ผลของโปรแกรมเสริมสร้างแรงจูงใจต่อความพร้อมในการเปลี่ยนแปลงพฤติกรรม ในผู้ป่วยจิตเวชสารเสพติดในระยะเตรียมจำหน่าย

Sarinya Chansuk; Kochanipa kwawong; Natchamonphan Pluemroongroj; Kaniwan Poosa; Methavee Punyasawad; Kanchana Buddee

Authors

Sarinya Chansuk Faculty of Nursing, Udon Thani Rajabhat University
Kochanipa kwawong Faculty of Nursing, Udon Thani Rajabhat University
Natchamonphan Pluemroongroj Nongkhai Hospital
Kaniwan Poosa Nongkhai Hospital
Methavee Punyasawad Nongkhai Hospital
Kanchana Buddee Nongkhai Hospital

Keywords:

substance-induced psychosis, pre-discharge phase, motivational enhancement program, readiness to change

Abstract

Introduction: Behavioral problems and risks among psychiatric patients with substance use disorders are increasing, affecting both social safety and patients’ quality of life. Treatment in general hospitals is often constrained by the short length of stay, which limits the provision of adequate psychosocial therapy and may increase the risk of relapse in substance use.

Research objectives: To examine the effects of a motivational enhancement program on readiness to change for relapse prevention among psychiatric inpatients with substance use disorders during the pre-discharge phase.

Research methodology: This quasi-experimental study employed a two-group pretest-posttest design with repeated measures. The sample consisted of 46 psychiatric inpatients with substance use disorders in the pre-discharge phase at Nong Khai Hospital, selected through purposive sampling and divided into an experimental group (n = 23) and a control group (n = 23). The research instruments included: 1) the motivational enhancement program, and 2) the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES-8D). The content validity of the program was assessed by experts, yielding an average item-objective congruence score ranging from .67 to 1. The readiness-to-change scale demonstrated high reliability, with a Cronbach’s alpha coefficient of .87. Data were analyzed using descriptive statistics, paired sample t-tests, and independent sample t-tests.

Results: The experimental group showed significantly higher mean readiness-to-change scores at the immediate posttest compared to the pretest, and the scores at 2-week follow-up were significantly higher than the immediate posttest scores. Furthermore, the readiness-to-change scores of the experimental group were significantly higher than those of the control group at both the immediate posttest and the 2-week follow-up (p < .05).

Conclusions: The motivational enhancement program effectively increases motivation to change and promotes problem recognition among psychiatric inpatients with substance use disorders during the pre-discharge phase.

Implications: Substance use treatment units should implement this program during the rehabilitation phase to enhance patients’ readiness for behavioral change.

Downloads

Download data is not yet available.

References

Chuta W, Buapuan S. New incidence rates of drug-related disorders and behaviors in Thai people: Health Data Center (HDC) 2023 [Internet]. 2023 [cited 2025 Jul 11]. Available from: https://dmh-elibrary.org/items/show/1688. (in Thai)

High focus Treatment Centers. Relapse statistics you need to know [Internet]. 2022 [cited 2025 Jul 11]. Available from: https://pa.highfocuscenters.com/relapse-statistics-you-need-to-know/

Miller WR, Rollnick S. Motivational interviewing. 3rd ed. New York: Guilford Press; 2013.

Prochaska JO, DiClemente CC. Transtheoretical therapy: toward a more integrative model of change. Psychotherapy 1982;19(3):276-88.

Saengchanchai P. Handbook of addiction psychiatry. Bangkok: Addiction Psychiatry Association; 2022.

Nuansit S, Sriraksa J, Sumpatanarax T, Khotchanam S. Effect of modify motivational enhancement therapy program on readiness and treatment acceptance of substance-use patients in initial treatment. Songklanagarind Journal of Nursing 2022;42(2):163-77. Available from: https://he02.tci-thaijo.org/index.php/nur-psu/article/view/255301/176499 (in Thai)

Sirinanunth Y, Sriruecha C, Isrankura Na Ayudhya V. Effectiveness of the motivational interviewing program on change readiness and treatment needs among the amphetamine addicts, Si Chomphu District, Khon Kaen Province Academic Journal of Community Public Health 2023;9(2):159-68. Available from: https://he02.tci-thaijo.org/index.php/ajcph/article/view/261136 (in Thai)

Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New Jersey: Lowrence Erlbaum Associates; 1998.

Santa Ana EJ, Wulfert E, Nietert PJ. Efficacy of group motivational interviewing (GMI) for psychiatric inpatients with chemical dependence. Journal of Consulting and Clinical Psychology 2007;75(5):816-22. Academic Journal of Community Public Health 2023;9(2):159-68. Available from: https://doi.org/10.1037/0022-006X.75.5.816

Miller WR, Tonigan JS. Assessing drinkers' motivation for change: the stages of change readiness and treatment eagerness scale (SOCRATES). Psychology of Addictive Behaviors 1996;10:81-9. Available from: https://doi.org/10.1037/0893-164X.10.2.81

Saengchanchai P, Phukhao D, Sombatmai S, Sraubon N, Nokknoi S, Uthis P. Counseling and therapy to enhance motivation in patients with alcohol drinking problems. Chiang Mai: Wanida Printing; 2010. (in Thai)

Kittirattanaphaiboon P, Booncharoen H. Clinical practice guideline for mental health services for individuals with alcohol problems in psychiatric hospitals. Chiang Mai: I Am Organizer and Advertiser; 2006. (in Thai)

Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. American Journal of Health Promotion 1997;12(1):38–48.

Ryan RM, Deci EL. Intrinsic motivation and self-determination in human behavior. New York: Springer; 2020.

Kumar S, Srivastava M, Srivastava M, Yadav JS, Prakash S. Effect of motivational enhancement therapy (MET) on the self-efficacy of individuals of alcohol dependence. Journal of Family Medicine and Primary Care 2021;10(1):367–72.

Abdel Moneam MH, Mohsen N, Azzam LA, Elshahat Y, Saleh I. The outcome of integrated motivational interviewing and cognitive-behavioral therapy in Egyptian patients with substance use disorder. Middle East Current Psychiatry 2023;30(1):1-12.

Hsiao HY, Wang TY, Lee CH, Lu YC, Huang YC, Chien YC, et al. Advancing readiness for change in substance use for people with substance use disorders using the Kawa model based intervention program: a quasi-experimental study. Hong Kong Journal of Occupational Therapy 2024;37(2):91–101. Available from: https://doi.org/10.1177/15691861241268143