College of Behavioral & Social Sciences
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Item PSYCHOLINGUISTIC INDICATORS OF MOTIVATION FOR SUBSTANCE USE BEHAVIOR CHANGE AMONG INDIVIDUALS WITH SERIOUS MENTAL ILLNESS(2011) Sargeant, Marsha Nneka; Blanchard, Jack J; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The co-occurrence of mental illness and substance use disorders (termed "dual diagnosis") represents a significant public health issue and is associated with significant impairment and negative health consequences, particularly among individuals with serious mental illness. Given the negative consequences associated with dual diagnosis, researchers have sought to identify treatment components that would improve outcomes among individuals with serious mental illness. Therefore, significant efforts have been made to increase motivation for change within severe mental illness populations using Motivational Interviewing, a client-centered therapy. The primary mechanism underlying the effect of Motivational Interviewing on behavior change is hypothesized to be the selective reinforcement of change talk by the therapist with the aim of reducing ambivalence. Change language has been found to predict substance use treatment outcomes; however, it is not clear if change language has similar predictive utility in individuals with serious mental illness. Therefore, the current study sought to validate change language as an indicator of motivation among 45 individuals with serious mental illness and co-occurring substance use disorders. Overall, we found that change language could be reliably coded in this sample. Evidence supported the predictive utility of Ability language (i.e., statements regarding self-efficacy) in prospectively predicting long term substance use treatment outcomes (i.e., six months after the Motivational Interview session) above and beyond negative symptoms, depressive symptoms, and substance use severity. These findings suggest that the investigation of client language during MI represents a promising avenue for understanding motivational processes underlying substance use treatment outcomes among individuals with serious mental illness. Specifically, elicitation of client statements regarding self-efficacy to reduce or stop substance use is particularly important in predicting favorable outcomes in this population. Future studies should evaluate the utility of incorporating treatment components aimed at cultivating self-efficacy for substance use behavior change among individuals with serious mental illness.Item DUI: TREATMENT COMPLIANCE, RETENTION, AND MOTIVATION FOR TREATMENT(2006-08-04) Harris, Aaron Ashby; O'Grady, Kevin E.; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Alcohol abuse and its treatment have been an increasing focus of legal, social, and treatment research during recent decades. Motivational Interviewing (MI) is one treatment approach that has received considerable attention and increasing empirical support for treating individuals with alcohol use problems. DUI offenders represent a subgroup of the alcohol-abusing population who appear to face unique issues related to "coerced treatment", low motivation for change, and a major treatment focus on decreasing recidivism. Success in treating this population been mixed. Given their unique treatment issues, DUI offenders may particularly benefit from MI's focus on increasing motivation for change. However, only preliminary research examining the impact of MI on DUI offenders currently exists. The purpose of this study was to examine the factors that affect treatment participation, treatment engagement, and drinking behaviors by implementing a MI intervention with DUI offenders mandated to enroll in an outpatient treatment program. This study was the first to consider recidivist status and examine the efficacy of MI with DUI offenders with a reasonable sample size (N = 98). A brief MI intervention was randomly administered to 48 of the DUI offenders enrolling in outpatient treatment and data was collected at baseline and 3-month follow-up. Results of primary analyses revealed that only one outcome, self-confidence, was significantly affected by any predictor variables (i.e., treatment group, recidivist status, and motivation for treatment). Secondary analyses were conducted with two revised models. Offender compliance (i.e., number of positive urine tests) was predicted by recidivist status when the additional predictor variable of drug co-morbidity was included in the model. The second revised model limited the sample size to 54 "recent" offenders (i.e., entered treatment within 180 days of their most recent DUI offense) and revealed several additional significant findings. Although few significant findings were found relating to the impact of MI, results of this study nevertheless suggest that further examination of MI for treatment with DUI offenders is warranted. Moreover, the offender's recidivist status and the amount of time lapse since offense appear to be important clinical and empirical considerations for this population. Study limitations and future directions are discussed.