Tese Doutorado - OLIVEIRA M S

Tese apresentada à Universidade Federal de São Paulo – Escola Paulista de Medicina para obtenção de Título de Doutor em Ciências.

São Paulo
2000

The main objective of this study has been to evaluate the efficiency of Motivational Intervention with alcohol-dependent patients. The study has been designed as a prospective random clinical trial, aiming at comparing the Motivational Intervention to the Conventional Treatment. The sample was made up by 152 male subjects who were inpatients at special units for chemical addiction. The average age of the target sample was 40 years and 6 months old, the minimum school level was 5^th grade, and the avarage salary was 5 minimum salaries. The patients were selected randomly, 76 belonging to the Control Group and 76 belonging to the Intervention Group. All patients joining the research were submitted to the initial evaluation, answering to a series of instruments, from the Structured Interview for the collection of personal data to the specific instruments: Form-90, SADD, DrInC, SOCRATES/URICA, BAI/BDI, Vocabulary, Symbols, Cubes, and Rey´s Complex Figures. The Control Group patients, after hospital release, were directed to group work or AA, and the Intervention Group patients were assisted in four structured and planned sections, according to the model by William Miller (1992). The follow-up evaluation was done three months after the hospital release and the data were treated according to the Treating Intention Analisys and the comparison within each group as well as between them. The results show that 66% of patients from the Intervention Group undertook a follow-up exam, while 51% participated from the Control Group, there were more frequent losses in the Control Group than in the Intervention Group. The whithdrawal was higher in the Intervention Group than in the Control Group and even when there was relapse the amount of drinks was lower for the Intervention Group patients than for the Control Group. Concerning the scales that measure the Motivation for Change, the differences between the groups were significant for the sub-scale ambivalence and in the maintenance that represents that the Intervention Group patients have reduced their motivational ambivalence towards the problematic behavior. For the remaining scales the differences have been significant between the two groups. The conclusions of this study point to the efficency of the Motivational Intervention for subjects who are severe alcohol dependents; the subjects who undergo the Motivational Intervention present higher levels of compliance what implies consistent patterns of bonds with the therapy and, the solving of ambivalence. This change is characterized as a fundamental aspect for the treatment once the relapses take place in a “controlled” fashion, it is easier for the recovery. Therefore, the therapeutic basis of Motivational Intervention happens through empathy, making it possible for the patient to experience the changing of his own change.