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Evidence Based Practice

Extracts from this document...

Introduction

Abstract The purpose of the study is to compare the effectiveness of Motivational Interviewing and Relapse Prevention as treatments for alcohol problems. The most popular forms of less-intensive treatment currently available are based on the set of therapeutic principles and counselling techniques known as motivational interviewing (Miller & Rollnick, 1991; 2002). The Relapse Prevention model is an important component of alcoholism treatment and is based on social-cognitive psychology (Marlatt & Gordon, 1985). Previous research by Carroll (1996) concluded that Relapse Prevention appears to be more effective than no treatment although not necessarily more effective than other active treatments. It has also been found that Relapse Prevention can reduce the severity of relapse episodes if they occur (Carroll 1996). Dunn, DeRoo and Rivara (2001) concluded that there is substantial evidence that MI is an effective substance abuse intervention method. This particular study will be carried out a three treatment sites in Glasgow. At each treatment site there will be 48 participants who will be furthered divided into two groups of 24 (24 in RP and 24 in MI) bringing the total number of participants to 148. To analyse the results a simple t-test will be used. Alcohol misuse not only affects the health and welfare of individuals themselves but also has a major impact on family relationships, communities and society as a whole. In order to combat this, a small number of major trials of psychosocial treatment in Britain have been carried out (e.g. ...read more.

Middle

Burke, Arkowitz and Dunn (2002) began by noting that virtually all published research in this area involves the study of adaptations of MI (AMIs), rather than MI in its relatively pure form. AMIs refer to enclosed versions of MI in which certain methods, such as feedback of assessment results, are used as a shortcut to draw out the service user's reflections on the pros and cons of the behaviour in question, such as a drinker's check-up (Miller, Sovereign and Krege, 1988), motivational enhancement therapy (Miller et al., 1992) and brief motivational interviewing (Rollnick, Heather and Bell, 1992). The reviewing method used by Burke and colleagues was based on the box score method developed by Miller et al. (1995) although this has been criticised by Finney (2000). However, the earlier review by Burke, Arkowitz and Dunn (2002) was outmoded by later work by Burke, Arkowitz and Menchola (2003) that used quantitative meta-analysis in a technically sophisticated manner. None of the conclusions reached by Burke, Arkowitz and Dunn were overturned by this later review. The authors identified 30 controlled trials that met their inclusion criteria, of which 15 were in the area of alcohol problems. Two trials (Bien, Miller and Boroughs, 1993; Brown and Miller, 1993) looked at AMI as a prelude to treatment among service users at the more severe end of the range of alcohol related problems. Both found clear evidence of the effectiveness of AMI for this specific purpose. ...read more.

Conclusion

Analysis The independent variable for this study will be in two categories namely the motivational interviewing group and the relapse prevention group. The dependant variable will be the number of abstinent days recorded. The scores for Relapse Prevention will be added and the mean and standard deviation will be shown for all follow up points. The data for each treatment centre will be calculated independently in order to ascertain the variance between treatment centres. The data from all treatment centres will then be shown as one set of data for the all of the participants assigned to Relapse Prevention. The procedure will then be repeated for participants in the Motivational Interviewing group. The data will be compared along the 4 time points using the unpaired two-group t-test (Two-sample t). This test is very commonly used to compare the means of each group, where the samples in both groups are independent of each other (Robson 1993). Implications and Limitations Due to the nature of the research topic there may be a greater drop-rate as a result of the chaotic lifestyles that many alcohol dependant people lead. Collating pre-test information by means of psychometric testing in this instance may affect post-test results by means of sensitizing the sampled population (Nachmias & Nachmias, 1992). This study may lack sample size and statistical power due to the relatively small sample size which may result in the limited generalisability of the findings. A final and probably the most important limitation of this study will be the lack of a no-treatment control group. Ultimately, the possibility exists that any effect may have occurred naturally with no treatment. ...read more.

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