Integration Of Motivational Interviewing Research Articles

W155 - Preparing the Addiction Workforce to Practice Informed Eclecticism Through Integration of Motivational Interviewing and Cognitive-Behavioral Therapy

W155 - Preparing the Addiction Workforce to Practice Informed Eclecticism Through Integration of Motivational Interviewing and Cognitive-Behavioral Therapy

Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial)

IntroductionCurrent treatments for pain in breast cancer survivors (BCSs) are mostly biomedically focused rather than biopsychosocially driven. However, 22% of BCSs with pain are experiencing perceived injustice, which is a...

Integration of Motivational Interviewing and Self-Affirmation Theory into a Culturally Adapted Motivational Interview: A Case Study

Annually, alcohol, tobacco, and illicit drug use are responsible for the 11.8 million deaths worldwide, exceeding the number of deaths from all cancers ( Ritchie & Roser, 2018 ). Motivational Interviewing (MI), a person-centered addiction counseling approach ( Miller & Rollnick, 2013 ), is designed for those with low motivation to change. MI is presumed to minimize client defensiveness by avoiding confrontation. Culturally adapting evidence-based treatments such as MI may reduce alcohol-related health disparities among Latinx adults. A completed randomized trial tested the relative efficacy of Culturally Adapted Motivational Interview (CAMI) compared to MI in Latinx drinkers. CAMI had beneficial alcohol use effects among persons who reported high discrimination and stigma ( Lee et al., 2019 ). Self-Affirmation Theory, which provides a mechanism where stigma effects can be buffered, was integrated into the CAMI. Augmenting affirmation in the CAMI is postulated to lower defensiveness and increase openness to information that pose a threat to self-image ( Sherman & Cohen, 2006 ). The purpose of this case example is to present the novel features of CAMI and to suggest how affirmation may have played in the CAMI’s beneficial effects for individuals with high discrimination. The case example illustrates how the CAMI addresses three conditions for self-affirmation associated with strongest effects on motivating behavior change ( Ferrer & Cohen, 2019 ): the presence of psychological threat, timing and availability of resources.

Can the integration of Motivational Interviewing skills in a virtual self-conversation be effective in promoting lifestyle changes among healthy adults and patients with obesity? A usability study

IntroductionThe integration of Motivational Interviewing (MI) with behavioural and psychological interventions for the treatment of obesity has the potential to improve health-related outcomes of patients in the long-term.ObjectivesOur objective is to examine the usability of a VR embodiment tool for treating obesity.MethodsFourteen participants (6 healthy and 8 with morbid obesity) with a desire to make lifestyle changes were randomly assigned to the experimental group (EG) and the control group (CG). Participants from the EG engaged in a virtual self-conversation aiming at understanding their own motivation to make lifestyle changes. Using the body swapping technique, participants were embodied alternately in their own virtual representation and in their counsellor’s body. To better guide this virtual self-conversation, participants were previously trained on MI skills. Participants from the CG were embodied in their own virtual bodies and participated in a “scripted dialogue” with a virtual counsellor who gave them practical recommendations about how to achieve lifestyle changes. A mixed-methods design was used, involving a semi-structured interview examining users´ satisfaction with the virtual experience, as well as self-report questionnaires, including readiness to change habits, body ownership, and system usability.ResultsParticipants showed high usability of the platform with higher scores among participants from the EG compared to the CG. Levels of body ownership were satisfactory, with no differences between groups.ConclusionsThrough the integration of MI in the VR context with the patient being properly trained to carry out his/her own motivational self-conversation, we will provide an important advance in the psychological treatments of obesity.DisclosureThis project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 951930

Integration of Motivational Interviewing Within Prelicensure Nursing Programs: A National Survey.

Vital to the nurse-patient partnership is the use of active listening and a clear understanding of the patient's health care goals. Motivational Interviewing is an evidence-based, patient-centered communication technique that assists patients in self-identifying and committing to health behavior change. This study explored whether, where, and how Motivational Interviewing is integrated into current prelicensure nursing curricula. An exploratory, descriptive study incorporated a researcher-developed survey. Participants (N = 112) represented 5 types of prelicensure nursing programs from across the United States. Forty-one participants reported using Motivational Interviewing within their program with accreditation being the primary rationale. Seventy-one participants reported not integrating Motivational Interviewing within their program with lack of knowledge being the primary rationale. Further research on optimizing the integration of Motivational Interviewing educational content and practice into all levels and specialty areas of nursing education would help to identify best practices.

Integration of motivational interviewing and behavioral economic theories to enhance brief alcohol interventions: Rationale and preliminary examination of client language.

Motivational interviewing (MI) is a widely disseminated evidence-based therapeutic approach for engaging clients and motivating health behavior change, especially risky substance use. Refinement of MI theory over the past few decades has provided empirical evidence that the technical component of MI (in-session client language) is a promising mechanism of behavior change (MOBC). However, heterogeneous and small to moderate effect sizes suggest the need for refinement of MOBC measurement and consideration of other types of client language. The current article presents a complementary integration of current MI theory and behavioral economic (BE) mechanisms to further understanding of in-session factors associated with subsequent behavior change. In this paper, we define some of the key MOBCs from MI and BE theories, describe our integrated framework, and present preliminary findings from a pilot study of the effectiveness and MOBCs of a novel BE-informed application of MI in risky college student drinkers. Results from preliminary coding development suggest that BE-informed measures of client language better predict response to a brief intervention in risky college students than traditional change talk measures. We posit that BE theory can offer insight into meaningful session content beyond the current MI constructs of change talk and sustain talk, which in turn may serve to enhance development of clinical practice and inform scientific investigations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Integrating Motivational Interviewing and Brief Behavioral Activation Therapy: Theoretical and Practical Considerations

Behavioral Activation and specifically the Brief Behavioral Activation Therapy for Depression (BATD) has a strong record of empirical support but its focus on practical out-of-session activation-based assignments can lead to poor levels of adherence if efforts to enhance motivation are not prioritized. Towards this end, this paper describes the assimilative integration of Motivational Interviewing (MI) and BATD to improve clinical outcomes by integrating MI’s focus on building and maintaining motivation to change into BATD. The paper provides an overview of MI and BATD, theoretical issue raised in integrating the two approaches, and examples of how this integration results in a nondirective and motivation-focused approach to conducting BATD.

