Effects of Motivational Enhancement Therapy on Readiness to Change MDMA and Methamphetamine Use Behaviors in Taiwanese Adolescents

Abstract

The aim of this study was to examine the effect of brief modified motivational enhancement therapy (MET) on readiness to change patterns of methylenedioxymethamphetamine (MDMA) and methamphetamine (MAMP) use behaviors in adolescents. A total of 94 adolescents who used MDMA or MAMP were consecutively recruited from a juvenile abstinence center; 46 received a three-session MET intervention (intervention group), and 48 received educational materials only and no MET intervention (control group). Analysis of covariance was performed to examine the effect of motivational interviewing on the readiness of change scores on the University of Rhode Island Change Assessment and on the scores of its subscales. By using the pretreatment scores as covariates, the intervention group demonstrated higher posttreatment scores of readiness to change and of the contemplation subscale on the University of Rhode Island Change Assessment than the control group. The results of this study support the finding that brief modified MET is effective in promoting readiness to change MAMP and MDMA use behaviors in adolescents who receive short-term treatment programs.

RÉSUMÉ

Cette étude a pour but d’examiner les effets d’une thérapie d’amélioration de la motivation (TAM) légèrement modifiée sur la capacité à changer les comportements liés à l’usage de méthylènedioxyméthamphétamine (MDMA) et de méthamphétamine (MAMP) chez les adolescents. Un total de 94 adolescents usagers de MDMA ou de MAMP ont été choisis dans un centre de désintoxication. Parmi eux, 46 ont participé à trois sessions de TAM (groupe d’étude) et 48 n’ont reçu que des documents éducatifs sans participer à des sessions de TAM (groupe de contrôle). Une analyse de covariance (ANCOVA) a été mise en place pour observer les effets sur la capacité d’un entretien motivationnel à changer les résultats au questionnaire URICA (University of Rhode Island Change Assessment) ainsi que les résultats pour chaque sous-échelle de ce questionnaire. En utilisant les résultats obtenus avant traitement comme variables, le groupe d’étude a obtenu des résultats supérieurs au groupe de contrôle après traitement quant à la capacité à changer ainsi que sur la sous-échelle «contemplation» du questionnaire. Les résultats de cette étude démontrent qu’une brève TAM modifiée est efficace sur les capacités à changer les comportements des usagers de MAMP et de MDMA chez les adolescents qui suivent des programmes de traitement à court terme.

RESUMEN

El objetivo del presente studio era examiner el efecto de la terapia de modificación breve de la motivación (MET) sobre el uso de methylenedioxymethamphetamina (MDMA) y methamphetamina (MAMP) en el cambio de conducta en adolescentes. Un total de 94 adolescentes que usaban MDMA o MAMP fueron seleccionados consecutivamente en un centro de rehabilitación juvenil. De ellos, 46 se sometieron a 3 sesiones de MET (intervención grupal) y 48 (grupo de control) recibieron materiales educativos pero no se sometieron a las sesiones de MET. Se realizó un análisis de la covarianza (ANCOVA) sobre los resultados para examinar los efectos de la intervención motivacional en las puntuaciones en la subescala URICA (Escala de la Universidad de Rhode Island). Tras el uso de los valores previos al tratamiento como covariantes, se comprobó que el grupo sometido a la intervención de grupo demostró mayores valores que el grupo control en la escala URICA. Los resultados de este estudio refuerzan la creencia que el uso de MET es efectivo en el refuerzo del cambio conductual en los usuarios adolescentes de MAMP y MDMA en terapias de corta duración.

Keywords :

• adolescents
• MDMA
• methamphetamine
• motivational enhancement therapy

THE AUTHORS

Ya-Shune Huang, M.S., received her master's degree from the Graduate Institute of Psychology of Kaohsiung Medical University and is a clinical psychologist at the Taoyuan Mental Hospital, Department of Health, Executive Yuan, Taipei, Taiwan. Her main research interests are substance use of adolescents and psychotherapy.

Tze-Chun Tang, M.D., Ph.D., is an assistant professor of psychiatry at Kaohsiung Medical University and is in charge of the Outpatient Clinics at Kaohsiung Medical University Hospital in Kaohsiung, Taiwan. His main research interests are psychotherapy and community mental health of adolescents.

Chi-Hung Lin, M.D., M.S, is a lecturer at Kao Yuan University and is an attending physician in the Department of Psychiatry at Military Kaohsiung General Hospital in Kaohsiung, Taiwan. His main research interests are genetics of substance use and mental illness.

Cheng-Fang Yen, M.D., Ph.D., is an associate professor of psychiatry at Kaohsiung Medical University and is the attending doctor in the Department of Psychiatry at Kaohsiung Medical University Hospital in Kaohsiung, Taiwan. His main research interests are substance use and mental health of children and adolescents.

GLOSSARY

• Motivational enhancement therapy (MET): One approach to motivating change in substance use and combination with an MI counseling style.

• Motivational interviewing (MI): A client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.

• Readiness to change: Prochaska's Transtheoretical Model identifies an individual's readiness to change behavior in five stages: precontemplation, contemplation, preparation, action, and maintenance. Readiness is a state of mind, namely, that a person will change his/her behavior on the basis of his/her readiness for change and not just on the information presented.