Matching motivation enhancement treatment to client motivation: re-examining the Project MATCH motivation matching hypothesis

Authors


Katie Witkiewitz, Alcohol and Drug Abuse Institute, University of Washington, 1107 NE 45th Street, Suite 120, Box 354805, Seattle, WA 98105-4631, USA. E-mail: kate19@u.washington.edu

ABSTRACT

Aims  The current study was designed to re-examine the motivation matching hypothesis from Project MATCH using growth mixture modeling, an analytical technique that models variation in individual drinking patterns.

Design, setting and participants  Secondary data analyses of data from Project MATCH (n = 1726), a large multi-site alcoholism treatment-matching study.

Measurements  Percentage of drinking days was the primary outcome measure, assessed from 1 month to 12 months following treatment. Treatment assignment, alcohol dependence symptoms and baseline percentage of drinking days were included as covariates.

Findings  The results provided support for the motivation matching hypothesis in the out-patient sample and among females in the aftercare sample: the majority of individuals with lower baseline motivation had better outcomes if assigned to motivation enhancement treatment (MET) compared to those assigned to cognitive behavioral treatment (CBT). In the aftercare sample there was a moderating effect of gender and alcohol dependence severity, whereby males with lower baseline motivation and greater alcohol dependence drank more frequently if assigned to MET compared to those assigned to CBT.

Conclusions  Results from the current study lend partial support to the motivation-matching hypothesis and also demonstrated the importance of moderating influences on treatment matching effectiveness. Based upon these findings, individuals with low baseline motivation in out-patient settings and males with low levels of alcohol dependence or females in aftercare settings may benefit more from motivational enhancement techniques than from cognitive–behavioral techniques.

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