The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial

Sorsdahl, K.; Stein, D. J.; Corrigall, J.; Cuijpers, P.; Smits, N.; Naledi, T.; Myers, B.

doi:10.1186/s13011-015-0042-1

Cited by 84Substance Abuse Treatment and OutcomesPsychotherapy Techniques and ApplicationsHomelessness and Social Issues

The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial

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Sorsdahl, K., Stein, D. J., Corrigall, J., Cuijpers, P., Smits, N., Naledi, T., Myers, B.·2015·Substance Abuse Treatment, Prevention, and Policy

DOI 10.1186/s13011-015-0042-1PMC PMC4650345

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Abstract

BACKGROUND: The treatment of substance use disorders is a public health priority, particularly in South Africa where the prevalence of these disorders is high. We tested two peer-counsellor delivered brief interventions (BIs) for risky substance use among adults presenting to emergency departments (EDs) in South Africa. METHODS: In this randomised controlled trial, we enrolled patients presenting to one of three 24-hour EDs who screened at risk for substance use according to the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Eligible patients were randomly allocated to one of three conditions: Motivational Interviewing (MI), blended MI and Problem Solving Therapy (MI-PST) or a Psycho-educational Control Group (CG). The primary outcome was reduction in ASSIST scores at three months follow-up. RESULTS: Of the 2736 patients screened, 335 met inclusion criteria, were willing to participate in the intervention and were randomised to one of three conditions: 113 to MI, 112 to MI-PST and 110 to CG. ASSIST scores at three months were lower in the MI-PST group than they were in the MI and CG groups (adjusted mean difference of -1.72, 95 % CI -3.36 - -0.08). We recorded no significant difference in ASSIST scores between the CG and MI group (adjusted mean difference of -0.02, 95 % CI -2.01 - 1.96). CONCLUSION: With the addition of minimal resources, BIs are feasible to conduct in EDs in a low resourced country. These preliminary findings report that MI-PST appears to be an effective BI for reducing substance use among at risk participants. Further research is required to replicate these findings with effort to limit attrition, to determine whether reductions in substance use are persistent at 6 and 12 month follow-up and whether parallel changes occur in other indications of treatment outcomes, such as injury rates and ED presentations. TRIAL REGISTRATION: This trial registered with the Pan African Clinical Trial Registry (PACTR201308000591418).

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Enrollment rates were relatively high (41%, 75 of 181 screened) compared to Sorsdahl's ED-based brief intervention clinical trials (12%, 335 of 2736) in South Africa.
“While young healthy men seen in an ED are traditionally a difficult population for follow-up, our enrollment rates were relatively high (41%, 75 of 181 screened) compared to Sorsdahl’s ED-based brief intervention clinical trials (12%, 335 of 2736) in South Africa [14].”
From Feasibility of a pragmatic randomized adaptive clinical trial to evaluate a brief negotiational interview for harmful and hazardous alcohol use in Moshi, Tanzania (2023) · cites this paper as [14]
The 6-month follow-up rate was 84%, compared to Sorsdahl's South African trial (54% completed 3-month follow-up) and Segatto's 85.2% 3-month follow-up in Brazil.
“Similarly, our 6-month follow-up rate at 84% is promising when compared to Sorsdahl’s South African trial, where 54% completed 3-month follow-up [14], or Segatto’s 85.2% 3-month follow-up in Brazil [13].”
From Feasibility of a pragmatic randomized adaptive clinical trial to evaluate a brief negotiational interview for harmful and hazardous alcohol use in Moshi, Tanzania (2023) · cites this paper as [14]
Sorsdahl and colleagues focused on a MI-Problem Solving combination treatment and thus was likely not powered to evaluate the MI only arm.
“While Sorsdahl and colleagues focused on a MI-Problem Solving combination treatment and thus was likely not powered to evaluate the MI only arm [14].”
From Feasibility of a pragmatic randomized adaptive clinical trial to evaluate a brief negotiational interview for harmful and hazardous alcohol use in Moshi, Tanzania (2023) · cites this paper as [14]
Sorsdahl and colleagues found a reduction in the ASSIST scale for those who received the MI with problem solving intervention compared to the control, but no difference between MI alone and control.
“Sorsdahl and colleagues found a reduction in the ASSIST scale for those who received the MI with problem solving intervention compared to the control, yet there was no difference between the MI alone and the control group [92].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [92]
Psychotherapy and counseling interventions are demonstrably effective.
“although psychotherapy and counseling interventions are demonstrably effective [45,61,73,83,92]”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [92]

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Authors: Sorsdahl, K., Stein, D. J., Corrigall, J., Cuijpers, P., Smits, N., Naledi, T., & Myers, B.
Affiliations: University of Cape Town (ZA)
Western Cape Department of Health (ZA)
Vrije Universiteit Amsterdam (NL)
South African Medical Research Council (ZA)
Corresponding author: Sorsdahl, K.
ORCID: Sorsdahl, K.
Stein, D. J.
Cuijpers, P.
Smits, N.
Naledi, T.
Myers, B.
Venue: Substance Abuse Treatment, Prevention, and Policy
Publisher: Springer Science and Business Media LLC
Published: 2015-11-14
Volume: 10
Issue: 1
Pages: 46-46
ISSN: 1747-597X (ISSN-L)
DOI: 10.1186/s13011-015-0042-1
PMC: PMC4650345
OpenAlex: W2175669953
Cited by: 84
References: 36
Citations by year: 2026: 3 · 2025: 1 · 2024: 6 · 2023: 18 · 2022: 14 · 2021: 10 · 2020: 9 · 2019: 11 · 2018: 7 · 2017: 4 · 2016: 1
FWCI: 3.14
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Substance Abuse Treatment Prevention and Policy (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
UvA-DARE (University of Amsterdam) (publishedVersion, cc-by)
VU Research Portal (publishedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
eSpace (Curtin University) (submittedVersion, cc-by)
Open University of Cape Town (University of Cape Town) (submittedVersion)
Funders: Department of Health, Western Cape Government
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
Keywords: motivational interviewing, problem-solving therapy, brief intervention, substance use reduction, emergency department, peer counseling, ASSIST screening, risky substance use, resource-limited settings, South Africa
MeSH terms: Adolescent, Adult, Aged, Emergency Medical Services, Female, Humans, Male, Middle Aged, Problem Solving, Psychotherapy, Brief, South Africa, Treatment Outcome, Substance-Related Disorders, Young Adult, Motivational Interviewing

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The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial

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