ScienceWatch.com talks with the lead author of this paper,
Dr. Brian Burke. Dr. Burke is an Associate Professor in the
Psychology Department at Fort Lewis College in Durango,
Would you please describe the significance
of your paper and why it is highly cited?
This paper was the first meta-analysis—or quantitative
summary—of the research on motivational interviewing (MI), a
relatively new treatment for substance abuse (and other problem behaviors)
that combines humanistic principles of change with cognitive-behavioral
techniques. The central idea is that the client decides what—if
any—changes they want to make in their lives without counselor
How did you become involved in this research, and
were there any particular successes or obstacles that stand
"The future of motivational
interviewing lies in its broader application
to clinical problems beyond substance
This research was my doctoral dissertation. I became involved because I was
interested in studying relationship factors in psychotherapy, and Dr. Bill
Miller (the founder of motivational interviewing) came to speak at the
University of Arizona where I was studying. His therapeutic approach rested
heavily on the client-counselor relationship and I became intrigued by the
results that his method—a 180-degree shift from the confrontive
"break through the denial" approaches formerly standard in many substance
abuse clinics—was producing.
Where do you see your research and the broader
field leading in the future?
Brad Lundahl and I, along with several of his colleagues at the University
of Utah, are currently working on a new meta-analysis of motivational
interviewing. My original meta-analysis had only 30 studies while we now
have hundreds of trials that have empirically investigated the efficacy of
motivational interviewing. The future of motivational interviewing lies in
its broader application to clinical problems beyond substance abuse,
ranging from diet/exercise and eating disorders to anxiety and depression.
I am currently involved in a research study to determine the most effective
way to teach other health-care providers how to employ MI techniques in
What are the implications of your work for this
My meta-analysis showed that MI treatments were equivalent to other active
treatments and yielded moderate effects compared to no-treatment/placebo
for problems involving alcohol, drugs, and diet & exercise. Results did
not support the efficacy of MI for smoking or HIV-risk behaviors at that
time. Most importantly, MI showed clinical impact, with 51% improvement
rates, a 56% reduction in client drinking, and moderate effect sizes on
social impact measures such as marital satisfaction and days of work/school
lost due to drinking.
One of the most critical findings was that MI worked best as a prelude to
further treatment (e.g., subsequent entry into a substance abuse treatment
program) or when it was used for more than one to two sessions itself. Of
course, the societal implications of developing more effective treatments
for addiction are profound given the extremely high cost (both social and
economic) of these problem behaviors.
Brian Burke, Ph.D.
Fort Lewis College
Durango, CO, USA
Keywords: meta-analysis, quantitative summary, motivational
interviewing, substance abuse, problem behaviors,
cognitive-behavioral techniques, relationship factors,