Efficacy of Motivational Interviewing (MI)

Using social psychology research methodologies, psychologists can better understand what motivates some people to engage in certain activities. The majority of social psychology research is done to develop and evaluate a causal hypothesis. The emphasis on causation is implicit in the science's overarching goals: to comprehend phenomena by bringing them within the scope of general causal laws  and to indicate how unwanted social conditions might be changed by modifying their causal predecessors (Mesoudi, 2007). As a matter of fact, some individual research findings, for example, those pointed just at depicting existing conditions of affairs or at building and reining measurements instruments, don't straightforwardly address causal issues. All things considered, such research is best viewed as a component of a general research process that emphasize on building a causal hypothesis. Social psychologists are keen on the ways that other individuals influence thought, feeling, and conduct. To investigate these ideas requires extraordinary research techniques. Following a concise outline of conventional research designs, this module presents how complex trial designs, survey research, field tests, encounter sampling methods, naturalistic observation, non-conscious strategies, and subtle for example, priming, and documented research and the utilization of huge information may each be adjusted to address social psychological questions.

The main aim of this research is to test the efficacy of motivational interviewing therapy on alcohol use disorder among students in selected universities

Problem statement

Alcohol abuse presents a major healthiness problem and is associated to such adverse consequences as criminal behaviors, delinquency, suicide and psychological difficulties. Youth and young adults in the universities are at a great risk of alcohol intake and those using it consequently develop alcohol problems; which may possibly result in injury, increased risk of illness, and even death (Toomela, 2010). The severity of an alcohol problem depends on several factors including the type of alcohol one drink, how much he/she drinks, and how long he/she has been drinking. This leads to poor academic outcomes, risky sexual behavior, alcohol use disorder, relational problems, health problems, aggression, traffic accidents and other negative consequences. Specialists divide stages of liquor abuse and use into the following categories in terms of risk for developing problems: moderate drinking; at-risk drinking; alcohol abuse; and alcohol dependence (alcoholism), all of which need intervention before destroying one’s life.

Social learning theory/ Self efficacy

The motivational interviewing principle of supporting clients’ self-efficacy draws on the social learning theory by Albert Bandura. According to social learning theory, individuals learn behavior via observing and imitating models. Alcohol use has been viewed as social problem and the youth mostly learn the behavior mostly from family and peers. Self-efficacy is the belief that one is capable of behaving in a certain manner to attain certain goals. Bandura indicated that efficacy is more strongly learned and is a mastery of new behavior. He also posited that it is more durable when an individual is an active participant in behavior change (Huang, 2016). Defined self-efficacy as what drives an individual to act towards changing a problem behavior and to persevere when it is hard to do so. Lack of self-efficacy makes it difficult to manage the situation effectively even when an individual knows how to go about it or has necessary skills.

Students using alcohol might know the dangers of alcohol abuse, how to stop and might have some necessary skills. However, increasing presence of alcohol among students could be indicative that students are unable to stop using alcohol even when have desire to do so. According to Bandura, “self-doubts override knowledge and self-protective action”, which make it impossible for people to act on what they know and they fail to protect themselves from harmful habits such a alcohol use. Consequently, applying the intervention would assist the students increase their self-efficacy and enable them to tackle alcohol use problem.

Social psychology methods

For one to uncover the relationship between variables in social psychology, use of experimental research is a key factor. In the experimental research there are two groups the and there are the control group and the experimental group

Theoretical framework

Either a conceptual framework explains graphically or forms narratives from the main variables to be studied. It shows key factors, constructs or variables and the assumed relationship among them. The following are the various variables in this research. The exposure variable will be Motivational Interviewing Therapy and the exposed variable will be students using alcohol. The students from one campus will be used as the control group of the experiment. The outcome variable will be reduction of alcohol use or stopping of alcohol use by students who will be exposed to the intervention (Marsh, 2013). Another outcome variable will be the academic achievement, whereby after intervention, the students who have been using alcohol will be expected to improve in their academic performance.

Effect modifiers will be the other variables in the study. They consist of age, gender and common mental syndromes. The common mental syndromes that will be assessed include depression using BDI and anxiety using Beck Anxiety Inventory (BAI). The assessment will be done on all students who will participate in the research. This is useful when carrying out analysis because of the various relationships among the variables, which will be tested and controlled (Johnson, 2013). For example, it is important to find out whether those who did or did not improve after interventions scored the common mental disorders or not.

Confounders will include year of study, duration in college, peers using drugs, family influence (parents’ marital status, parental drug use, economic status-fees payment status), setting of primary and secondary schools and siblings in schools.

