Intensive Motivational Interviewing for Methamphetamine Dependence
Condition: Methamphetamine Dependence
Intervention: Intensive MI; Single session MI
Intervention description: Weekly individual therapy sessions over 9 weeks (Intensive MI condition) consisting of supportive and directive interventions. The control condition consists on a single session of MI and nutritional education.; Comparator arm that includes 1.5 hours of MI, 8 hours of nutrition classes and outpatient substance abuse treatment
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 217.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: methamphetamine; motivational interviewing

Summary:

      A Stage 2 randomized clinical trial (RCT) to test the efficacy of a 9-session model of
      motivational interviewing (MI) for methamphetamine (MA) dependence. Stage 1 pilot testing
      indicated the intervention could be easily learned and implemented with fidelity. The
      tailored treatment approach draws upon our previous conceptual papers on MI as well as our
      experience with a variety of MI protocols, including two Clinical Trials Network (CTN)
      studies of MI. An innovative feature of the "Higher Dose Motivational Enhancement Therapy"
      manual is that it comprehensively addresses the issues of clients who have achieved sustained
      sobriety as well as those still using substances. Thus, it is designed to facilitate
      treatment entry and engagement as well as maintenance of the gains made in treatment. MA
      dependent clients (N=220) were recruited from New Leaf outpatient treatment in Lafayette,
      California. Study participants were randomly assigned to 1) a single session of Motivational
      Interviewing (MI) plus 8 hours of health/nutrition education, or 2) the intensive 9-session
      MI intervention. In addition to the study interventions, both groups received standard
      outpatient treatment services at New Leaf. Study participants were assessed weekly during the
      first 9 weeks of treatment for MA use. More extensive assessments were conducted at treatment
      entry and 2-, 4-and 6-month follow-ups. Two therapists were "crossed" to treat clients in
      both conditions. Primary outcome measures included Timeline Follow Back (TLFB) for MA use, MA
      urinalysis results, and retention in treatment. Secondary outcomes include Addiction Severity
      Index scales and the TLFB for alcohol and other drugs. A mediation model will build upon MI
      research proposed by Moyers (2005) and our construct of "supportive confrontation" by testing
      whether feedback enhanced with warnings about the potential harm of MA use facilitates the
      therapeutic alliance, and whether this in turn facilitates better outcome. Clients with MA
      dependence are good candidates for a more intensive dose of MI because of their severe
      medical and psychosocial problems.
    

Eligibility criteria:

        Inclusion Criteria:

          1. 18 years old,

          2. Meets DSM IV criteria for MA dependence during the past year as assesses by the DSM-IV
             Checklist,

          3. able to speak and read English,

          4. capable of giving informed consent, and

          5. likely to be in the area the next 6 months.

        Exclusion Criteria:

          1. requires inpatient treatment for detoxification, medical or psychiatric treatment, and

          2. Serious psychiatric condition that would impair their ability to provide informed
             consent.