mental disorders (COD) within forensic psychiatric care often suffer poor treatment outcomes and high rates of criminal recidivism, substance use, and psychiatric problems. This study aimed to describe the conditions for, and mental health care staff's experiences with, implementing integrated SUD-focused clinical guidelines, including assessment and treatment for patients with COD at a high-security forensic mental health services (FMHS) facility in Sweden.</p></div><div><h3>Methods</h3><p>Study staff conducted nineteen semi-structured interviews with health care staff experienced in administering the new SUD assessment and treatment. The study conducted a thematic analysis to describe the health care staff's experiences with these guidelines and suggestions for improvement.</p></div><div><h3>Results</h3><p>Most participants reported appreciation for the implementation of clinical guidelines with an SUD focus, an area they considered to have previously been neglected, but also noted the need for more practical guidance in the administration of the assessments. Participants reported the dual roles of caregiver and warden as difficult to reconcile and a similar, hindering division was also present in the health care staff's attitudes toward SUD. Participants' reports also described an imbalance prior to the implementation, whereby SUD was rarely assessed but treatment was still initiated. One year after the implementation, an imbalance still existed, but in reverse: SUD was more frequently assessed, but treatment was difficult to initiate.</p></div><div><h3>Conclusions</h3><p>Despite indications of some ambivalence among staff regarding the necessity of the assessment and treatment guidelines, many participants considered it helpful to have a structured way to assess and treat SUD in this patient group. The imbalance between frequent assessment and infrequent treatment may have been due to difficulties transitioning patients across the “gap” between assessment and treatment. To bridge this gap, mental health services should make efforts to increase patients' insight concerning their SUD, flexibility in the administration of treatment, and the motivational skills of the health care staff working with this patient group. Participants considered important for enhancing treatment quality a shared knowledge base regarding SUD, and increased collaboration between different professions and between in- and outpatient services.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108899"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10739422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying factors that contribute to burnout and resilience among hospital-based addiction medicine providers: A qualitative study","authors":"Erin Bredenberg ,&nbsp;Caroline Tietbohl ,&nbsp;Ashley Dafoe ,&nbsp;Lindsay Thurman ,&nbsp;Susan Calcaterra","doi":"10.1016/j.jsat.2022.108924","DOIUrl":"10.1016/j.jsat.2022.108924","url":null,"abstract":"<div><h3>Introduction</h3><p>Inpatient Addiction Consultation Services (ACS) fill an important need by connecting hospitalized patients with substance use disorders with resources for treatment; however, providers of these services may be at risk for burnout. In this qualitative study, we aimed to identify factors associated with burnout and, conversely, resilience among multidisciplinary providers working on ACS.</p></div><div><h3>Methods</h3><p>We completed 26 semi-structured interviews with clinicians working on ACS, including physicians, social workers, and advanced practice providers. Twelve institutions across the country were represented. The study recruited participants via email solicitation to ACS directors and then via snowball sampling. We used an inductive, grounded theory approach to analyze data.</p></div><div><h3>Results</h3><p>Providers described factors contributing to burnout and strategies for promoting resilience, and three main themes arose: (1) Systemic barriers contributed to provider burnout, (2) Engaging in meaningful work increased resilience, and (3) Team dynamics influenced perceptions of burnout and resilience.</p></div><div><h3>Conclusion</h3><p>Our results suggest that hospital-based addiction medicine work is intrinsically rewarding for many providers and that engaging with other addiction providers to debrief challenging encounters or engage in advocacy work can be protective against burnout. However, administrative and systemic factors are frequent sources of frustration for providers of ACS. Structured debriefings may help to mitigate burnout. Furthermore, training to enhance providers' ability to engage effectively in advocacy work within and between hospital systems has the potential to promote resilience and protect against burnout among ACS providers.