From the above listed variables, the researcher expects to have four different data sets:

Social demographic data on students, their parents, and their peers (whether they use or abuse drugs or not)

Harmful use of alcohol, which will be obtained through the use of Alcohol Use Disorders Identification Test (AUDIT)

Academic achievement. The researcher will obtain the student’s academic records from the registrar’s office.

Common mental disorders that will be identified through the use of Beck’s Depression Inventory (BDI) and Beck’s Anxiety Inventory (BAI)

The main aim of using these tools is to assess the behavior problems that could lead people to use alcohol and also perform poorly academically. It is expected that if a student has any mental disorder, it can affect the treatment outcomes and their academic achievements. Therefore the tools will help to rule out other common mental disorders. Those with severe conditions will be referred for medical treatment. It is however not possible to control what will happen to the referred students since it is out of scope of this study.

The following is a diagram of the conceptual framework that will guide this study.



Effect modifiers: Age, gender, common mental syndromes





DV

IV



Less alcohol use, mental disorders, no aggression





Academic achievement



Experimental

group

MI Therapy



Control

group

Counseling as usual

















Confounders: year of study, duration in college, peers using alcohol, family influence (parents married/single, do they use alcohol), economic status of parents, religiosity











IV – Independent Variable

DV – Dependent Variable





Covariates







Outcome







Exposure 1:

Alcohol Assessment



Exposure 2:

Interventions



Improved

Academic

Achievement



No academic

Improvement



Total

Experimental

Group

Motivational

Intervention

Therapy



A



B



A+B



Control Group

Psychotherapy as usual



C



D



C+D



Total







A+C



B+D



A+B+C+D



Illustration of variables table 1.1

Research design

Research design refers to how a study is carried out. It involves a well thought out plan for collection and analysis of data to provide the information being sought. The study will use a quasi-experimental design which involves the application of Motivational Interviewing therapy to the experimental group while the control group will be given counseling as usual by the university counselors (Kennedy-Clark, 2015). Quasi experimental designs are used to test the effect of an intervention by comparison of respondents in the experimental and the control groups but it lacks proper randomization in the allocation respondents for the intervention

Quantitative methods of data collection will be employed for the required data for the study, which will be obtained from students who will be exposed to the psychological assessment instruments and a structured questionnaire. The study will involve an initial pre-assessment at baseline followed by two assessments at the mid of intervention and at the end line three months later.

Research procedure

The researcher will use respondents-driven sampling technique to get the respondents for the study. The students will be requested to give their consent to be involved in the research after which assessment will be done. Age- appropriate instruments will be used which the students will self-administer with the help of the research assistants (YU, PENG, DONG, CHAI & HAN, 2013). After filling the assessment instruments, the respondents will be directed to a container where they will drop the filled instruments in order to maintain anonymity. As the respondents return the completed assessment instruments, the research team will confirm that they have been filled appropriately.

The treatment procedures to be used in the study as described below, will involve group therapy for the students found to be having alcohol use problems after assessment. With the experimental and control groups comprising of 112 respondents each, the respondents in each group will be randomly divided into ten groups of 11 students and one of 12 students. 20 well-trained therapists on motivational interviewing therapy will conduct the experimental groups. A therapist, who holds a MA in counselling or clinical psychology, with a co-therapist who has BA in psychology or counselling psychology, will lead each group.

The control groups will be referred to the university counsellors for drug/alcohol counselling. The control group counsellors will be requested to use any other modality of their choice apart from motivational interviewing to treat the referred students.

Data collection instruments

For data collection, the assessment instruments (AUDIT, BDI and BAI) will be used together with a social-demographic questionnaire that has been developed to capture the social-demographic characteristics of the respondents. The questionnaire includes; age, gender, year of study, duration in college, peers using alcohol, marital status of the parents, where the parents use drugs/alcohol, economic status of the parents, sibling in schools and status of their fees payment among other details.

