Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-26T10:12:59.600Z Has data issue: false hasContentIssue false
  • English
  • Français

Motivational interviewing and interaction skills training for parents to change cannabis use in young adults with recent-onset schizophrenia: a randomized controlled trial

Published online by Cambridge University Press:  08 December 2011

M. Smeerdijk ,
R. Keet ,
N. Dekker ,
B. van Raaij ,
M. Krikke ,
M. Koeter ,
L. de Haan ,
C. Barrowclough ,
G. Schippers  and
D. Linszen
M. Smeerdijk*
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
R. Keet
Affiliation:
Mental Health Service North Holland North, Alkmaar, The Netherlands
N. Dekker
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
B. van Raaij
Affiliation:
Training Company ‘Bureau de Mat’, Haarlem, The Netherlands
M. Krikke
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
M. Koeter
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
L. de Haan
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
C. Barrowclough
Affiliation:
School of Psychological Sciences, University of Manchester, UK
G. Schippers
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
D. Linszen
Affiliation:
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
*
*Address for correspondence: M. Smeerdijk, M.Sc., Department of Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cannabis use by people with schizophrenia has been found to be associated with family distress and poor clinical outcomes. Interventions to reduce drug use in this patient group have had limited efficacy. This study evaluated the effectiveness of a novel intervention for parents of young adults with recent-onset schizophrenia consisting of family-based motivational interviewing and interaction skills (Family Motivational Intervention, FMI) in comparison with routine family support (RFS).

Method

In a trial with 75 patients who used cannabis and received treatment for recent-onset schizophrenia, 97 parents were randomly assigned to either FMI (n=53) or RFS (n=44). Assessments were conducted at baseline and 3 months after completion of the family intervention by an investigator who remained blind throughout the study about the assignment of the parents.

Results

At follow-up, patients' frequency and quantity of cannabis use was significantly more reduced in FMI than in RFS (p<0.05 and p<0.04 respectively). Patients' craving for cannabis was also significantly reduced in FMI whereas there was a small increase in RFS (p=0.01). There was no difference between FMI and RFS with regard to patients' other substance use and general level of functioning. Both groups showed significant improvements in parental distress and sense of burden.

Conclusions

Training parents in motivational interviewing and interaction skills is feasible and effective in reducing cannabis use among young adults with recent-onset schizophrenia. However, FMI was not more effective than RFS in increasing patients' general level of functioning and in reducing parents' stress and sense of burden.

