MOTIVATIONAL ENHANCEMENT THERAPY FOR DEPRESSION, ANXIETY, AND PTSD IN SUBSTANCE USE DISORDERS: A QUASI-EXPERIMENTAL STUDY FROM PAKISTAN

Abstract

Background: Substance use disorders (SUDs) frequently co-occur with internalizing psychological problems, yet rehabilitation centres in Pakistan rarely integrate evidence-based psychological interventions targeting these comorbid conditions. Objective: This study evaluated the effectiveness of a four-session Motivational Enhancement Therapy (MET) intervention in reducing depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms among individuals with SUDs in Pakistani rehabilitation settings. Method: A quasi-experimental pretest-posttest design with a waitlist control group was employed. One hundred and two adult male participants were recruited from five rehabilitation centres in Islamabad/Rawalpindi and assigned to an MET intervention group (n = 51) or a waitlist control group receiving treatment as usual (n = 51). Depression (PHQ-9), anxiety (GAD-7), and PTSD (PCL-5) were assessed at baseline (T1) and post-intervention (T2). Results: The MET group demonstrated significant within-group reductions in depression (d = 1.70), anxiety (d = 2.09), and PTSD (d = 1.90), while the control group showed no significant changes. Between-group comparisons at T2 confirmed significantly lower scores for the MET group on depression (d = 1.08), anxiety (d = 0.82), and PTSD (d = 0.45). ANCOVA controlling for baseline scores and age yielded large effects: partial eta-squared = .43 (depression), .54 (anxiety), and .50 (PTSD). Treatment fidelity was high (M = 0.84) with a 96.1% completion rate. Conclusion: MET is an effective, feasible, and culturally acceptable intervention for reducing internalizing symptoms among individuals with SUDs in Pakistani rehabilitation settings. The findings support integrating brief motivational interventions into existing addiction treatment programmes.