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108924"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10679363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of polysubstance use disorder with treatment quality among Medicaid beneficiaries with opioid use disorder","authors":"Rosanna Smart ,&nbsp;Joo Yeon Kim ,&nbsp;Susan Kennedy ,&nbsp;Lu Tang ,&nbsp;Lindsay Allen ,&nbsp;Dushka Crane ,&nbsp;Aimee Mack ,&nbsp;Shamis Mohamoud ,&nbsp;Nathan Pauly ,&nbsp;Rosa Perez ,&nbsp;Julie Donohue","doi":"10.1016/j.jsat.2022.108921","DOIUrl":"10.1016/j.jsat.2022.108921","url":null,"abstract":"<div><h3>Introduction</h3><p>The opioid crisis is transitioning to a polydrug crisis, and individuals with co-occurring substance use disorder (SUDs) often have unique clinical characteristics and contextual barriers that influence treatment needs, engagement in treatment, complexity of treatment planning, and treatment retention.</p></div><div><h3>Methods</h3><p>Using Medicaid data for 2017–2018 from four states participating in a distributed research network, this retrospective cohort study<span> documents the prevalence of specific types of co-occurring SUD among Medicaid enrollees with an opioid use disorder (OUD) diagnosis, and assesses the extent to which different SUD presentations are associated with differential patterns of MOUD and psychosocial treatments.</span></p></div><div><h3>Results</h3><p>We find that more than half of enrollees with OUD had a co-occurring SUD, and the most prevalent co-occurring SUD was for “other psychoactive substances”, indicated among about one-quarter of enrollees with OUD in each state. We also find some substantial gaps in MOUD treatment receipt and engagement for individuals with OUD and a co-occurring SUD, a group representing more than half of individuals with OUD. In most states, enrollees with OUD and alcohol, cannabis, or amphetamine use disorder are significantly less likely to receive MOUD compared to enrollees with OUD only. In contrast, enrollees with OUD and other psychoactive SUD were significantly more likely to receive MOUD treatment. Conditional on MOUD receipt, enrollees with co-occurring SUDs had 10 % to 50 % lower odds of having a 180-day period of continuous MOUD treatment, an important predictor of better patient outcomes. Associations with concurrent receipt of MOUD and behavioral counseling were mixed across states and varied depending on co-occurring SUD type.</p></div><div><h3>Conclusions</h3><p>Overall, ongoing progress toward increasing access to and quality of evidence-based treatment for OUD requires further efforts to ensure that individuals with co-occurring SUDs are engaged and retained in effective treatment. As the opioid crisis evolves, continued changes in drug use patterns and populations experiencing harms may necessitate new policy approaches that more fully address the complex needs of a growing population of individuals with OUD and other types of SUD.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108921"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10019261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of the efficacy, effectiveness, and cost-effectiveness of stepped-care interventions for the prevention and treatment of problematic substance use","authors":"Ashleigh K. Morse ,&nbsp;Jayden Sercombe ,&nbsp;Mina Askovic ,&nbsp;Alana Fisher ,&nbsp;Christina Marel ,&nbsp;Mary-Lou Chatterton ,&nbsp;Frances Kay-Lambkin ,&nbsp;Emma Barrett ,&nbsp;Matthew Sunderland ,&nbsp;Logan Harvey ,&nbsp;Natalie Peach ,&nbsp;Maree Teesson ,&nbsp;Katherine L. Mills","doi":"10.1016/j.jsat.2022.108928","DOIUrl":"10.1016/j.jsat.2022.108928","url":null,"abstract":"<div><h3>Background</h3><p>Stepped-care is a commonly recommended and implemented care model across health care domains, including substance use. Despite their presumed efficient allocation of treatment resources, a current and robust evidence synthesis is needed on the efficacy, effectiveness and cost-effectiveness of stepped-care for substance use.</p></div><div><h3>Methods</h3><p>This systematic review analyzed articles describing evaluations of stepped-care models that measured the use of acutely psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in participants over 18 years old. The analysis investigated model and participant characteristics associated with treatment outcomes.