Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial

Objectives To evaluate the effectiveness of integrated motivational interviewing and cognitive behaviour therapy in addition to standard care for patients with psychosis and a co-morbid substance use problem. Design Two-centre, open, rater-blind randomised controlled trial Setting UK Secondary Care Participants 327 patients with clinical diagnoses of schizophrenia, schizophreniform or schizoaffective disorder and DSM-IV diagnoses of drug and/or alcohol dependence or abuse Interventions Participants were randomly allocated to integrated motivational interviewing and cognitive behaviour therapy or standard care. Therapy has two phases. Phase one – “motivation building” – concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. Phase two –“Action” – supports and facilitates change using cognitive behavioural approaches. Up to 26 therapy sessions were delivered over one year. Main outcomes The primary outcome was death from any cause or admission to hospital in the 12 months after therapy. Secondary outcomes were frequency and amount of substance use (Timeline Followback), readiness to change, perceived negative consequences of use, psychotic symptom ratings, number and duration of relapses, global assessment of functioning and deliberate self harm, at 12 and 24 months, with additional Timeline Followback assessments at 6 and 18 months. Analysis was by intention-to-treat with robust treatment effect estimates. Results 327 participants were randomised. 326 (99.7%) were assessed on the primary outcome, 246 (75.2%) on main secondary outcomes at 24 months. Regarding the primary outcome, there was no beneficial treatment effect on hospital admissions/ death during follow-up, with 20.2% (33/163) of controls and 23.3% (38/163) of the therapy group deceased or admitted (adjusted odds-ratio 1.16; P= 0.579; 95% confidence interval 0.68 to 1.99). For secondary outcomes there was no treatment effect on frequency of substance use or perceived negative consequences, but a statistically significant effect of therapy on amount used per substance-using day (adjusted odds-ratios: (a) for main substance 1.50; P=0.016; 1.08 to 2.09, (b) all substances 1.48; P=0.017; 1.07 to 2.05). There was a statistically significant treatment effect on readiness to change use at 12 months (adjusted odds-ratio 2.05; P=0.004; 1.26 to 3.31), not maintained at 24 months. There were no treatment effects on assessed clinical outcomes. Conclusions Integrated motivational interviewing and cognitive behaviour therapy for people with psychosis and substance misuse does not improve outcome in terms of hospitalisation, symptom outcomes or functioning. It does result in a reduction in amount of substance use which is maintained over the year’s follow up. Trial registration Current Controlled Trials: ISRCTN14404480

Stated willingness-to-pay for organic fruit and pesticide ban: an evaluation using both web-based and face-to-face interviewing

Income growth in highly industrialised countries has resulted in consumer choice of foodstuffs no longer being primarily influenced by basic factors such as price and organoleptic features. From this perspective, the present study sets out to evaluate how and to what extent consumer choice is influenced by the possible negative effects on health and environment caused by the consumption of fruit containing deposits of pesticides and chemical products. The study describes the results of a survey which explores and estimates consumer willingness to pay in two forms: a yearly contribution for the abolition of the use of pesticides on fruit, and a premium price for organically grown apples guaranteed by a certified label. The same questionnaire was administered to two samples. The first was a conventional face-to-face survey of customers of large retail outlets located around Bologna (Italy); the second was an Internet sample. The discrete choice data were analysed by means of probit and tobit models to estimate the utility consumers attribute to organically grown fruit and to a pesticide ban. The research also addresses questions of validity and representativeness as a fundamental problem in web-based surveys.

Interviewing children and young people with learning disabilities: guidelines for researchers and multi-professional practice

We argue that it is important for researchers and service providers to not only recognize the rights of children and young people with learning disabilities to have a ‘voice’, but also to work actively towards eliciting views from all. A set of guidelines for critical self-evaluation by those engaged in systematically collecting the views of children and young people with learning disabilities is proposed. The guidelines are based on a series of questions concerning: research aims and ethics (encompassing access/gatekeepers; consent/assent; confidentiality/anonymity/secrecy, recognition, feedback and ownership; and social responsibility) sampling, design and communication

Interviewing : a guide for journalists and writers

A practical guide to all aspects of interviewing for print and broadcast journalists and writers. The authors explain how to prepare, and what to do when you don't have time to prepare; outline the difference between "soft" and "hard" interviews; and show how to make the most of any interview.

Specialist training in investigative and evidential interviewing: is it having any effect on the behaviour of professionals in the field?

While numerous concerns have been voiced over the past decade regarding the inappropriate question styles of investigative and evidential interviewers, there has been relatively little research, discussion, and critique in relation to the content, structure, and efficacy of existing interviewer training courses. This article provides a brief up-to-date summary of the essential elements of an investigative or evidential interview, followed by a review of research relating to the effectiveness of training programs for forensic interviewers and the factors that are needed to promote the use of appropriate questioning techniques. Finally, this article offers recommendations for future research and for the revision of existing training programs in forensic interviewing.

Guidelines for interviewing children during child custody evaluations

This paper offers a brief review of the current literature related to the interviewing of children during child custody evaluations. In particular, the paper highlights several key issues and concerns, and provides a series of recommendations for professionals working in this area. These recommendations (which apply to children aged 3 to 12 years) are organised under the following headings: (a) establish rapport using broad open-ended questions, (b) make the purpose and ground rules of the interview clear to the child, (c) allow the child's perspective be heard without expecting an outright custody preference, (d) demonstrate a willingness to consider all reasonable perspectives or hypotheses about what has occurred, (e) try not to exacerbate the child's stress or guilt, (f) pursue all possible explanations for a child's report, irrespective of whether there are clear signs of “coaching” or contamination, (g) obtain appropriate training in the use of forensic interviewing techniques, and (h) engage in research on the impact of children's participation in custody cases.

The importance of using open-ended questions when interviewing children

In addition to making reference to best practices, already known, concerning the conduct of interviews with child victims of sexual abuse, the author describes some of the questions of development that must be made and the four benefits of free narrative. Despite the qualities of this type of approach, surveys show that professionals do not get the research, as a rule, free of narrative descriptions by children and that interviews tend to contain the short answer questions, with few breaks and an excessive number of closed questions and trick.According to trainers, experts in this field, there should be greater recognition of the interview as a forensic specialist skills and promote themselves to more effective supervision and monitoring of the forensic interview at work.