La entrevista motivacional en adicciones | Revista Colombiana de Psiquiatría

Información del artículo

Resumen

Introducción

En los últimos 15 años, la entrevista motivacional se ha convertido en uno de los métodos más populares y efectivos en el manejo de las adicciones, hecho sustentado por numerosas investigaciones.

Objetivo

Llevar a cabo una revisión teórica de las principales características de la entrevista motivacional y la evidencia clínica disponible.

Método

Revisión de la literatura médica publicada sobre el tema, utilizando la base de datos MedLine.

Resultados

La entrevista motivacional es un tipo de intervención centrado en el paciente, ampliamente documentado e investigado y con efectividad demostrada, que aprovecha la ambivalencia frente a una problemática y, por medio de una escucha reflexiva y algunas intervenciones puntuales, intenta lograr su resolución, generando una mayor disposición al cambio del comportamiento lesivo en el paciente.

Conclusión

La entrevista motivacional es una herramienta efectiva en el manejo de los pacientes, que recupera espacios terapéuticos y favorece el proceso de cambio. Podría ser una herramienta útil en el ámbito colombiano, dadas sus características.

Palabras clave:

comportamiento

entrevista psicológica

farmacodependencia

motivación

Abstract

Introduction

In the last 15 years, Motivational Interviewing (MI) has become one of the most popular and effective methods to treat drug addictions. Its efficacy is supported by numerous investigations.

Objective

To review the main theoretical characteristics of MI and clinical evidence available.

Method

We reviewed the medical literature on the subject, using the Medline database.

Results

MI is a patient-centered intervention, with proven effectiveness that takes advantage of the ambivalence toward a problem, and through reflective listening and some targeted interventions, achieve resolution of the ambivalence, leading to greater willingness to change the addictive behavior in the patient.

Conclusions

MI is an effective tool in the management of drug addicted patients by recovering therapeutic areas and encouraging the process of change. Given its characteristics, MI could be a useful tool for the treatment of drug addicts in the Colombian context.

Key words:

Behaviour

psychological interview

drug addiction

motivation

El Texto completo está disponible en PDF

Referencias

[1]

A Pérez.

Sustancias psicoactivas: historia del consumo en Colombia, Presencia, (1994),

[2]

Dirección Nacional de Estupefacientes.

Estudio Nacional De Consumo De Sustancias Psicoactivas En Colombia: Informe Final, DNE, (2008),

[3]

RL DuPont.

Implications for prevention policy: a commentary.

Cost-benefit/cost-effectiveness research of drug abuse prevention: implications for programming and policy. NIDA Monograph. No 176, pp. 214-221

[4]

N Coggans, B Cheyne, S McKellar.

The life skills training drug education programme: a review of research, Effective intervention unit, (2003),

Disponible en: http://www.drugmisuse.isdscotland.org/eiu/pdfs/eiu_lifeskl.pdf

[5]

A Moyer, JW Finney, CE Swearingen, P Vergun.

Brief interventions for alcohol problems: a meta-analytical review of controlled investigations in treatment-seeking and non-treatment-seeking populations.

Addiction, 97 (2002), pp. 279-292

Medline

[6]

Treating addictive behaviours. 2nd Ed,

[7]

WR Miller.

Motivational interviewing with problem drinkers.

Behav Psychother, 11 (1983), pp. 147-172

[8]

K Carrol, S Ball, C Nich, S Martino, TL Frankforter, C Farentinos, et al.

Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study.

Drug Alcohol Dependence, 81 (2006), pp. 301-312

http://dx.doi.org/10.1016/j.drugalcdep.2005.08.002 | Medline

[9]

WR Miller, S Rollnick.

Motivational interviewing: preparing people to change, Guilford, (1991),

[10]

S Rollnick, WR Miller.

What is motivational interviewing?.

Behav Cogn Psychother, 23 (1995), pp. 325-334

[11]

CC DiClemente, JO Prochaska.

Self change and therapy change of smoking behavior: A comparison of processes of change in cessation and maintenance.