Keywords

Cannabisfamily interventioninteraction skillsmotivational interviewingschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 8 , August 2012 , pp. 1627 - 1636
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH): an instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615–623.CrossRefGoogle ScholarPubMed
Anton, RF, Moak, DH, Latham, PK (1996). The obsessive compulsive drinking scale: a new method of assessing outcome in alcoholism treatment studies. Archives of General Psychiatry 53, 225–231.CrossRefGoogle Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Barrowclough, C, Haddock, G, Tarrier, N, Lewis, SW, Moring, J, O'Brien, R, Schofield, N, McGovern, L (2001). Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorder. American Journal of Psychiatry 158, 1706–1713.CrossRefGoogle Scholar
Barrowclough, C, Ward, J, Weardon, A, Gregg, L (2005). Expressed emotion and attributions in relatives with and without substance misuse. Social Psychiatry and Psychiatric Epidemiology 40, 1–8.CrossRefGoogle ScholarPubMed
Butzlaff, RL, Hooley, JM (1998). Expressed emotion and psychiatric relapse: a meta-analysis. Archives of General Psychiatry 55, 547–552.CrossRefGoogle ScholarPubMed
Carey, KB, Cary, MP, Maisto, SA, Henson, JM (2004). Temporal stability of the Timeline Followback interview for alcohol and drug use with psychiatric outpatients. Journal of Studies on Alcohol 65, 774–781.CrossRefGoogle ScholarPubMed
Cleary, M, Hunt, GE, Matheson, S, Walter, G (2009). Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review. Journal of Advanced Nursing 65, 238–258.CrossRefGoogle ScholarPubMed
de Vries, K, van Heck, GL (1995). The Dutch Version of the WHOQOL-100. University of Tilburg: Tilburg.Google Scholar
Garety, PA, Fowler, GD, Freeman, D, Bebbington, P, Dunn, G, Kuipers, E (2008). Cognitive-behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial. British Journal of Psychiatry 192, 412–423.CrossRefGoogle ScholarPubMed
Goldberg, DP, Hillier, VF (1979). A scaled version of the General Health Questionnaire. Psychological Medicine 9, 139–145.CrossRefGoogle ScholarPubMed
Haddock, G, Cross, Z, Beardmore, R, Tarrier, N, Lewis, S, Moring, J, Barrowclough, C (2009). Assessing illicit substance use in schizophrenia: the relationship between self report and detection by hair analysis. Schizophrenia Research 114, 180–181.CrossRefGoogle ScholarPubMed
Hettema, J, Steele, J, Miller, WR (2005). Motivational interviewing. Annual Review of Clinical Psychology 1, 91–111.CrossRefGoogle ScholarPubMed
Hjorthøj, C, Fohlmann, A, Nordentoft, M (2009). Treatment of cannabis use disorders in people with schizophrenia spectrum disorder – a systematic review. Addictive Behaviors 34, 520–525.CrossRefGoogle ScholarPubMed
Koeter, MWJ, Ormel, J (1991). General Health Questionnaire Manual: Dutch Adaptation [in Dutch]. Swets & Zeitinger: Lisse.Google Scholar
Kuipers, T (2003). Show them where you're coming from: interaction skills training for psychiatry [in Dutch]. Maandblad Geestelijke Volksgezondheid 58, 1137–1148.Google Scholar
Kuipers, T (2008). Disability and prosthesis in psychiatry [in Dutch]. Maandblad Geestelijke Volksgezondheid 63, 20–32.Google Scholar
Kuipers, T, Raaij, B (2006). Interaction Skills Training for Family Members [in Dutch]. Bureau de Mat: Haarlem.Google Scholar
Linszen, D, Dingemans, P, Lenior, M (1994). Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry 51, 273–279.CrossRefGoogle ScholarPubMed
Linszen, DH, Dingemans, P, Van der Does, AJW, Nugter, A, Scholte, P, Lenior, R, Goldstein, MJ (1996). Treatment, expressed emotion and relapse in recent-onset schizophrenic disorders. Psychological Medicine 26, 333–342.CrossRefGoogle ScholarPubMed
Linszen, D, Dingemans, P, Nugter, MA, Van der Does, A, Scholte, W, Lenior, M (1997). Patient attributes and expressed emotion as risk factors for psychotic relapse. Schizophrenia Bulletin 23, 119–130.CrossRefGoogle ScholarPubMed
Lopez, SR, Nelson, KA, Snyder, KS, Mintz, J (1999). Attributions and affective reactions of family members and course of schizophrenia. Journal of Abnormal Psychology 108, 307–314.CrossRefGoogle ScholarPubMed
Miller, WR, Benefield, RG, Tonigan, JS (1993). Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles. Journal of Consulting and Clinical Psychology 61, 455–461.CrossRefGoogle ScholarPubMed
Miller, WR, Rollnick, S (2002). Motivational Interviewing: Preparing People to Change, 2nd edn. Guilford Press: New York.Google Scholar
Miller, WR, Moyers, TB (2006). Eight stages in learning motivational interviewing. Journal of Teaching in the Addictions 5, 3–17.CrossRefGoogle Scholar
Mueser, KT, Yarnold, PR, Levinson, DF, Singh, H, Bellack, AS, Kee, K, Morrison, RL, Yadalam, KG (1990). Prevalence of substance use in schizophrenia: demographic and clinical correlates. Schizophrenia Bulletin 16, 31–56.CrossRefGoogle ScholarPubMed
Mueser, KT, Glynn, SM, Cather, C, Zarate, R, Fow, L, Feldman, J, Wolfe, R, Clark, RE (2009). Family intervention for co-occurring substance use and severe psychiatric disorders: participant characteristics and correlates of initial engagement and more extended exposure in a randomized controlled trial. Addictive Behaviors 34, 867–877.CrossRefGoogle ScholarPubMed
O'Farrell, TH, Fals-Stewart, W (2006). Behavioural Couples Therapy for Alcoholism and Drug Abuse. Guilford Press: New York.Google Scholar
Pharoah, FM, Rathbone, J, Mari, JJ, Streiner, D (2006). Family intervention for schizophrenia. Cochrane Database of Systematic Reviews 18, CD000088.CrossRefGoogle Scholar
Quinn, J, Barrowclough, C, Tarrier, N (2003). The Family Questionnaire (FQ): a scale for measuring symptom appraisal in relatives of schizophrenic patients. Acta Psychiatrica Scandinavica 208, 290–296.CrossRefGoogle Scholar
Schippers, GM, De Jong, CAJ, Lehert, P, Potgieter, A, Deckers, F, Casselman, J, Geerlings, PJ (1997). The Obsessive Compulsive Drinking Scale: translation into Dutch and possible modifications. European Addiction Research 3, 116–122.CrossRefGoogle Scholar
Smeerdijk, AM, Keet, IPM, Merkx, M, Krikke, M, De Jager, A, Schippers, GM (2007). Motivational Interviewing for Parents: Trainer's Manual [in Dutch]. Academic Medical Centre: Amsterdam.Google Scholar
Sobell, LC, Sobell, MB (1992). Timeline Followback: a technique for assessing self-reported alcohol consumption. In Measuring Alcohol Consumption (ed. Litten, R. Z. and Allen, J. P.), pp. 41–72. Humana Press: Totowa, NJ.CrossRefGoogle Scholar
Stasiewicz, PR, Vincent, PC, Bradizza, CM, Connors, GJ, Maisto, SA, Mercer, ND (2008). Factors affecting agreement between severely mentally ill alcohol abusers' and collaterals' reports of alcohol and other substance abuse. Psychology of Addictive Behaviors 22, 78–87.CrossRefGoogle ScholarPubMed
Szmukler, GI, Burgess, P, Herrman, H, Benson, A, Colusa, S, Bloch, S (1996). Caring for relatives with serious mental illness: the development of the Experience of Caregiving Inventory. Social Psychiatry and Psychiatric Epidemiology 31, 137–148.CrossRefGoogle ScholarPubMed
van Meijel, B, Megens, Y, Koekkoek, B, de Vogel, W, Kruitwagen, C, Grypdonck, M (2009). Effective interaction with patients with schizophrenia: qualitative evaluation of the interaction skills training programme. Perspectives in Psychiatric Care 45, 254–261.CrossRefGoogle ScholarPubMed
WHOQOL Group (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine 28, 551–558.CrossRefGoogle Scholar
Zammit, S, Moore, THM, Lingford-Hughes, A, Barnes, TRE, Jones, PB, Burke, M, Lewis, G (2008). Effects of cannabis use on outcomes of psychotic disorders: systematic review. British Journal of Psychiatry 193, 357–363.CrossRefGoogle ScholarPubMed