Motivational Enhancement More Effective than Cognitive Behavioral Therapy for Alcoholics with Low Motivation
This study re-examined patient motivation data from Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), a 1993 multi-site trial that assessed how patient-treatment interactions relate to outcomes. Although the original analysis did not find motivation enhancement treatment (MET) worked better than cognitive behavioral therapy (CBT) at reducing drinking days for subjects with low motivation, it did not adequately consider potential moderating influences such as severity of alcohol dependence or sex. This analysis used growth-mixture modeling to reevaluate the motivation-matching hypothesis.
- In the outpatient sample (n=617), 69% of individuals assigned to MET with below-average motivation at baseline had a lower increase in their drinking during follow-up than similar individuals assigned to CBT. Similar effects were seen among aftercare patients (n=527) but only for women.
- Conversely, aftercare patients assigned to MET with the most severe alcohol dependence and the least motivation at baseline had the greatest increases in drinking frequency over time.