Long-Term Effects of Motivational Enhancement Therapy on Severity and Motivation to Change in Alcohol Use Disorders: A Longitudinal Intervention Study

Abstract

Background: Alcohol Use Disorder (AUD) remains a significant public health concern globally and in India, with high prevalence and substantial personal and societal costs. Motivational Enhancement Therapy (MET), an adaptation of motivational interviewing, is designed to enhance readiness to change and reduce harmful alcohol use. However, evidence on its long-term effectiveness, particularly in Indian settings, remains limited. Objectives: This study aimed to evaluate the long-term impact of MET on alcohol use severity and motivation to change among individuals with AUD, comparing outcomes with a waitlisted control group receiving treatment as usual (TAU). Methods: A total of 108 male participants diagnosed with AUD were allocated to either an experimental group receiving MET (n = 55) or a waitlisted TAU group (n = 53). Participants were assessed at baseline, 3 months, 6 months, and 12 months using the Alcohol Use Disorders Identification Test (AUDIT) and the SOCRATES subscales (Recognition, Ambivalence, Taking Steps). Baseline sociodemographic characteristics, including age, education, marital status, employment, socioeconomic strata, residence, and family history of alcohol use, were comparable across groups. Results: MET participants showed a marked reduction in mean AUDIT scores from 24.7 at baseline to 10.1 at 12 months, while TAU participants decreased only to 18.2, with significant between-group differences emerging at 3 months and persisting through 12 months (p < .001). Similarly, MET participants demonstrated increased recognition of alcohol problems (from 25.2 to 31.0) and taking proactive steps (23.5 to 31.4), alongside reduced ambivalence (22.6 to 15.8), compared to relatively stable scores in the TAU group. All differences were statistically significant (p < .001). Conclusions: Findings underscore the effectiveness of MET in achieving sustained reductions in alcohol use severity and improving motivational processes over a 12-month period. These results align with previous international studies (e.g., Project MATCH; Miller & Rollnick, 2013) and extend them to an Indian context, supporting the integration of MET into standard care for AUD. Limitations include reliance on self-reports, male-only sampling, and a single-site design. Future research should explore longer-term outcomes and broader populations to further validate these findings.