Klansuwan A, M.N.S., RN*

Takviriyanun N, Ph.D, RN**

Jirapramukpitak T, MD, Ph.D*** *Princess Mother National Institute on Drug Abuse Treatment,

**Faculty of Nursing, Thammasat University

***Faculty of Medicine, Thammasat University

THE EFFECT OF A MOTIVATIONAL INTERVIEWING TOGETHER WITH COGNITIVE BEHAVIORAL THERAPY PROGRAM ON THE ADHERENCE

BEHAVIORS OF AMPHETAMINE DEPENDENCE PATIENTS IN ONE TREATMENT CENTER

IN PATHUM THANI PROVINCE

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Amawasee KlansuwanSenior Nurse Princess Mother National Institute on Drug Abuse Treatment

(PMNIDAT)

West Africa appears

to have become an

established source

of the

methamphetamine

The established

market for

methamphetamine in

East and South-East

Asia continues

to grow, while there

are also indications

of increasing

methamphetamine

use in parts of North

America and

Europe.

(UN Office on Drugs and Crime, 2015)

Background and significance of problems

Effect of

Amphetamine

1.Physical and mental symptoms

2.Cognition problems

3. Behavior problems

4. Socio-economic problems

4(Sujittra Ritmontri and Manop Kanatoa, 2513, UNODC, 2015)

Brain addicted

chronic &

relapse disease(Markou & Koob, 1991; Munn &

Wise,1992, NIDA, 2012)

Amphetamine dependence

Emotional &

Behavior problems (NIDA, 2014, Galante , et al.,

2015)

cognitive

distortions(Beck, et al., 1993 )

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No motivation to

quit Amphetamine

dependence

(Jamieson, 2008)Use long time

for treatment(NIDA, 2012)

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Amphetamine dependence need help and appropriate

treatment.

∗ There is no single treatment for all substance abuse patients. UN

Office on Drugs and Crime, 2012 [UNODC])

(Burke, et al., 2003; Dunn, Deroo, & Rivara, 2002; Hettema, et al., 2005, Donovan, Rosengren, Downey, Cox, & Sloan, 2001; Miller, Yahne, & Tonigan, 2003; Mullins,Suarez, Ondersma, & Page, 2004; Schneider, Casey, & Kohn, 2000; Winhusen et al., 2008, Moyers & Houck, 2011)

7

MI for prepare patients to another

intensive drug treatment

Objective

This quasi-experimental study was conducted to determine the effectiveness of motivational interviewing (MI) together with cognitive behavioral therapy (CBT) on the adherence behaviors of amphetamine-dependent patients (ADPs).

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∗ The seventy-two samples were ADPs undergoing rehabilitation at a treatment center in Pathum ThaniProvince, Thailand.

∗ The samples were randomized evenly into experimental and control groups.

∗ The latter received only standard care, while the former were given additional MI and eight sessions of CBT.

∗ Data were collected before and after the trial, using questionnaires concerning the adherence behaviors of substance abusers.

METHODS&PARTICIPANTS

∗ The intervention was integrated motivational interviewing and cognitive behavioural therapy plus standard care, which was compared with standard care alone.

∗ —“motivation building”—concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. (Miller et al, 2002)

∗ —“action”—supports and facilitates change using cognitive behavioural approaches. (Beck ,1995, Carroll et al, 1998)

∗ 8 therapy sessions were delivered 3 wks.

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Intervention

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Intervention

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Intervention

∗ SPSS∗ Independent t-test ∗ Chi-Square test∗ Fisher’s Exact test ∗ Descriptive statistics

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The data analyzed.

∗ The results of the study revealed that after the trial, 94.44 percent of the samples had motivation to practice adherence behaviors.

∗ Also, the program was able to improve motivation significantly by changing it from the stage of contemplation to the stage of having motivation (x2=21.34, p<.05).

∗

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Results

Before After

Not change change χ2 p

contemplation 29 (80.56) 2 (5.56) 27 (75.00) 26.07 0.00

Motivational 7 (19.44) 7 (19.44) 0 (0.00)

motivation to practice adherence behaviors.

∗ In addition, the mean score for adherence behaviors after the trial was significantly higher than that before the trial and that of the control group (p<.05).

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Results

the adherence behaviors score

Experimental group (n=36) Control group (n=36)

score M SD scoreM

SD t p

Before 35-140 83-121 103.44 9.73 69-123 103.14 13.34 0.11 0.45

After 35-140 107-139 125.36 13.47 82-127 109.36 7.06 7.06 0.00***

p< .00***

the adherence behaviors

∗ These findings suggest that MI together with CBT is able to improve the adherence behaviors of amphetamine-dependent patients in their rehabilitation at treatment centers. The effect of the program on the adherence behaviors, however, may be extended in future studies with larger samples.

THANK YOU