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Hilton CE. Behaviour change, the itchy spot of healthcare quality improvement: How can psychology theory and skills help to scratch the itch? Health Psychol Open 2023; 10:20551029231198938. [PMID: 37746584 PMCID: PMC10517624 DOI: 10.1177/20551029231198938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Despite the clear utility and transferability, National Health Service (NHS) quality improvement initiatives have yet to benefit fully from what is already known within health psychology. Thus far, evidence from established, seminal behaviour change theory and practice have been ignored in favour of newly developed models and frameworks. Further, whilst there is a growing interest in what is commonly referred to as 'human factors' of change and improvement, there is scant transferability of known psychologically informed implementation skills into routine NHS Improvement practice. The science and practice of healthcare improvement is growing, and the behaviour change aspect is critical to sustainable outcomes. Therefore, this paper offers practical guidance on how seminal psychological behaviour change theory and motivational interviewing (a person-centred skills-based approach specifically developed to support people through change) can be combined to better address individual and organisational change within a healthcare improvement context.
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Strodl E, Yang J. Motivational Interviewing Enhances Group Cognitive Behavioral Therapy for Anxiety Disorders. J Cogn Psychother 2021; 35:JCPSY-D-20-00025. [PMID: 33833090 DOI: 10.1891/jcpsy-d-20-00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This pilot study tested whether the addition of motivational interviewing (MI) prior to group cognitive behavioral therapy (CBT) for anxiety may improve the effectiveness of the treatment. Prior to group CBT, 40 individuals with a principal diagnosis of an anxiety disorder (40% panic disorder, 25% generalized anxiety disorder, 22.5% social phobia, and 12.5% others) were randomly assigned to receive either three individual sessions of MI or were assigned to a control group that did not receive MI. The pretreatment MI group, compared to the control group, experienced significantly greater reduction in anxiety symptoms post-CBT. These results suggest that brief MI pretreatment enhances the efficacy of CBT on anxiety. A combination of MI and CBT may be particularly promising for the treatment of anxiety, with MI directed at increasing motivation and commitment to change, and CBT directed at helping the client achieve the desired changes.
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Affiliation(s)
- Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joel Yang
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
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Wang Q, Lu Y. Coaching college students in the development of positive learning dispositions: A randomized control trial embedded mixed‐methods study. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Qing Wang
- Faculty of Education East China Normal University Shanghai China
| | - Yujie Lu
- School of Psychology and Cognitive Science East China Normal University Shanghai China
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Gibson LP, Gust CJ, Gillman AS, Bryan AD, Feldstein Ewing SW. Mechanisms of Action for Empirically Supported Interventions to Reduce Adolescent Sexual Risk Behavior: A Randomized Controlled Trial. J Adolesc Health 2020; 67:53-60. [PMID: 32169523 PMCID: PMC7311249 DOI: 10.1016/j.jadohealth.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/05/2019] [Accepted: 01/02/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Adolescents are at high risk for sexually transmitted infections, including HIV. Interventions to reduce adolescent sexual risk often have modest outcomes. Understanding of the mechanisms of program effectiveness is needed to develop stronger interventions. We used a randomized controlled trial to examine mechanisms of response to two empirically supported interventions: motivational interviewing versus behavioral skills training. METHODS A total of 262 adolescents (mean age = 15.89 years, standard deviation = 1.24; 34% female and 61% Latinx) were recruited from juvenile justice programs in the U.S.; all youth were randomized to motivational interviewing or behavioral skills training. Primary outcomes included (1) theory-based mechanisms (condom use attitudes, norms, self-efficacy, and intentions measured before and immediately after the interventions); and (2) risky sexual behavior (frequency of unprotected sex) and condom use measured 3 months postintervention. RESULTS Both interventions significantly increased positive attitudes toward condom use, self-efficacy for condom use, and intentions to use condoms post-test, with no differences by condition. Neither intervention impacted norms for condom use. Both interventions significantly decreased risky sexual behavior and increased condom use at the 3-month follow-up. The pattern of associations of Theory of Planned Behavior constructs to behavior were of similar magnitude in the two groups. CONCLUSIONS The results indicate common mechanisms of action for these two interventions and support the use of transdiagnostic mechanisms of treatment impact for sexual risk reduction.
