THE EFFECT OF A MOTIVATIONAL INTERVIEWING ......Amphetamine dependence Emotional & Behavior problems...
Transcript of THE EFFECT OF A MOTIVATIONAL INTERVIEWING ......Amphetamine dependence Emotional & Behavior problems...
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Klansuwan A, M.N.S., RN*
Takviriyanun N, Ph.D, RN**
Jirapramukpitak T, MD, Ph.D*** *Princess Mother National Institute on Drug Abuse Treatment,
**Faculty of Nursing, Thammasat University
***Faculty of Medicine, Thammasat University
THE EFFECT OF A MOTIVATIONAL INTERVIEWING TOGETHER WITH COGNITIVE BEHAVIORAL THERAPY PROGRAM ON THE ADHERENCE
BEHAVIORS OF AMPHETAMINE DEPENDENCE PATIENTS IN ONE TREATMENT CENTER
IN PATHUM THANI PROVINCE
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Amawasee KlansuwanSenior Nurse Princess Mother National Institute on Drug Abuse Treatment
(PMNIDAT)
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West Africa appears
to have become an
established source
of the
methamphetamine
The established
market for
methamphetamine in
East and South-East
Asia continues
to grow, while there
are also indications
of increasing
methamphetamine
use in parts of North
America and
Europe.
(UN Office on Drugs and Crime, 2015)
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Background and significance of problems
Effect of
Amphetamine
1.Physical and mental symptoms
2.Cognition problems
3. Behavior problems
4. Socio-economic problems
4(Sujittra Ritmontri and Manop Kanatoa, 2513, UNODC, 2015)
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Brain addicted
chronic &
relapse disease(Markou & Koob, 1991; Munn &
Wise,1992, NIDA, 2012)
Amphetamine dependence
Emotional &
Behavior problems (NIDA, 2014, Galante , et al.,
2015)
cognitive
distortions(Beck, et al., 1993 )
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No motivation to
quit Amphetamine
dependence
(Jamieson, 2008)Use long time
for treatment(NIDA, 2012)
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1/02/20176
Amphetamine dependence need help and appropriate
treatment.
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∗ There is no single treatment for all substance abuse patients. UN
Office on Drugs and Crime, 2012 [UNODC])
(Burke, et al., 2003; Dunn, Deroo, & Rivara, 2002; Hettema, et al., 2005, Donovan, Rosengren, Downey, Cox, & Sloan, 2001; Miller, Yahne, & Tonigan, 2003; Mullins,Suarez, Ondersma, & Page, 2004; Schneider, Casey, & Kohn, 2000; Winhusen et al., 2008, Moyers & Houck, 2011)
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MI for prepare patients to another
intensive drug treatment
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Objective
This quasi-experimental study was conducted to determine the effectiveness of motivational interviewing (MI) together with cognitive behavioral therapy (CBT) on the adherence behaviors of amphetamine-dependent patients (ADPs).
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∗ The seventy-two samples were ADPs undergoing rehabilitation at a treatment center in Pathum ThaniProvince, Thailand.
∗ The samples were randomized evenly into experimental and control groups.
∗ The latter received only standard care, while the former were given additional MI and eight sessions of CBT.
∗ Data were collected before and after the trial, using questionnaires concerning the adherence behaviors of substance abusers.
METHODS&PARTICIPANTS
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∗ The intervention was integrated motivational interviewing and cognitive behavioural therapy plus standard care, which was compared with standard care alone.
∗ —“motivation building”—concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. (Miller et al, 2002)
∗ —“action”—supports and facilitates change using cognitive behavioural approaches. (Beck ,1995, Carroll et al, 1998)
∗ 8 therapy sessions were delivered 3 wks.
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Intervention
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Intervention
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Intervention
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∗ SPSS∗ Independent t-test ∗ Chi-Square test∗ Fisher’s Exact test ∗ Descriptive statistics
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The data analyzed.
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∗ The results of the study revealed that after the trial, 94.44 percent of the samples had motivation to practice adherence behaviors.
∗ Also, the program was able to improve motivation significantly by changing it from the stage of contemplation to the stage of having motivation (x2=21.34, p<.05).
∗
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Results
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Before After
Not change change χ2 p
contemplation 29 (80.56) 2 (5.56) 27 (75.00) 26.07 0.00
Motivational 7 (19.44) 7 (19.44) 0 (0.00)
motivation to practice adherence behaviors.
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∗ In addition, the mean score for adherence behaviors after the trial was significantly higher than that before the trial and that of the control group (p<.05).
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Results
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the adherence behaviors score
Experimental group (n=36) Control group (n=36)
score M SD scoreM
SD t p
Before 35-140 83-121 103.44 9.73 69-123 103.14 13.34 0.11 0.45
After 35-140 107-139 125.36 13.47 82-127 109.36 7.06 7.06 0.00***
p< .00***
the adherence behaviors
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∗ These findings suggest that MI together with CBT is able to improve the adherence behaviors of amphetamine-dependent patients in their rehabilitation at treatment centers. The effect of the program on the adherence behaviors, however, may be extended in future studies with larger samples.
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THANK YOU