</p></div><div><h3>Results</h3><p>The study team conducted a search of five databases of literature (PsychINFO, MEDLINE, Embase, Cochrane Library and Scopus) published between January 1, 2010, and November 1, 2020. The search yielded 1051 unique articles, 19 of which were included in the analysis. The studies had considerable variability in sample sizes (<em>n</em> = 18–2310), time to follow-up (4.5 months to 3 years), and retention rates (35.1–100 %). Studies examined outcomes for either alcohol alone (<em>n</em> = 9), alcohol and other drug use (<em>n</em> = 9), or drug use alone (<em>n</em> = 1). Most studies (<em>n</em> = 13;) were rated as good quality. Three (15.8 %) were rated as fair and three (15.8 %) were rated as poor quality. The evidence regarding the efficacy, effectiveness and cost-effectiveness of stepped-care approaches is limited, but four of seven studies found that adaptive-care interventions delivered in the context of other systemic interventions produced greater benefit than control conditions in relation to at least one alcohol-related outcome. We have insufficient evidence to determine whether the modes or intensity of interventions included in the models, or decision rules used to step people up or down to differing levels of care, have an impact on outcome.</p></div><div><h3>Conclusion</h3><p>Heterogeneity between studies with regard to model and evaluation design limited the degree to which the analysis could draw robust conclusions. Sample recruitment and statistical power are particular challenges, and the field needs more innovative evaluation designs to assess the efficacy, effectiveness, and cost-effectiveness of stepped-care models.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108928"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10672631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cohort study examining changes in treatment patterns for alcohol use disorder among commercially insured adults in the United States during the COVID-19 pandemic","authors":"Alisa B. Busch ,&nbsp;Ateev Mehrotra ,&nbsp;Shelly F. Greenfield ,&nbsp;Lori Uscher-Pines ,&nbsp;Sherri Rose ,&nbsp;Haiden A. Huskamp","doi":"10.1016/j.jsat.2022.108920","DOIUrl":"10.1016/j.jsat.2022.108920","url":null,"abstract":"<div><h3>Introduction</h3><p>We know very little about how the pandemic impacted outpatient alcohol use disorder (AUD) care and the role of telemedicine.</p></div><div><h3>Methods</h3><p>Using OptumLabs® Data Warehouse de-identified administrative claims, we identified AUD cohorts in 2018 (<em>N</em> = 23,204) and 2019 (N = 23,445) and examined outpatient visits the following year, focusing on week 12, corresponding to the March 2020 US COVID-19 emergency declaration, through week 52. Using multivariable logistic regression, we examined the association between patient demographic and clinical characteristics and receipt of any outpatient AUD visits in 2020 vs. 2019.</p></div><div><h3>Results</h3><p>In 2020, weekly AUD visit utilization decreased maximally at the pandemic start (week 12) by 22.5 % (2019: 3.8 %, 2020: 3.0 %, percentage point change [95 % CI] = −0.86[−1.19, −0.05]) but was similar to 2019 utilization by mid-April 2020 (week 16). Telemedicine accounted for 50.1 % of AUD visits by early July 2020 (week 27). Individual therapy returned to 2019 levels within 1 week (i.e., week 13) whereas group therapy did not consistently do so until mid-August 2020 (week 31). Further, individual therapy exceeded 2019 levels by as much as 50 % starting mid-October 2020. The study found no substantial differences in visits by patient demographic or clinical characteristics.</p></div><div><h3>Conclusions</h3><p>Among patients with known AUD, initial outpatient care disruptions were relatively brief. However, substantial shifts occurred in care delivery—an embrace of telemedicine but also more pronounced, longer disruptions in group therapy vs. individual and an increase in individual therapy use. Further research needs to help us understand the implications of these findings for clinical outcomes.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108920"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC (update)","authors":"","doi":"10.1016/S0740-5472(22)00214-8","DOIUrl":"10.1016/S0740-5472(22)00214-8","url":null,"abstract":"","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108932"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42084706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer support to reduce readmission in Medicaid-enrolled adults with substance use disorder","authors":"Shari L. Hutchison,&nbsp;Kim L. MacDonald-Wilson,&nbsp;Irina Karpov,&nbsp;Amy D. Herschell,&nbsp;Tracy Carney","doi":"10.1016/j.jsat.2022.108901","DOIUrl":"10.1016/j.jsat.2022.108901","url":null,"abstract":"<div><h3>Introduction</h3><p>Peer support service in substance use disorder systems (PS SUD) is an optional supplement to treatment services for Medicaid-enrolled individuals across Pennsylvania. The value of PS SUD was defined through association with improved service utilization patterns. We examined service utilization in a subset of individuals receiving PS SUD following an acute service (hospitalization or withdrawal management) compared to utilization in propensity-score-matched controls via an observational analysis.