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Affiliation(s)
- Laurel P. Gibson
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO USA
| | - Charleen J. Gust
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO USA
| | - Arielle S. Gillman
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO USA
| | - Angela D. Bryan
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO USA,,Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO USA
| | - Sarah W. Feldstein Ewing
- Division of Clinical Psychology, School of Medicine, Oregon Health and Science University, Portland, Oregon, USA
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Use of Motivational Interviewing to Improve Return-to-work and Work-related Outcomes: A Review. AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2014. [DOI: 10.1017/jrc.2014.5] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Work-based return-to-work (RTW) interventions can help to reduce the duration and cost of work disability, and in turn, prevent the negative effects of long-term sickness absence. However, there are a number of complex cognitive, affective and behavioural factors that can impact an individual's confidence, motivation and willingness to RTW that need to be addressed to facilitate effective outcomes. This literature review investigates evidence for the use of motivational interviewing (MI) for improving return-to-work (RTW) and employment outcomes. Whilst evidence for the efficacy of MI in clinical settings to motivate health behaviour change is strong, more research is needed to determine whether MI can be usefully applied to improve RTW and other work-related outcomes.
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Patel SH, Lambie GW, Glover MM. Motivational Counseling: Implications for Counseling Male Juvenile Sex Offenders. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2011. [DOI: 10.1002/j.2161-1874.2008.tb00035.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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THOMPSON SUZANNEC, ROBBINS TERESA, PAYNE REBECCA, CASTILLO CHRISTINA. Message Derogation and Self-Distancing Denial: Situational and Dispositional Influences on the Use of Denial to Protect Against a Threatening Message1. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2011. [DOI: 10.1111/j.1559-1816.2011.00855.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lawson G, Lambert SF, Gressard CF. Reframing Recovery: Developmental Considerations for Maintaining Change. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2011. [DOI: 10.1002/j.2161-1874.2011.tb00208.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bricker J, Tollison S. Comparison of motivational interviewing with acceptance and commitment therapy: a conceptual and clinical review. Behav Cogn Psychother 2011; 39:541-59. [PMID: 21338532 PMCID: PMC3135725 DOI: 10.1017/s1352465810000901] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Motivational Interviewing (MI) and Acceptance and Commitment Therapy (ACT) are two emerging therapies that focus on commitment to behavior change. AIM The aim was to provide the first systematic comparison of MI with ACT. METHOD A systematic comparison was undertaken of MI and ACT at the conceptual level, with a focus on their philosophical and theoretical bases, and at the clinical level, with a focus on the therapeutic relationship, use of language in therapy, and use of values in therapy. RESULTS Conceptually, MI and ACT have distinct philosophical bases. MI's theoretical basis focuses on language content, whereas ACT's theoretical basis focuses on language process. Clinically, ACT and MI have distinct approaches to the therapeutic relationship, fundamentally different foci on client language, and different uses of client values to motivate behavior change. ACT, but not MI, directly targets the willingness to experience thoughts, feelings, and sensations. CONCLUSIONS Despite their conceptual and clinical differences, MI and ACT are complementary interventions. Collaborations between MI and ACT researchers may yield fruitful cross-fertilization research on core processes and clinical outcomes.