Integration of Motivational Interviewing into Practice in the National Exercise Referral Scheme in Wales: A Mixed Methods Study

Though motivational interviewing (MI) has demonstrated efficacy in a range of behaviour change settings, effectiveness will require successful integration into everyday practice. This study examines implementers' views on delivering MI within an exercise referral scheme and consistency of consultations with MI before and after a 2-day workshop. Semi-structured interviews were conducted with 27 exercise professionals and 10 area coordinators delivering the Welsh National Exercise Referral Scheme (NERS), and the MI trainer. Eleven professionals provided consultation recordings before and 6-months after training, coded for fidelity using the Behaviour Change Counselling Index. The workshop was well received by most, triggering increased recognition of potential motivational roles of consultations. However, some cited difficulties combining MI with structured data gathering activities, whilst a minority rejected MI, seeing current practice as effective, or MI as unnecessary because patients were ready to change. Although limited aggregate improvement in practice was observed, substantial improvements were observed in some individuals. Comments on the need for further practice or training were widespread. Efforts to implement MI should ensure that training and structures to provide monitoring and feedback are in place and that activities incorporated within consultations are compatible with MI delivery.

Setting the Stage for the Integration of Motivational Interviewing With Cognitive Behavioral Therapy in the Treatment of Depression

Unipolar depression is one of the most disabling and costly medical illnesses in the world (Lancet Global Mental Health Group et al., 2007; Moussavi et al., 2007). Cognitive behavioral therapy (CBT), a widely studied and taught psychotherapeutic treatment for depression, is among the recommended evidence-based treatments. Although CBT and other treatments are largely effective, many depressed individuals do not fully respond to treatment, leaving them vulnerable for relapse and poor outcomes over the lifespan. This article explores the integration of Motivational Interviewing (MI) as one possible strategy of enhancing CBT outcomes. MI provides an evidence-based approach to addressing motivation for treatment and emphasizing key therapist-client interactional factors that have been linked to clinical outcomes. As such, it may be synergistic with specific aspects of CBT, such as enhancing therapeutic alliance, motivation, and specifically addressing ambivalence/resistance affecting treatment engagement, retention and adherence to various aspects of the treatment (such as homework). For clinicians learning CBT, MI may also provide a specified model for learning basic psychotherapeutic skills such as empathy, collaboration, and client-centered active listening. Given the urgency of improving the potency of depression treatments, the extent to which the blending of a MI with CBT will improve the overall effectiveness is worthy of clinical research.

Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Eating Disorders: Tailoring Interventions to Patient Readiness for Change

This paper focuses on the integration of Motivational Interviewing (MI) and cognitive behavioral therapy (CBT) in the treatment of eating disorders. Although CBT is regarded as the treatment of choice in this population, it nevertheless has limitations: some patients fail to engage, drop out from treatment prematurely, or simply do not improve. These are common problems in a population characterized by high levels of ambivalence about change. MI strategies can assist clinicians in enhancing readiness for change, tailoring interventions to patient readiness status, and maintaining a therapeutic alliance throughout all stages of treatment. Preliminary research examining the efficacy of adaptations of MI in the treatment of individuals with eating disorders has been promising. This paper presents 4 patient scenarios involving individuals with varying degrees of readiness and in the context of different treatment settings. For each patient scenario, key issues are described and common roadblocks to developing or maintaining a therapeutic alliance are provided. Vignettes illustrate conversations between the patient and therapist for each scenario, highlighting how MI techniques can be integrated into CBT treatment and promote a working therapeutic relationship that enhances long-term treatment outcome.

Integration of Motivational Interviewing and Cognitive Behavioral Therapy to Improve HIV Medication Adherence and Reduce Substance Use Among HIV-Positive Men and Women: Results of a Pilot Project

Directly addressing HIV medication adherence and substance use together is ideal in light of the research on the complex connections between these two behaviors. This paper describes the development of a pilot program in which a combined motivational interviewing and cognitive behavioral therapy intervention was used to increase adherence to highly active antiretroviral therapy (HAART) and reduce substance use in HIV-infected adults. The main goals of the pilot study were (1) to confirm the ability to recruit HIV-positive substance users taking HAART; (2) to demonstrate the ability to retain participants over the course of an eight-session intervention; and (3) to examine changes in substance use and HAART adherence from pretreatment to posttreatment. Twelve HIV-positive adults with a substance use disorder participated in an 8-week intervention, which consisted of weekly individual sessions with a trained therapist. Results showed that despite the small sample size, there was a significant reduction in substance use from pretreatment to posttreatment. No statistically significant differences were found for changes in HIV medication adherence, but the trends suggest the potential for positive results with a larger sample. Retention for all eight sessions of the treatment was 73.3%. Eighty percent completed the 3-month follow-up assessment. Participants reported high therapeutic alliance reflecting comfort with their therapists and in the treatment. Overall, the pilot demonstrated feasibility and acceptability of the treatment. Furthermore, results suggest that this may, in fact, be an effective intervention to reduce substance use and improve HIV medication adherence.