No Effect of Brief Motivational Interview on Co-Occurring IPV and Heavy Drinking

Daniel M. Lindberg, MD reviewing Rhodes KV et al. JAMA 2015 Aug 4.

A well-designed, well-executed trial showed no benefit in women screening positive for intimate partner violence and heavy drinking.

Prior trials of brief motivational interviewing in the emergency department (ED) suggest a small benefit for reducing heavy drinking, but this benefit has been highly gender-specific, occurring mostly among men. In the current study, researchers tested whether an intervention designed to reduce both intimate partner violence (IPV) and heavy drinking could provide a benefit to women.

Of 600 eligible women identified from two urban Pennsylvania EDs (mean age, 32 years), 242 were randomized to receive a 20 to 30 minute motivational interview from an experienced, master's-level therapist and a follow-up telephone booster. Controls included 237 patients who received the same weekly assessments of primary outcomes (days of heavy alcohol consumption and any verbal, physical, or sexual abuse) as the intervention group and 121 patients who were assessed only at 3 months (to test for the Hawthorne effect).

No significant benefits were seen in the intervention group relative to either control group for primary or secondary outcomes. The authors conclude that these results do not support the use of brief motivational interviews for this population in this setting. For those looking for a silver lining, rates of both heavy drinking and IPV tended to decrease slightly over time, with or without the intervention.

Citation(s):

Rhodes KV et al. Brief motivational intervention for intimate partner violence and heavy drinking in the emergency department: A randomized clinical trial. JAMA 2015 Aug 4; 314:466.