Although Motivational Enhancement Therapy (MET) has emerged as one of the cornerstones of addiction psychosocial treatments, this approach is rarely used by community-based, addiction clinicians. A major barrier to using MET is the fact that the Personalized Feedback component of MET is not community-friendly. Current MET Feedback tools can be complex and require the use of multiple research instruments not used by clinicians, are available only for a single drug problem, and lack normative feedback for drug abuse. We will address these three problems in the First phase of this NIDA Stage I a/b therapy development grant by developing and pilot testing a computer-assisted MET (C-MET) intervention. C-MET will provide clinicians with Personalized Feedback for multiple-drug problems, be based on data from the Addiction Severity Index (ASI), and provide normative data for specific drug problems based on a large ASI database. C-MET is designed for the common community-based clinical problem of poly-drug abuse. Because MET is believed to contain two active ingredients (Personalized Feedback and Motivational Interviewing), a simplified Personalized Feedback (PF) only approach will also be developed and piloted to teach clinicians how to deliver Personalized Feedback alone without MI. In the Second phase of this grant (Stage lb phase) we will then compare the relative efficacy of our C-MET and PF approaches by comparing 4 weeks of C-MET vs. PF vs. Individual Drug Counseling (IDC). This will also serve as a dismantling study that disentangles the effects of Feedback and MI, as well as an opportunity to assess our products, the feasibility of training clinicians in this new approach and its relative effectiveness. Overall this study will facilitate the integration of MET into the community by addressing poly-drug abuse, simplifying MET with computerized Feedback Reports, and assessing whether Personalized Feedback alone can adequately enhance patient engagement and retention without the extensive training requirements for clinicians to adhere and be competent in MI.
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