Adjunctive Motivational Alcohol Intervention to Prevent IPV (MET-SAH)

VA Office of Research and Development

Status: Enrolling

Conditions: Alcohol Use and Intimate Partner Violence

Treatments: Behavioral: Alcohol Education Control; Behavioral: Motivational Enhancement Therapy; Behavioral: Treatment as Usual; Behavioral: Strength at Home

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT05287711

NURA-007-20F

Details and patient eligibility

About

This is a study to provide much-needed experimental data on the efficacy of a brief alcohol Motivational Enhancement Therapy (MET) pre-group intervention for Veterans receiving group treatment for IPV perpetration. The investigators will compare those assigned to receive this 2-session MET intervention to those receiving a 2-session Alcohol Education (AE) intervention or a 2-session standard treatment as usual (TAU) telephone monitoring intervention. The investigators will examine whether MET leads to greater reductions in alcohol use problems and IPV perpetration, and increased help-seeking behavior for alcohol use problems. Participants will be 300 Veterans drawn from the Strength at Home IPV intervention program across the entire Veterans Health Administration system.

Full description

Veterans exposed to trauma are at elevated risk for perpetration of intimate partner violence (IPV) and for the development of alcohol-related problems. Despite commonly found associations between alcohol misuse and IPV, the investigators are aware of no prior research in Veterans examining the impact of adjunctive alcohol interventions for those receiving IPV intervention. The investigators propose to provide much-needed experimental data on the efficacy of a brief 2-session alcohol Motivational Enhancement Therapy (MET) pre-group intervention for Veterans receiving group treatment for IPV perpetration. More specifically, the investigators propose to examine whether those assigned to receive this 2-session MET intervention, relative to those receiving a 2-session Alcohol Education (AE) intervention or a 2-session standard treatment as usual (TAU) telephone monitoring intervention, evidence greater reductions in alcohol use problems and IPV perpetration, and increased help-seeking behavior for alcohol use problems. Participants will be 300 Veterans drawn from the Strength at Home IPV intervention program across the entire Veterans Health Administration system. Participants will be randomized to their pre-group conditions and then assigned to Strength at Home groups for IPV, and will receive referrals for substance use treatment in the VA system or the community. Participants with clinically relevant alcohol use problems, as determined by baseline screening measures, will complete assessments of alcohol use, readiness to change, IPV and help-seeking behavior at baseline, post IPV intervention group (3 months after completion of 2-session alcohol intervention), and four separate 3-month follow-ups after the post-treatment assessment. Differences between conditions on the major outcome variables involving alcohol use, IPV, help-seeking, and treatment engagement will be examined with random-effects regression models using an intent-to-treat approach. Study findings may assist in enhancing the efficacy of IPV interventions for the Veteran population to help ensure the safety and well-being of Veterans and their families.

Enrollment: 300 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

All Veteran participants must meet the following eligibility criteria:

• participant is a Veteran

• minimum age 18

• participant is enrolled in the Strength at Home program following program intake

• participant displays evidence of alcohol-related problems during program intake, as indicated by any of the following:

  • a report of physical IPV while under the influence of alcohol in the past year
  • a score of 8 or greater on the Alcohol Use Disorders Identification Test (AUDIT)
  • consumption of 6 or more standard drinks per occasion on one or more occasions in the previous 6 months
  • average weekly consumption of 14 or more standard drinks in the prior 6 months

• participant provides written consent to participate in the study

• inclusion for this study is broad because this is a population who possesses a number of comorbid problems and exclusion for those based on psychopathology or risk for aggression could potentially lead to a biased sample

Exclusion criteria

• None

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

300 participants in 3 patient groups

Motivational Enhancement Therapy

Experimental group

Description:

Motivational enhancement therapy for alcohol use problems, which includes empathic support, feedback and advice, strategies for enhancing self-efficacy, techniques for eliciting self-motivational statements from the participant, strategies for addressing participant ambivalence about change and participant resistance to change, and methods for eliciting and affirming commitment to a specific change plan (active intervention).

Treatment:

Behavioral: Strength at Home

Behavioral: Motivational Enhancement Therapy

Alcohol Education Control

Experimental group

Description:

Psychoeducational intervention intended to: (1) dispel myths about the effects of alcohol, (2) provide information about the general risks of drinking and process of recovery from alcohol problems, (3) provide information about the specific risks related to family relationships and IPV, (4) offer self-help program information and related strategies to address drinking problems, (5) promote and encourage healthy decision-making, and (6) reinforce the benefits of abstinence or controlled drinking.

Treatment:

Behavioral: Strength at Home

Behavioral: Alcohol Education Control

Telephone Monitoring

Other group

Description:

Brief supportive telephone monitoring sessions that are commonly delivered while Veterans wait to begin their groups (treatment as usual).

Treatment:

Behavioral: Strength at Home

Behavioral: Treatment as Usual