Addict Behav, 7 (1982), pp. 133-142

Medline

[12]

J Prochaska, C DiClemente.

Comments, criteria and creating better models: in response to Davidson.

Treating addictive behaviours, 2nd Ed.,

[13]

WR Miller, S Rollnick, T Moyers.

Motivational Inteviewing. Professional training video-tape series, University of New Mexico, (1998),

[14]

WR Miller, S Rollnick.

La entrevista motivacional, Paidós, (1999),

[15]

N Freixa.

La entrevista con el enfermo alcohólico. Estrategias motivacionales.

Jano, 59 (2000), pp. 1383-1384

[16]

H Mcllvain, JK Bobo, A Leed-Kelly, MA Sitorius.

Practical steps to smoking cessation for recorvering alcoholics.

Am Fam Physician, 57 (1998), pp. 1869-1882

Medline

[17]

J Cebriá, JM Bosch.

La peregrinación por la rueda del cambio tiene indulgencia sanitaria plena.

FMC, 7 (2000), pp. 233-236

[18]

J Cebriá, JM Bosch.

Querer y no querer. El dilema de la ambivalencia.

FMC, 6 (1999), pp. 393-395

[19]

C Rogers.

Psicoterapia centrada en el cliente, Paidós, (1986),

[20]

J Cebriá, JM Bosch.

¿Médico o abogado del diablo?.

FMC, 7 (2000), pp. 320-322

[21]

JM Bosch, J Cebriá.

La Sra Pesáez en el país de los espejos de la atención primaria (II).

FMC, 7 (2000), pp. 39-42

[22]

JM Bosch, J Cebriá.

Reactancia psicológica: “Fumar es un placer”.

FMC, 6 (1999), pp. 59-61

[23]

C Rogers.

El poder de la persona, El manual moderno, (1980),

[24]

CR Rogers.

A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework.

Psychology: the study of a science. Formulations of the person and the social contexts, pp. 184-256

[25]

CB Truax, RR Carkhuff.

Toward effective counseling and psychotherapy, Aldine, (1967),

[26]

WR Miller, S Rollnick.

Motivational interviewing: preparing people for change, 2nd Ed., Guilford Press, (2002),

[27]

TB Moyers, T Martin.

Therapist influence on client language during motivational interviewing sessions: support for a potential causal mechanism.

J Subst Abuse Treat, 30 (2006), pp. 245-251

http://dx.doi.org/10.1016/j.jsat.2005.12.003 | Medline

[28]

TB Moyers, T Martin, PJ Christopher, JM Houck, JS Tonigan, PC Amrhein.

Client language as a mediator of motivational interviewing efficacy: Where is the evidence?.

Alcohol Clin Exp Res, 31 (2007), pp. 40-47

[29]

PC Amrhein, WR Miller, C Yahne, A Knupsky, D Hochstein.

Strength of client commitment language improves with therapist training in motivational interviewing.

Alcohol Clin Exp Res, 28 (2004), pp. 74A

[30]

Houck JM, Moyers TB. What you do matters: Therapist influence on client behavior during motivational interviewing sessions. Paper presented at the International Addiction Summit. Melbourne, Australia. 2008.

[31]

PC Amrhein, WR Miller, CE Yahne, M Palmer, L Fulcher.

Client commitment language during motivational interviewing predicts drug use outcomes.

J Consult Clin Psychol, 71 (2003), pp. 862-878

http://dx.doi.org/10.1037/0022-006X.71.5.862 | Medline

[32]

WR Miller, RG Benefield, JS Tonigan.

Enhancing motivation for change in problem drinking: A controlled comparison of two therapist styles.

J Consult Clin Psychol, 61 (1993), pp. 455-461

Medline

[33]

WR Miller, CE Yahne, TB Moyers, J Martinez, M Pirritano.

A randomized trial of methods to help clinicians learn motivational interviewing.

J Consult Clin Psychol, 72 (2004), pp. 1050-1062

http://dx.doi.org/10.1037/0022-006X.72.6.1050 | Medline

[34]

WR Miller, KA Mount.

