Social Influence and Clinical Intervention

2015 ◽  
Author(s):  
Martin Heesacker
Keyword(s):  
Drug Abuse ◽  
Social Influence ◽  
Motivational Interviewing ◽  
Clinical Outcomes ◽  
Clinical Intervention ◽  
Tripartite Model ◽  
Application Research ◽  
Normative Feedback ◽  
Identification Research ◽  
Clinically Relevant Behaviors

Kelman’s tripartite model organizes advances in research on social influence and clinical outcomes. Recent years have produced important advances in the field’s understanding of compliance, identification, and internalization. In compliance research, normative feedback has, under some conditions, altered clinically relevant behaviors, including drug abuse and gambling. In identification research, the therapeutic alliance has predicted 5–30 percent of the variance in clinical outcomes. Evidence suggests a causal relationship between alliance and outcomes, and that ruptured alliances can be repaired. Internalization theories from basic science have generated little recent clinical application research, but a clinician-developed approach to internalization, motivational interviewing, has generated substantial recent research. Though mixed, enough evidence supports motivational interviewing to warrant additional research.

Natural History and Clinical Outcomes of Paravertebral Arteriovenous Shunts

Stroke ◽  
2021 ◽  
Author(s):  
Yueshan Feng ◽  
Jiaxing Yu ◽  
Jiankun Xu ◽  
Chuan He ◽  
Lisong Bian ◽  
...  
Keyword(s):  
Natural History ◽  
Clinical Outcomes ◽  
Clinical Intervention ◽  
Type A ◽  
Neurological Deficits ◽  
Type B ◽  
Deterioration Rate ◽  
Arteriovenous Shunts ◽  
Spinal Segments

Background and Purpose: Paravertebral arteriovenous shunts (PVAVSs) are rare. Whether the intradural venous system is involved in drainage may lead to differences in clinical characteristics through specific pathophysiological mechanisms. This study aims to comprehensively evaluate the natural history and clinical outcomes of PVAVSs with or without intradural drainage. Methods: Sixty-four consecutive patients with PVAVSs from 2 institutes were retrospectively reviewed. Lesions were classified as type A (n=28) if the intradural veins were involved in drainage; otherwise, they were classified as type B (n=36). The clinical course from initial presentation to the last follow-up was analyzed. Results: The patients with type A shunts were older at presentation (52.5 versus 35.5 years, P <0.0001) and more likely to have lower spinal segments affected than patients with type B PVAVSs (67.8% versus 13.9%, P =0.00006). After presentation, the deterioration rates related to gait and sphincter dysfunction were significantly higher in patients with type A than type B shunts (gait dysfunction: 71.8%/y versus 17.0%/y, P =0.0006; sphincter dysfunction: 63.7%/y versus 11.3%/y, P =0.0002). According to the angiogram at the end of the latest treatment, 79% of type A and 75% of type B PVAVSs were completely obliterated. If the lesions were partially obliterated, a significantly higher clinical deterioration rate was observed in patients with type A shunts than those with type B shunts (69.9%/y versus 3.2%/y, P =0.0253). Conclusions: Type A PVAVSs feature rapid progressive neurological deficits; therefore, early clinical intervention is necessary. For complex lesions that cannot be completely obliterated, surgical disconnection of all refluxed radicular veins is suggested.

scholarly journals Brief Motivational Interviewing and Normative Feedback for Adolescents: Change Language and Alcohol Use Outcomes

2016 ◽  
Vol 65 ◽  
pp. 66-73 ◽  
Author(s):  
Jordan P. Davis ◽  
Jon M. Houck ◽  
Lauren N. Rowell ◽  
Jennifer G. Benson ◽  
Douglas C. Smith
Keyword(s):  
Alcohol Use ◽  
Motivational Interviewing ◽  
Normative Feedback

Strengthening the Impact of Digital Cognitive Behavioral Interventions through a Dual Intervention: Motivational Interviewing Coaching Protocol Plus In-Application Techniques (Preprint)

2021 ◽  
Author(s):  
Catherine Serio ◽  
Amanda Gabarda ◽  
Fatma Uyar-Morency ◽  
Valerie Silfee ◽  
Justin Ludwig ◽  
...  
Keyword(s):  
Mental Health ◽  
Motivational Interviewing ◽  
Clinical Outcomes ◽  
Behavioral Interventions ◽  
Digital Health ◽  
Cognitive Behavioral ◽  
Digital Interventions ◽  
Message Exchange ◽  
Cognitive Behavioral Interventions ◽  
The Impact