</p></div><div><h3>Methods</h3><p>We identified all Medicaid-enrolled adults with receipt of PS SUD from 2016 to 2019 and included those with prior acute service (<em>n</em> = 349); the study successfully matched all to individuals receiving outpatient SUD services without peer support (<em>n</em><span> = 698). Individuals were matched on age, gender, race, ethnicity, diagnosis, and prior utilization of acute care. A large percentage of individuals receiving PS SUD (74 %) had co-occurring mental health diagnoses, which we included in matching. We examined service utilization rates via administrative paid claims data for both groups in the first 90 days following peer support/outpatient discharge.</span></p></div><div><h3>Results</h3><p>Acute service utilization differed between groups over time, <em>p</em><span> = .0014. We observed a larger reduction in the rate of acute care during PS SUD service (8.6 %) versus outpatient service (21.2 %), with lower rates remaining 90 days following PS SUD (13.8 %) or outpatient discharge (16.8 %). Individuals receiving PS SUD showed connection to community-based services in the 90 days following discharge from PS SUD, including 45.0 % receiving outpatient SUD and 31.8 % receiving outpatient mental health services.</span></p></div><div><h3>Conclusions</h3><p>Peer support may help individuals to navigate the behavioral health system and reduce hospitalization or other restrictive levels of care.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108901"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the relational context and therapists' technical behaviors in brief motivational interviewing sessions for heavy alcohol consumption: Findings from a sample of Latinx adults","authors":"Molly Magill ,&nbsp;Justin Walthers ,&nbsp;Victor Figuereo ,&nbsp;Liliana Torres ,&nbsp;Zulma Montanez ,&nbsp;Kristina Jackson ,&nbsp;Suzanne M. Colby ,&nbsp;Christina S. Lee","doi":"10.1016/j.jsat.2022.108898","DOIUrl":"10.1016/j.jsat.2022.108898","url":null,"abstract":"<div><h3>Introduction</h3><p>Motivational interviewing (MI) theory and process research highlights the role of therapist technical and relational behaviors in predicting client in-session statements for or against behavior change (i.e., change and sustain talk, respectively). These client statements, in turn, have been shown to predict intervention outcomes. The current study examines sequential associations between therapist behaviors and client change and sustain talk in a sample of Latinx individuals who engage in heavy alcohol consumption.</p></div><div><h3>Data</h3><p>Data are from a completed randomized clinical trial of a culturally adapted (CAMI) versus unadapted MI targeting alcohol use and consequences among Latinx individuals.</p></div><div><h3>Method</h3><p>The study collected observational coding data with the Motivational Interviewing Skill Code (MISC 2.5, i.e., therapist behaviors and global ratings) and the Client Language Assessment – Proximal/Distal (CLA-PD, i.e., client language). Frequentist and Bayesian sequential analyses examined the relationship among nine different categories of therapist behaviors and three different categories of client language (i.e., change talk, sustain talk, neutral). We examined odds ratios and conditional probabilities for the direction, magnitude, and significance of the association between the use of MI technical behaviors and subsequent client statements about change. The study compared these same transitional associations between low/average (i.e., &lt;4) and high (i.e., ≥4) MI Spirit sessions.</p></div><div><h3>Results</h3><p>The pattern of results was replicated across both analytic frameworks. Questions and reflections about change talk versus sustain talk versus neutral statements showed greater odds of predicting the intended client response (i.e., change talk, sustain talk, neutral, respectively) compared to other possible client responses. Conditional probabilities for these transitions were high, ranging from 0.55 to.88. The magnitude of certain technical transitions significantly differed between low/average and high MI Spirit sessions.</p></div><div><h3>Conclusions</h3><p>Analyses supported the hypothesized associations between therapist use of technical MI behaviors and client change language within this Latinx sample. Analyses of MI Spirit as a moderator of these transitions showed partial support.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"144 ","pages":"Article 108898"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10739421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}