Dismantling Motivational Interviewing: Effects on Initiation of Behavior Change Among Problem Drinkers Seeking Treatment

Motivational Interviewing (MI) is an efficacious treatment for alcohol use disorders (AUD). MI is thought to enhance motivation via a combination of two therapeutic strategies or active ingredients: one relational and one directional. The primary aim of this study was to examine MI’s hypothesized active ingredients using a dismantling design. Problem drinkers (N=139) seeking treatment were randomized to one of three conditions: MI, relational MI without the directional elements labeled spirit-only MI (SOMI) or a non-therapy control (NTC) condition and followed for eight weeks. Those assigned to MI or SOMI received four sessions of treatment over eight weeks. All participants significantly reduced their drinking by week 8, but reductions were equivalent across conditions. The hypothesis that baseline motivation would significantly moderate condition effects on outcome was generally not supported. Failure to find support for MI s hypothesized active ingredients is discussed in the context of the strengths and limitations of the study design