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BackgroundWhile brief intervention (BI) for risky alcohol use generally yields positive effects among those identified by screening, effect sizes are small and there is unexplained heterogeneity in outcome. The heterogeneity may be related to differences in intervention style and content, including elements of motivational interviewing (MI). To date, it has been difficult to interpret the role of MI in BI and these gaps in knowledge interfere with efforts to train, disseminate and implement BI that retains and maximizes efficacy. This study sought to develop BI protocols with varying doses of MI and test their differentiability. Differentiable BI protocols could allow for future studies that prospectively evaluate the role MI plays in affecting BI outcome.MethodsWe developed three intervention protocols: brief advice, standard BI (NIAAA Clinician's Guide), and MI-enhanced BI and administered them to 45 primary care patients who reported exceeding recommended drinking limits. We then rated the BI sessions for fidelity to the assigned protocol as well as MI consistency based on Motivational Interviewing Treatment Integrity (MITI) scale scores. The differentiability of BI protocols was determined by calculating fidelity to assigned protocols and comparing MITI scores using pairwise, Tukey-adjusted comparisons of least squares mean scores.ResultsHigh rates of fidelity to each protocol were achieved. The three BI protocols were also highly differentiable based on MITI scores.ConclusionsThe three interventions can be used in future trials to prospectively examine the role MI has in determining BI outcome. Trial registration clinicaltrials.gov NCT02978027, retrospectively registered 11/28/16.

Background: The past two decades have seen expanding interest in the application of motivational interviewing (MI) with couples. Thus far, the literature detailing the development of MI with couples has focused primarily on elucidating counselling processes and techniques or on evaluating intervention effects. To date, no published studies have examined client perceptions of the counselling process in MI with couples. Methods: This study involved qualitative analysis of 55 sessions from 24 couples (48 individuals) who received short (three‐session) courses of MI with couples in the context of a randomised controlled trial. All participants identified as cisgender male and were 18 or older. In each couple, at least one partner was aged 18–29, HIV negative and reported drug use in the past 30 days. Results: Analysis revealed that client couples attributed the benefits of MI with couples to expectancy‐related effects (merely structuring time to talk) and common factors (the presence of the counsellor as a non‐judgmental observer). Clients also conveyed appreciation for techniques and activities that enhanced dyadic functioning through communication skill building and the identification of shared values. Finally, clients appreciated the opportunity to discuss drug use and sexual behaviour in an integrated way. Discussion: Findings indicated the utility of counsellor‐delivered behavioural interventions. They also align with recent formulations of the counsellor's role in MI with couples and the introduction of facilitating dyadic functioning as a distinct process. Finally, they highlight the potential value of training counsellors to address the intersection of drug use, sexual risk and sexual pleasure in sessions. These dimensions of practice receive inconsistent attention across counselling training programme curricula. [ABSTRACT FROM AUTHOR]

Project CHOICES developed an integrated behavioral intervention for prevention of prenatal alcohol exposure in women at high risk for alcohol-exposed pregnancies. Settings included primary care, university-hospital based obstetrical/gynecology practices, an urban jail, substance abuse treatment settings, and a media-recruited sample in three large cities. The intervention was based on motivational interviewing and targeted both adoption of effective contraception and reduction of alcohol use. Treatment included 4 manual-guided sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. This paper describes the rationale for treatment; the use of motivational interviewing and the transtheoretical model for a dual-focused approach to behavior change; the development of the Project CHOICES intervention; development of the study protocol and treatment manual; and selection, training, supervision, and monitoring of study counselors. Implications for future applications of the intervention are discussed. (Contains 3 tables.)

The Republic of South Africa has the highest documented fetal alcohol syndrome prevalence globally. In the Limpopo province, little is known about students' or community members' knowledge of fetal alcohol syndrome or fetal alcohol spectrum disorder rates and risk behaviors. The aim of this study was to characterize and compare knowledge about fetal alcohol syndrome and other fetal alcohol spectrum disorders and the related behaviors such as drinking among University of Venda students and local community residents in villages to inform educational efforts to prevent fetal alcohol syndrome. Participants (n = 404) were from the University of Venda and two villages, Maungani and Ha-Mangilasi, and completed an epidemiological survey about their characteristics, behaviors, and fetal alcohol spectrum disorder risks. We analyzed differences between the university students and community residents in fetal alcohol syndrome knowledge and the related risk behaviors. University students have heard of fetal alcohol syndrome (Fisher's exact test p <.001), have seen warning labels about drinking during pregnancy (Fisher's exact test p =.003), and were aware that a baby is born with birth defects if diagnosed with fetal alcohol syndrome (Fisher's exact test p =.03) with more knowledge of fetal alcohol syndrome compared to community residents. Most respondents thought it was unacceptable to drink during pregnancy. Despite this, a substantial number of participants thought it was acceptable to have one drink after pregnancy recognition. There was little knowledge of best practices about alcohol consumption to prepare for pregnancy, or once recognized. We recommend an education campaign to raise awareness of fetal alcohol spectrum disorders across Limpopo, especially in smaller villages, and further research to determine demographic and experiential risk factors to aid in prevention efforts. [ABSTRACT FROM AUTHOR]

