A randomized controlled trial of motivational enhancement therapy (MET) for mild to moderate alcohol dependence

Objective: This study was designed to conduct a randomized controlled trial of motivational enhancement therapy (MET) with two control conditions: non directive reflective listening (NDRL) and no further counseling (NFC); and to conduct this study in a sample of patients with a primary diagnosis of m ild to moderate alcohol dependence, in a "real-life" clinical setting. Meth od: Patients with mild to moderate alcohol dependence were recruited assess ed and treated at the Community Alcohol and Drug Service of Christchurch, N ew Zealand. All patients received a feedback/education session before rando mization to either four sessions of MET, four sessions of NDRL, or NFC. Out come data on 122 subjects (57.4% men) were obtained 6 months following the end of treatment, by an interviewer who was blind to the treatment conditio n. The primary drinking outcome was unequivocal heavy drinking, defined as drinking 10 or more standard drinks six or more times in the follow-up peri od. Global assessment scale (GAS) measured general personal/social function ing. Results: Of patients treated with MET 42.9% showed unequivocal heavy d rinking compared with 62.5% of the NDRL rand 65.0% of the NFC groups (p = . 04). No significant differences were found for GAS score according to treat ment condition. Conclusions: In patients with mild to moderate alcohol depe ndence, MET is more effective for reducing unequivocal heavy drinking than either a feedback/education session alone or four sessions of NDRL. MET can be considered an effective "value added" counseling intervention in a real -life clinical setting. In patients with mild to moderate alcohol dependenc e, nondirective reflective listening provides no additional advantage over a feedback/education session alone.