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Affiliation(s)
- Jonathan Bricker
- Fred Hutchinson Cancer Research Center and University of Washington, Seattle, USA
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Chair SY, Chan SWC, Thompson DR, Leung KP, Ng SKC, Choi KC. Short-term effect of motivational interviewing on clinical and psychological outcomes and health-related quality of life in cardiac rehabilitation patients with poor motivation in Hong Kong: a randomized controlled trial. Eur J Prev Cardiol 2011; 19:1383-92. [PMID: 21960653 DOI: 10.1177/1741826711425428] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Motivational interviewing (MI) is effective in promoting behavioural changes in patients with substance abuse and smoking. However, its effectiveness on health outcomes in cardiac rehabilitation patients is unclear. DESIGN A randomized controlled trial. METHOD A total of 146 patients assessed as having poor motivation attended a cardiac rehabilitation programme from February 2008 to June 2010. Patients (n = 73) in the control group received usual care while those in the experimental group (n = 73) received usual care plus four sessions of MI, each lasting 30-45 min. Clinical and psychological outcomes and health-related quality of life were measured at baseline and 3 months after entering the programme. Descriptive statistics, independent t-test, Pearson Chi-squared test, and generalized estimating equations models were used to analyse the data. RESULTS There was no significant difference between the two groups on clinical outcomes (all p-values >0.05). Patients in the experimental group had higher increases in health-related quality of life (SF-36) scores in the aspects of general health (4.74, 95% CI 0.04-9.44; p = 0.048) and role limitation due to emotional problems (8.80, 95% CI 1.16-16.43; p = 0.024). However, they reported significantly higher increases in anxiety levels (Hospital Anxiety and Depression Scale) than those in the control group (0.96, 95% CI 0.09-1.83; p = 0.030). CONCLUSION The short-term effectiveness of MI on clinical outcomes and health-related quality of life in poorly motivated cardiac rehabilitation patients is limited. MI, however, was shown to increase anxiety levels of patients during the study period (3 months). More evidence is needed to better understand this phenomenon in the future studies.
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Wain RM, Wilbourne PL, Harris KW, Pierson H, Teleki J, Burling TA, Lovett S. Motivational interview improves treatment entry in homeless veterans. Drug Alcohol Depend 2011; 115:113-9. [PMID: 21145181 DOI: 10.1016/j.drugalcdep.2010.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 10/29/2010] [Accepted: 11/02/2010] [Indexed: 11/19/2022]
Abstract
Motivational Interviewing (MI) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs. Some questions have been raised as to the effectiveness of MI in severely distressed populations. This study aims to assess the effectiveness of MI in a population of homeless, unemployed, and substance dependent veterans who are being wait-listed for entry into a residential treatment program. Seventy-five veterans placed on a wait-list were randomized to receive a single MI or standard (Std) intake interview. Outcomes assessed were entry, and length of stay (LOS). Secondary outcomes assessed included program completion and rates of graduation. Readiness to change and self-efficacy were assessed before and after the interview. Significantly more participants entered the program in the MI group (95%) than in the Std group (71%). Although those in the MI group remained in the program longer, and had higher program completion and graduation rates, these differences were not statistically significant. No significant between-group or within-group differences were found in readiness or self-efficacy. This study demonstrates that a single, easily administered intervention can increase program entry. Also based on the study findings, further research into the question of whether MI can increase program retention, in a severely distressed population, is warranted.
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Affiliation(s)
- R Morgan Wain
- VA Palo Alto Health Care System, 180D, 795 Willow Road, Menlo Park, CA 94025, USA
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Hind D, Scott EJ, Copeland R, Breckon JD, Crank H, Walters SJ, Brazier JE, Nicholl J, Cooper C, Goyder E. A randomised controlled trial and cost-effectiveness evaluation of "booster" interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods. BMC Public Health 2010; 10:3. [PMID: 20047672 PMCID: PMC2819992 DOI: 10.1186/1471-2458-10-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Accepted: 01/04/2010] [Indexed: 11/23/2022] Open
Abstract
Background Systematic reviews have identified a range of brief interventions which increase physical activity in previously sedentary people. There is an absence of evidence about whether follow up beyond three months can maintain long term physical activity. This study assesses whether it is worth providing motivational interviews, three months after giving initial advice, to those who have become more active. Methods/Design Study candidates (n = 1500) will initially be given an interactive DVD and receive two telephone follow ups at monthly intervals checking on receipt and use of the DVD. Only those that have increased their physical activity after three months (n = 600) will be randomised into the study. These participants will receive either a "mini booster" (n = 200), "full booster" (n = 200) or no booster (n = 200). The "mini booster" consists of two telephone calls one month apart to discuss physical activity and maintenance strategies. The "full booster" consists of a face-to-face meeting with the facilitator at the same intervals. The purpose of these booster sessions is to help the individual maintain their increase in physical activity. Differences in physical activity, quality of life and costs associated with the booster interventions, will be measured three and nine months from randomisation. The research will be conducted in 20 of the most deprived neighbourhoods in Sheffield, which have large, ethnically diverse populations, high levels of economic deprivation, low levels of physical activity, poorer health and shorter life expectancy. Participants will be recruited through general practices and community groups, as well as by postal invitation, to ensure the participation of minority ethnic groups and those with lower levels of literacy. Sheffield City Council and Primary Care Trust fund a range of facilities and activities to promote physical activity and variations in access to these between neighbourhoods will make it possible to examine whether the effectiveness of the intervention is modified by access to community facilities. A one-year integrated feasibility study will confirm that recruitment targets are achievable based on a 10% sample. Discussion The choice of study population, study interventions, brief intervention preceding the study, and outcome measure are discussed. Trial Registration Current Controlled Trials: ISRCTN56495859; ClinicalTrials.gov: NCT00836459.
