title: Brief interventions to reduce Ecstasy use: a multi-site randomized controlled trial.
abstract: Studies examining the ability of motivational enhancement therapy (MET) to augment education provision among ecstasy users have produced mixed results and none have examined whether treatment fidelity was related to ecstasy use outcomes. The primary objectives of this multi-site, parallel, two-group randomized controlled trial were to determine if a single-session of MET could instill greater commitment to change and reduce ecstasy use and related problems more so than an education-only intervention and whether MET sessions delivered with higher treatment fidelity are associated with better outcomes. The secondary objective was to assess participants' satisfaction with their assigned interventions. Participants (N=174; Mage=23.62) at two Australian universities were allocated randomly to receive a 15-minute educational session on ecstasy use (n=85) or a 50-minute session of MET that included an educational component (n=89). Primary outcomes were assessed at baseline, and then at 4-, 16-, and 24-weeks postbaseline, while the secondary outcome measure was assessed 4-weeks postbaseline by researchers blind to treatment allocation. Overall, the treatment fidelity was acceptable to good in the MET condition. There were no statistical differences at follow-up between the groups on the primary outcomes of ecstasy use, ecstasy-related problems, and commitment to change. Both intervention groups reported a 50% reduction in their ecstasy use and a 20% reduction in the severity of their ecstasy-related problems at the 24-week follow up. Commitment to change slightly improved for both groups (9%-17%). Despite the lack of between-group statistical differences on primary outcomes, participants who received a single session of MET were slightly more satisfied with their intervention than those who received education only. MI fidelity was not associated with ecstasy use outcomes. Given these findings, future research should focus on examining mechanisms of change. Such work may suggest new methods for enhancing outcomes. Australia and New Zealand Clinical Trial Registry: ACTRN12611000136909.
authors.affiliation: Centre for Emotional Health, Department of Psychology, Macquarie University; National Cannabis Prevention and Information Centre, UNSW Medicine, Sydney; National Drug and Alcohol Research Centre, UNSW Medicine, Sydney. Electronic address: melissa.norberg@mq.edu.au.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Norberg
authors.affiliation: Centre for Youth Substance Abuse Research, Institute of Health & Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology.
authors.forename: Leanne
authors.initials: L
authors.lastname: Hides
authors.affiliation: School of Mathematics and Statistics, UNSW, Sydney.
authors.forename: Jake
authors.initials: J
authors.lastname: Olivier
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Medicine, Sydney.
authors.forename: Laila
authors.initials: L
authors.lastname: Khawar
authors.affiliation: National Drug and Alcohol Research Centre, UNSW Medicine, Sydney; Centre for Research on Ageing, Health and Well-being, the Australian National University, Canberra.
authors.forename: Rebecca
authors.initials: R
authors.lastname: McKetin
authors.affiliation: National Cannabis Prevention and Information Centre, UNSW Medicine, Sydney.
authors.forename: Jan
authors.initials: J
authors.lastname: Copeland
mesh_terms: D005260:Female; D006266:Health Education; D006801:Humans; D020407:Internet; D008297:Male; D009042:Motivation; D062405:Motivational Interviewing; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018817:N-Methyl-3,4-methylenedioxyamphetamine
keywords: MDMA; ecstacy; education; motivational enhancement therapy; randomized controlled trial