Talk therapy may cut substance use more than nothing, but not other treatment

The review

1. 01

   Who took part

   59 studies with 13,342 people who had problems with alcohol, cannabis, cocaine or several drugs. Most of the studies were in the USA.

2. 02

   What they did

   Motivational interviewing is a talk therapy that helps people weigh their own reasons to change. Usually there were one to four sessions of about an hour. The studies compared it with no treatment, usual care, assessment with feedback or another active treatment.

3. 03

   What happened

   Compared with no treatment, people used less right after treatment and a little less later. There was no difference from usual care or other active treatments, though assessment with feedback did worse at six to twelve months. Many studies were at risk of bias, and small studies with weak results may be missing.

What the review found

1. Helped

   Across 4 studies, talk therapy cut drinking and drugs more than nothing, straight after treatment.

   • Action: Talk through your mixed feelings about changingtested
   • Rule: With a coach or therapistused

   Pooled analysis of 4 studies with 202 people · vs people who got nothing · the authors rated their certainty low · ⚠ signs that small negative studies went unpublished; whole programmes were tested, so no single part can be credited; mixes trials with other kinds of study

2. Helped

   Across 15 studies, talk therapy cut drinking and drugs a bit more than nothing, within six months.

   • Action: Talk through your mixed feelings about changingtested
   • Rule: With a coach or therapistused

   Pooled analysis of 15 studies with 2,327 people · vs people who got nothing · the authors rated their certainty moderate · ⚠ signs that small negative studies went unpublished; whole programmes were tested, so no single part can be credited; mixes trials with other kinds of study

3. Helped

   Across 12 studies, talk therapy cut drinking and drugs a bit more than nothing, from six to twelve months on.

   • Action: Talk through your mixed feelings about changingtested
   • Rule: With a coach or therapistused

   Pooled analysis of 12 studies with 2,326 people · vs people who got nothing · the authors rated their certainty low · ⚠ signs that small negative studies went unpublished; whole programmes were tested, so no single part can be credited; mixes trials with other kinds of study

4. No difference

   Across 12 studies, talk therapy did as well as other treatments for drinking or drugs within six months.

   • Action: Talk through your mixed feelings about changingtested

   Pooled analysis of 12 studies with 2,137 people · vs people on other active treatments · the authors rated their certainty moderate · ⚠ whole programmes were tested, so no single part can be credited; mixes trials with other kinds of study

Source