Combining motivational interviewing with compliance enhancement therapy (MI-CET): development and preliminary evaluation of a new, manual-guided psychosocial adjunct to alcohol-dependence pharmacotherapy.
OBJECTIVE
Psychosocial interventions that are practical, transportable, and effective in promoting treatment adherence and efficacy are greatly needed in both research and clinical settings involving alcohol-dependence pharmacotherapy. In this article, we describe the development and preliminary evaluation of an integrative treatment blending motivational interviewing and compliance enhancement therapy (MI-CET) as a means of enhancing adherence and retention in an ongoing clinical trial.


METHODS
Medication adherence, session attendance, and study completion rates were examined for 121 treatment-seeking, alcohol-dependent adults participating in a randomized clinical trial of citalopram (n = 81) versus placebo (n = 40). All participants received the manual-guided MI-CET intervention as an adjunct to pharmacotherapy. Preliminary adherence and retention data for this trial were compared with data from prior studies involving treatment for alcohol dependence with a selective serotonin reuptake inhibitor.


RESULTS
High rates of medication adherence (79% of citalopram and 91% of placebo completers took > or = 80% of doses), session attendance (average of 90% for citalopram and 93% for placebo groups), and study completion (81% for citalopram and 88% for placebo groups) were obtained in the present study using MI-CET. These rates were at least comparable to or were, in some cases, 20%-30% higher than rates obtained in the comparison trials.


CONCLUSIONS
These results suggest that MI-CET is feasible as a psychosocial adjunct to alcohol-dependence pharmacotherapy. Given its strengths as a clinical and research intervention (e.g., practicality, transportability), further evaluation of its efficacy is warranted.
Heffner
Jaimee L
JL
Tri-State Tobacco and Alcohol Research Center, Department of Psychiatry, University of Cincinnati College of Medicine, UC Reading Campus, 2120 E. Galbraith Road, Building A, Cincinnati, Ohio 45237, USA. Jaimee.Heffner@uc.edu
Tran
Giao Q
GQ
Johnson
Candace S
CS
Barrett
Suzan Winders
SW
Blom
Thomas J
TJ
Thompson
Rachel D
RD
Anthenelli
Robert M
RM
D000328:Adult; D000368:Aged; D000427:Alcohol Deterrents / Q000627:therapeutic use; D000437:Alcoholism / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D001521:Behavior Therapy / Q000379:methods*; D010054:Brief Psychiatric Rating Scale; D015283:Citalopram / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D055815:Young Adult
D000427:Alcohol Deterrents; D015283:Citalopram