A small study of training in motivational interviewing: Does one workshop change clinician and client behavior?.

Behav Cogn Psychother, 29 (2001), pp. 457-471

[35]

JM Brown, WR Miller.

Impact of motivational interviewing on participation and outcome in residential alcoholism treatment.

Psychol Addict Behav, 7 (1993), pp. 211-218

[36]

TH Bien, WR Miller, JM Boroughs.

Motivational interviewing with alcohol outpatients.

Behav Cogn Psychother, 21 (1993), pp. 347-356

[37]

BL Burke, H Arkowitz, M Menchola.

The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials.

J Consult Clin Psychol, 71 (2003), pp. 843-861

http://dx.doi.org/10.1037/0022-006X.71.5.843 | Medline

[38]

J Hettema, J Steele, WR Miller.

Motivational interviewing.

Annu Rev Clin Psychol, 1 (2005), pp. 91-111

http://dx.doi.org/10.1146/annurev.clinpsy.1.102803.143833 | Medline

[39]

S Rollnick, WR Miller, CC Butler.

Motivational interviewing in health care, Guilford, (2008),

[40]

Motivational interviewing in treating psychological problems,

[41]

JL Treasure, M Katzman, U Schmidt, N Troop, G Todd, P de Silva.

Engagement and outcome in the treatment of bulimia nervosa: first phase of a sequential design comparing motivational enhancement therapy and cognitive behavioural therapy.

Behav Res Ther, 37 (1998), pp. 405-418

Medline

[42]

WR Miller, CE Yahne, JS Tonigan.

Motivational interviewing in drug abuse services: a randomized trial.

J Consult Clin Psychol, 71 (2003), pp. 754-763

Medline

[43]

A Baker, R Richmond, M Haile, TJ Lewin, VJ Carr, RL Taylor, et al.

A randomized controlled trial of a smoking cessation intervention among people with a psychotic disorder.

Am J Psychiatry, 163 (2006), pp. 1934-1942

http://dx.doi.org/10.1176/ajp.2006.163.11.1934 | Medline

[44]

V Kuchipudi, K Hobein, A Fleckinger, FL Iber.

Failure of a 2-hour motivational intervention to alter recurrent drinking behavior in alcoholics with gastrointestinal disease.

J Stud Alcohol, 51 (1990), pp. 356-360

Medline

[45]

SA Ball, S Martino, C Nich, TL Frankforter, D Van Horn, P Crits-Christoph, et al.

Site matters: Multisite randomized trial of motivational enhancement therapy in community drug abuse clinics.

J Consult Clin Psychol, 75 (2007), pp. 556-567

http://dx.doi.org/10.1037/0022-006X.75.4.556 | Medline

[46]

T Winhusen, F Kropp, D Babcock, D Hague, SJ Erickson, C Renz, et al.

Motivational enhancement therapy to improve treatment utilization and outcome in pregnant substance users.

J Subst Abuse Treat, 35 (2008), pp. 161-173

http://dx.doi.org/10.1016/j.jsat.2007.09.006 | Medline

[47]

A Saltini, L Del Piccolo.

Patient-centered interviews in general practice.

Recenti Prog Med, 91 (2000), pp. 38-42

Medline

[48]

JM Bosch, J Cebriá, J Massons, R Casals.

Estrategias para modificar actitudes en el marco de la entrevista clínica “la motivación para el cambio”. Libro de ponencias del XIV Congreso Nacional de la SEMFYC, pp. 285-294

[49]

PL Peterson, JS Baer, E Wells, JA Ginzler, SB Garrett.

Short-term effects of a brief motivational intervention to reduce alcohol and drug risk among homeless adolescents.

Psych Addict Behav, 20 (2006), pp. 254-264

[50]

J McCambridge, J Strang.

The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial.

Addiction, 99 (2004), pp. 39-52

Medline

Conflicto de interés: el autor manifiesta que no tiene ningún conflicto de interés en este artículo.

Indexada en:

Síguenos:

Indexada en:

Síguenos:

Suscríbase a la newsletter