Mitchell Karno1, David Farabee, Mary-Lynn Brecht, Richard Rawson. 1. Integrated Substance Abuse Programs, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90025, USA. karno@ucla.edu
Abstract
OBJECTIVE: This study examined the impact of the interaction between patient reactance and treatment directiveness on the effectiveness of telephone aftercare for methamphetamine dependence. METHOD: Reactance was assessed at baseline, and participants were randomly assigned to directive or nondirective treatment conditions. Logistic regression tested for the significance of the interaction as a predictor of 3-month and 12-month use of methamphetamine and stimulants. RESULTS: A significant interaction was observed at the 3-month follow-up, in which the directive condition was less effective for patients higher in reactance and was more effective for patients lower in reactance. Among patients at a high level of reactance, the nondirective condition increased the likelihood of abstinence. CONCLUSIONS: This study suggests that, in the context of telephone-based care, directive interventions offer short-term clinical benefit for methamphetamine users who readily accept influence from authority figures, whereas nondirective interventions offer benefit for patients who do not readily accept influence. The short-term nature of these effects indicates that there is a need for brief but ongoing telephone support to maintain treatment gains.
RCT Entities:
OBJECTIVE: This study examined the impact of the interaction between patient reactance and treatment directiveness on the effectiveness of telephone aftercare for methamphetamine dependence. METHOD: Reactance was assessed at baseline, and participants were randomly assigned to directive or nondirective treatment conditions. Logistic regression tested for the significance of the interaction as a predictor of 3-month and 12-month use of methamphetamine and stimulants. RESULTS: A significant interaction was observed at the 3-month follow-up, in which the directive condition was less effective for patients higher in reactance and was more effective for patients lower in reactance. Among patients at a high level of reactance, the nondirective condition increased the likelihood of abstinence. CONCLUSIONS: This study suggests that, in the context of telephone-based care, directive interventions offer short-term clinical benefit for methamphetamine users who readily accept influence from authority figures, whereas nondirective interventions offer benefit for patients who do not readily accept influence. The short-term nature of these effects indicates that there is a need for brief but ongoing telephone support to maintain treatment gains.
Authors: David Farabee; Sarah J Cousins; Mary-Lynn Brecht; Valerie P Antonini; Anne B Lee; Julie Brummer; Jordana Hemberg; Mitchell Karno; Richard A Rawson Journal: Psychol Addict Behav Date: 2012-08-06
Authors: Robert L Hubbard; Jeffrey D Leimberger; Louise Haynes; Ashwin A Patkar; John Holter; Michael R Liepman; Kathi Lucas; Breque Tyson; Tammy Day; Elizabeth A Thorpe; Briar Faulkner; Albert Hasson Journal: Am J Addict Date: 2007 Nov-Dec