The Alcohol Use Disorders Identification Test (AUDIT) will be administered to the study respondents. AUDIT was also developed by WHO to help in identifying individuals with harmful use of alcohol. A total scale of 8 and above in AUDIT indicates harmful alcohol use. According to WHO (2001), AUDIT has been tested all over the world has been found valid and consistent for use in different populations because of its cross-national standardization. Shields et al., (as cited in the Reinert & Allen, 2007) found a Cronbach alpha of AUDIT of 0.74 and 0.80% among college students. According to Monti, Tewyaw, and Borsari, AUDIT has been adapted and used with American population. Results showed good reliability and validity for the tool. Beck’s Depression Inventory (BDI) and Beck’s Anxiety Inventory (BAI) are the other tools that will be administered to the research respondents. BAI is used to measure the severity of anxiety in both adults and adolescents. It has been found to be psychometrically sound with its internal consistency ranging from 92 to 94. BAI has been used at globally to measure anxiety among diploma students at a nursing college and it was reported to have sound psychometric properties. IES is used to assess the presence of PSTD and its severity, as cited in Christianson, reported that IES has good reliability and validity measures of PSTD with high internal consistency rating ranging from 0.87 to 0.85 for avoidance subscale and 0.79 to 0.9 for intrusion subscale. This makes the tool dependable and can be trusted to give authentic data.

Data analysis

The baseline data will be enumerated in order to get the 350 respondents to participate in the study. These are the students whose AUDIT scores are 8 and above on alcohol use. The 350 respondents’ baseline data will be analyzed by comparing their social demographics with alcohol use, harmful alcohol use, and common mental disorders. Comparisons will be done according to various factors associated with drug use among the university students, risk levels and academic performance.

In this study, both experimental and control groups will be compared at baseline, midline, and end line using independent t-test and pair t-test. These assessments will involve correlations between control and experimental groups and also within the groups in terms of levels of involvement with substances during the treatment period (Lee & Mercante, 2010). This is to check when the actual effect of the intervention occurred.

The efficacy of the intervention among respondents will also be tested. High scores on AUDIT indicates harmful use of alcohol at baseline, midline, and end line while low scores in the instrument indicate effective response to the intervention. The academic performance will be tested by comparing the mean score of school performance at the baseline, midline and end line.

The following is the model to be used during analysis:

Efficacy of motivational interviewing

ᶘ (study group (experimental, Control) +

Years of study (2nd, 3rd) +

Place of residences (hostels, living with family) +

Type of secondary school (private, public, both public and private) +

Close friends use drugs/alcohol (Yes/No) +

TVs as media influence to start using drugs (Yes/No) +

Feelings of difficulty in doing school work, taking care of things at home/ room or getting along with other people (Not difficult at all, Somewhat difficult, Very/ Extreme difficult) + E

Discussion

Ethics is the concern of how the researcher conducts the research. The researcher has to think about the best way to guide his or her research behavior when carrying out a study. The behavior has to be accepted morally and legally to avoid any negative effects on subjects. This study will have several ethical considerations. To begin with, the researcher will make sure that the respondent’s voluntarily participate in the study. Consequently, the students will be given an opportunity to consent to the study and none of them will be coerced or lured in any way to participate against their will. Before engaging the respondents, the researcher will make sure that they are clearly informed about the research before committing themselves. This will be done as the researcher will be getting their consent. The researcher will truthfully inform the respondents the details concerning the research in order to make them make an informed choice on whether to participate or not. This will help to avoid issues that could arise later concerning the respondents’ involvement in the research.















References

Huang, C. (2016). Coordination and social learning. Economic Theory. http://dx.doi.org/10.1007/s00199-016-1014-z

Johnson, R. (2013). Motivational Interviewing with Adolescents and Young Adults. Motivational Interviewing: Training, Research, Implementation, Practice, 1(2), 20. http://dx.doi.org/10.5195/mitrip.2013.34

Kennedy-Clark, S. (2015). Reflection: Research by design: Design-based research and the higher degree research student. Journal Of Learning Design, 8(3). http://dx.doi.org/10.5204/jld.v8i3.257

Lee, K., & Mercante, D. (2010). Longitudinal nominal data analysis using marginalized models. Computational Statistics & Data Analysis, 54(1), 208-218. http://dx.doi.org/10.1016/j.csda.2009.08.005

Marsh, K. (2013). Motivational Interviewing for Effective Classroom Management. Motivational Interviewing: Training, Research, Implementation, Practice, 1(2), 21. http://dx.doi.org/10.5195/mitrip.2013.35

Mesoudi, A. (2007). Using the methods of experimental social psychology to study cultural evolution. Journal Of Social, Evolutionary, And Cultural Psychology, 1(2), 35-58. http://dx.doi.org/10.1037/h0099359

Toomela. (2010). Quantitative methods in psychology: inevitable and useless. Frontiers In Psychology. http://dx.doi.org/10.3389/fpsyg.2010.00029

YU, F., PENG, K., DONG, R., CHAI, F., & HAN, T. (2013). The Psychological Research Paradigms of Moral Personality. Advances In Psychological Science, 21(12), 2235-2244. http://dx.doi.org/10.3724/sp.j.1042.2013.02235