This study assessed the social adjustment of female early college entrants using standard measures of adjustment and two comparison groups (traditional college students and boarding school students). Early entrants evidenced higher social conformity and solitary activity than boarding students. They evidenced social adjustment similar to college students but reported a high level of dissatisfaction with their social lives. (DB)

Intimate partner violence is an ongoing issue in South Africa, which has the highest rates of violence against women and girls in the world. Intimate partner violence is common in Limpopo, where women, including university students, experience elevated rates of violent crime. This qualitative study was conducted to examine university students' perspectives regarding intimate partner violence among their peers. A culturally tailored vignette was used to prompt reflection from 38 female university students in Limpopo. Audiotaped responses to the vignette were transcribed, coded and analysed using thematic analysis. Four main themes were developed from participants' responses to the vignette: cultural beliefs, the university's role in intimate partner violence, likely outcomes of intimate partner violence, and future interventions. Intimate partner violence was seen as a common problem within the university. Students' responses indicated that cultural beliefs perpetuated violence against women, with women entering and remaining in abusive relationships for financial security or resources such as housing. Students also reported lack of adequate on-campus housing options, limited knowledge of intimate partner violence, and few actions to reduce intimate partner violence, all of which placed then at heightened risk of intimate partner violence. [ABSTRACT FROM AUTHOR]

Descriptions of Motivational interviewing (MI) usually focus on helping clients change a single problematic behavior. In contrast, the current case study shows that MI can serve as a more comprehensive psychotherapy, focused not only on multiple problem behaviors but also on broader change consistent with its roots in client-centered therapy. In this case, the therapist interwove a focus on several discrete behaviors with a focus on broader lifestyle change as well as increased clarity of client cognitions, values, and choices, resulting in several lasting changes. [c] 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1180-1194, 2009. Keywords: motivational interviewing; alcohol-exposed pregnancy; multiple target behaviors; client-centered DOI: 10.1002/jclp.20639

A significant number of college women are at risk for alcohol-exposed pregnancy (AEP) owing to binge drinking paired with using contraception ineffectively. This article describes a randomized controlled trial of a one-session motivational interviewing-based intervention to reduce AEP risk among college women and presents 1-month outcomes demonstrating the early impact of this intervention. There were 228 female students from a mid-Atlantic urban university enrolled in the trial. Eligibility criteria were being in the age range of 18-24 years and being at risk for AEP. Risk for AEP was defined as having sexual intercourse with a man in the past 90 days while using contraception ineffectively (no use, incorrect use of an effective method, or use of an ineffective method only); drinking at risky levels was defined as engaging in at least one binge in the past 90 days or consuming an average of eight standard drinks per week. One-month outcome data were available for 212 of the 228 enrolled women (a follow-up rate of 93%), with complete data available for 105 women assigned to the control condition and 94 assigned to the intervention condition. At 1-month follow-up, 15% of the control subjects and 25% of the intervention women reported no risk drinking, a significant difference favoring the intervention group. Significantly fewer control subjects (48%) used effective contraception at 1-month follow-up as compared with intervention women (64%), [chi square](1) = 5.1, p < .03. Significantly more intervention women (74%) were no longer at risk for AEP at 1 month as compared with control subjects (54%), [chi square] (1) = 8.15, p < .005. Factors that were associated with continued AEP risk at 1-month follow-up were a higher number of standard drinks per day consumed in the month prior to baseline (odds ratio, 1.1) and assignment to the control condition (odds ratio, 2.9). The risks of unintended pregnancy and AEP among drinking women in college merit greater prevention efforts. The results of this study show the promise of one preventive intervention that warrants additional study.