BACKGROUND The COVID-19 pandemic has accelerated the adoption of digital tools to support individuals struggling with their mental health. The use of a digital intervention plus human coaching (“dual” intervention) is gaining momentum to increase overall engagement in digital cognitive behavioral interventions (dCBIs). However, there is limited insight about the methodologies and coaching models used by those deploying dual interventions. To achieve a deeper understanding, we need to identify and promote effective engagement that leads to clinical outcomes, versus simply monitoring engagement metrics. Motivational Interviewing (MI) is a collaborative, goal-oriented communication approach with particular attention to the language of change and an effective engagement approach for helping people manage mental health issues. However, this approach has been traditionally used in in-person or telephonic interventions and less is known about the application of MI to digital interventions. OBJECTIVE We sought to provide a dual intervention approach and address multiple factors across two levels to operationalize a dCBI that combined: (1) Cognitive behavioral therapy (CBT)-based techniques; and (2) MI-based interactions between the digital health coach (DHC) and user. METHODS We reviewed hundreds of digital exchanges between DHCs and users to identify and improve training and quality assurance activities for digital interventions. RESULTS We tested five hypotheses and found that: (1) users of a dual digital behavioral health intervention had greater engagement levels than users of a non-coached intervention (p<0.0001); (2) DHCs with a demonstrated competency in applying MI to digital messages had more engaged users, as measured by DHC-to-user message exchange ratio (p<0.001); (3) DHC-to-user message exchange ratio was correlated with more engagement in app activities (r = 0.28 (95% CI [0.23,0.33])); (4) DHCs with demonstrated MI proficiency elicited greater amount of “change talk” from users than did DHCs without MI proficiency (H = 25.12, p<0.0001); and (5) users who were engaged by DHCs with MI proficiency had better clinical outcomes compared to users engaged by DHCs without MI proficiency (p= 0.0151). CONCLUSIONS This data indicates potential and need for further research in establishing coaching models in dCBIs that incorporate MI to promote effective engagement and optimize positive behavioral outcomes.

Clinical outcomes of severe tricuspid valve infective endocarditis related to intravenous drug abuse – a case series

2021 ◽  
pp. 1-6
Author(s):  
Cheryl Zhiya Chong ◽  
Robin Cherian ◽  
Perryn Ng ◽  
Tiong Cheng Yeo ◽  
Lieng Hsi Ling ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Infective Endocarditis ◽  
Clinical Outcomes ◽  
Tricuspid Valve ◽  
Case Series ◽  
Intravenous Drug ◽  
Intravenous Drug Abuse

Motivational interview in drug abuse

2016 ◽  
Vol 33 (S1) ◽  
pp. S558-S558
Author(s):  
H. Guillen Rodrigo ◽  
R. Alonso Díaz ◽  
E. Cortázar Alonso
Keyword(s):  
Drug Abuse ◽  
Motivational Interviewing ◽  
Police Officers ◽  
Motivational Interview ◽  
Emotional And Behavioral Disorders ◽  
Treatment Plan ◽  
The Family ◽  
Motivation For Change ◽  
Competing Interest ◽  
First Time

According to the treatment plan from the motivational interviewing model, we have worked with a 25-year-old male, single and childless. He is currently unemployed and he lives with his grandparents. His parents divorced about 20 years ago, he has a paternal brother of two years and his mother lives in Barcelona. He went to the USMC Huelva for the first time in 2014.The patient and the family reported emotional and behavioral disorders for several years, which were getting worse since 4 months. He has been convicted for rash driving and he resisted to police officers for several times. The patient was also abusing of several substances like cigarettes, cannabis, MDMA and cocaine.In order to work with the motivational interviewing with this patient, we proposed five clinical principles: express empathy, create discrepancy, avoid discussion, put a spin on his strength and promote self-efficacy.The clinical evolution of the proposed patient was positive. As we could see, the motivation for change occurred when the patient perceived a discrepancy between the place where he was and the place he wanted to get. As we saw, the important thing was to define acceptable and accessible targets that represented the progress toward recovery.In this style, we avoid the persuasion based on the discussion with the patient, instead we assume the validity of the experiences and the subjective perspectives of the patient. The motivational interview represents an alternative to unleash the change, instead of direct persuasion and aggressive confrontation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sign in / Sign up

Export Citation Format

Share Document