Piloting a Motivational Interviewing Shame-Resilience Training

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the shame resilience theory in a pilot context to assess its feasibility in a potential full scale clinical trial. Shame resilience was developed through qualitative methods but currently has little quantitative backing. Continued research is needed to assess shame-resilience as a potential intervention for shame which little is known to combat prevalent negative health outcomes associated with shame.

Detailed Description
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Shame is an emotion that can have significant negative impacts on health outcomes, including engagement in care. Feelings of shame are commonly experienced with stigmatized behaviors, such as substance misuse, and may be particularly strong among pregnant women who misuse substances. Rates of opioid misuse during pregnancy are dramatically rising, particularly in New Mexico, leading to negative health outcomes for mothers and fetuses. Shame has been found to decrease these patients' willingness to attend and engage in care. Although a theoretical model is available to guide interventions to reduce shame, it has not been tested empirically. In the current study, investigators seek to evaluate the preliminary effectiveness and feasibility of a brief Shame Resilience Intervention among women seeking care in UNM's Milagro program, a prenatal medical clinic for opioid using pregnant women. This research has the potential to significantly improve public health by generating a tool to reduce barriers to care.

Official Title
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Piloting a Motivational Interviewing Shame-Resilience Training

Conditions
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Shame

Intervention / Treatment
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* Behavioral: Motivational Interviewing Informed Shame Resilience Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Study participants will be Milagro patients Engaged in medication assisted treatment At least 18 years of age Can read and speak English Are willing to be contacted for follow-up \ Are not incarcerated Are within the first or second trimester of pregnancy Exclusion Criteria: The study will not enroll non-English speaking Milagro patients Patients with obvious cognitive impairments Patients with the inability to provide informed consent.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Interventional Model Description: Longitudinal single group pilot study.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pilot Training<br>In this arm participants will complete a variety of baseline assessments then participate in 15-20 minute conversation based on motivational interviewing principles in which they are trained in shame resilience. Follow-ups will be conducted a month later. Assessments will be repeated and then participants will engage in a qualitative interview regarding the training. | Behavioral: Motivational Interviewing Informed Shame Resilience Training<br>* Shame resilience involves four elements. Understating shame, normalizing shame thoughts, reaching out, and speaking shame. Motivational interviewing will be used to elicit and guide participants through these four elements.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Willingness to Communicate | This measure looks at participants willingness to communicate about their health on a 5 point Likert Scale; 1-5 with higher scores indicating a greater willingness to communicate. Participants respond to a series of questions on a questionnaire. | 1-month | 
| Adult Trauma Symptom Checklist | This measure looks at current symptoms of past trauma experiences on a 4 point Likert scale; 0-3 with higher scores indicating a greater presence of adult trauma symptoms. Participants respond to a questionnaire. | 1-month | 
| Shame Compass | This measure looks at the intensity and frequency of shame experiences on a 4 point Likert Scale; 0-3 with higher scores indicating a greater intensity and frequency of shame experiences. Participants respond to a questionnaire. | 1 month | 
| WHO Big 5 Subjective Well-Being | This measure looks at participants well-being over the past two weeks on a 5 point Likert Scale; 1-5 with higher scores indicating a higher subjective well-being. Participants respond to a questionnaire. | 1-month | 
| Shame Resilience Amongst Mental Health Trainees | This measure looks at how much a participant is practicing shame resilience on a 4 point Likert Scale; 0-3 with higher scores indicating better shame resilience. Participants respond to a questionnaire. | 1-month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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shame resilience, motivational interviewing, shame