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Underage/College Drinking - November 2008
Interview Date: November 2008
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Burke Brian Burke
From the Special Topic of Underage/College Drinking

In our analysis of college drinking research over the past decade, a key paper in the Research Front Map of College Alcohol Misuse is "The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials" (Burke BL, Arkowitz H, Menchola M, J. Consult. Clin. Psychol. 71[5]: 843-61, October 2003), which has 151 cites. It is also a Highly Cited Paper in the field of Psychiatry & Psychology in Essential Science IndicatorsSM from Thomson Reuters.

This month, 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, Colorado.

  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 coercion.

  How did you become involved in this research, and were there any particular successes or obstacles that stand out?

"The future of motivational interviewing lies in its broader application to clinical problems beyond substance abuse..."

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 their work.

  What are the implications of your work for this field?

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.
Psychology Department
Fort Lewis College
Durango, CO, USA

Brian Burke's current most-cited paper in Essential Science Indicators, with 151 cites:
Burke BL, Arkowitz H, Menchola M, "The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials," J. Consult. Clin. Psychol. 71(5): 843-61, October 2003. Source: Essential Science Indicators from Thomson Reuters.

Keywords: meta-analysis, quantitative summary, motivational interviewing, substance abuse, problem behaviors, cognitive-behavioral techniques, relationship factors, psychotherapy.

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Special Topics : Underage/College Drinking : Brian Burke