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Affiliation(s)
- Daniel Hind
- Clinical Trials Research Unit, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
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L’entretien motivationnel, une nouvelle « panacée » dans la prise en charge de patients toxicodépendants ? Une revue de littérature. PRAT PSYCHOL 2009. [DOI: 10.1016/j.prps.2008.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Saarnio P, Knuuttila V. Readiness to Change Profiles in Two Different Groups of Alcohol/Other Drug Abusers in the United States and Finland. ALCOHOLISM TREATMENT QUARTERLY 2008. [DOI: 10.1080/07347320802072099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Pekka Saarnio
- a University of Tampere, Department of Social Policy and Social Work , FI-33014 University of Tampere, Finland E-mail:
| | - Vesa Knuuttila
- b Kankaanpää A-koti , P.O.Box 57, FI-38701, Kankaanpää, Finland E-mail:
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Hancock K, Davidson PM, Daly J, Webber D, Chang E. An exploration of the usefulness of motivational interviewing in facilitating secondary prevention gains in cardiac rehabilitation. ACTA ACUST UNITED AC 2006; 25:200-6. [PMID: 16056065 DOI: 10.1097/00008483-200507000-00004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Motivational interviewing is a client-centered, directive counseling approach aimed at promoting motivation in clients to change certain behaviors. Its effect is to reduce defensiveness and promote disclosure, engagement, and participation, thereby motivating the client to make behavioral changes. Motivational interviewing marries well with the principles of cardiac rehabilitation (CR) in terms of increasing motivation among CR clients, promoting a client-centered approach and in the cost- and time-effective practices of CR. Very little research has been conducted examining the effectiveness of motivational interviewing in enhancing CR outcomes. This article discusses research that has been conducted in motivational interviewing that relates to the components of CR, provides examples of how motivational interviewing can be applied to CR, and recommends further exploration, development, and investigation of the usefulness of motivational interviewing in the field of CR.
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Affiliation(s)
- Karen Hancock
- School of Nursing, Family and Community Health, University of Western Sydney, New South Wales, Australia.
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Foley K, Duran B, Morris P, Lucero J, Jiang Y, Baxter B, Harrison M, Shurley M, Shorty E, Joe D, Iralu J, Davidson-Stroh L, Foster L, Begay MG, Sonleiter N. Using motivational interviewing to promote HIV testing at an American Indian substance abuse treatment facility. J Psychoactive Drugs 2005; 37:321-9. [PMID: 16295016 DOI: 10.1080/02791072.2005.10400526] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Alcohol and drug use are associated with increased risk of HIV/AIDS. American Indians and Alaska Natives (AI/AN) have high rates of alcohol and other drug use, as well as a high incidence of unsafe sex behaviors and injection drug use practices. Indicators of AI/AN HIV risks involving sexual activity include high rates of STDs, such as gonorrhea, chlamydia, and syphilis. Despite these facts, the prevalence of HIV infection among AI/AN is not well known. The present study is part of a HRSA-funded SPNS HIV/AIDS health initiative, one goal of which is to increase the number of HIV-positive individuals who know their HIV status. To meet the goal of the SPNS project, patients in an inpatient alcohol and drug treatment center were provided with an HIV prevention educational presentation followed by one-on-one HIV counseling. Motivational interviewing was used in the counseling sessions to aid participants in recognizing their risk status and making a decision to be HIV tested. Results show that of the 134 who agreed to one-on-one HIV counseling and 105 (78%) returned for their results.
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