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Mercado J, Espinosa-Curiel IE, Martínez-Miranda J. Embodied Conversational Agents Providing Motivational Interviewing to Improve Health-Related Behaviors: Scoping Review. J Med Internet Res 2023; 25:e52097. [PMID: 38064707 PMCID: PMC10746972 DOI: 10.2196/52097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/20/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Embodied conversational agents (ECAs) are advanced human-like interfaces that engage users in natural face-to-face conversations and interactions. These traits position ECAs as innovative tools for delivering interventions for promoting health-related behavior adoption. This includes motivational interviewing (MI), a therapeutic approach that combines brief interventions with motivational techniques to encourage the adoption of healthier behaviors. OBJECTIVE This study aims to identify the health issues addressed by ECAs delivering MI interventions, explore the key characteristics of these ECAs (eg, appearance, dialogue mechanism, emotional model), analyze the implementation of MI principles and techniques within ECAs, and examine the evaluation methods and primary outcomes of studies that use ECAs providing MI interventions. METHODS We conducted a scoping review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) methodology. Our systematic search covered the PubMed, Scopus, IEEE Xplore, ACM Digital, and PsycINFO databases for papers published between January 2008 and December 2022. We included papers describing ECAs developed for delivering MI interventions targeting health-related behaviors and excluded articles that did not describe ECAs with human appearances and without the necessary evaluation or MI explanation. In a multistage process, 3 independent reviewers performed screening and data extraction, and the collected data were synthesized using a narrative approach. RESULTS The initial search identified 404 articles, of which 3.5% (n=14) were included in the review. ECAs primarily focused on reducing alcohol use (n=5, 36%), took on female representations (n=9, 64%), and gave limited consideration to user ethnicity (n=9, 64%). Most of them used rules-driven dialogue mechanisms (n=13, 93%), include emotional behavior to convey empathy (n=8, 57%) but without an automatic recognition of user emotions (n=12, 86%). Regarding MI implementation, of 14 studies, 3 (21%) covered all MI principles, 4 (29%) included all processes, and none covered all techniques. Most studies (8/14, 57%) conducted acceptability, usability, and user experience assessments, whereas a smaller proportion (4/14, 29%) used randomized controlled trials to evaluate behavior changes. Overall, the studies reported positive results regarding acceptability, usability, and user experience and showed promising outcomes in changes in attitudes, beliefs, motivation, and behavior. CONCLUSIONS This study revealed significant advancements in the use of ECAs for delivering MI interventions aimed at promoting healthier behaviors over the past 15 years. However, this review emphasizes the need for a more in-depth exploration of ECA characteristics. In addition, there is a need for the enhanced integration of MI principles, processes, and techniques into ECAs. Although acceptability and usability have received considerable attention, there is a compelling argument for placing a stronger emphasis on assessing changes in attitudes, beliefs, motivation, and behavior. Consequently, inclusion of more randomized controlled trials is essential for comprehensive intervention evaluations.
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Affiliation(s)
- José Mercado
- Unidad de Transferencia Tecnológica Tepic, Centro de Investigación Científica y de Educación Superior de Ensenada, Tepic, Nayarit, Mexico
| | - Ismael Edrein Espinosa-Curiel
- Unidad de Transferencia Tecnológica Tepic, Centro de Investigación Científica y de Educación Superior de Ensenada, Tepic, Nayarit, Mexico
| | - Juan Martínez-Miranda
- Unidad de Transferencia Tecnológica Tepic, Centro de Investigación Científica y de Educación Superior de Ensenada, Tepic, Nayarit, Mexico
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Sarkar S, Gaur M, Chen LK, Garg M, Srivastava B. A review of the explainability and safety of conversational agents for mental health to identify avenues for improvement. Front Artif Intell 2023; 6:1229805. [PMID: 37899961 PMCID: PMC10601652 DOI: 10.3389/frai.2023.1229805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 08/29/2023] [Indexed: 10/31/2023] Open
Abstract
Virtual Mental Health Assistants (VMHAs) continuously evolve to support the overloaded global healthcare system, which receives approximately 60 million primary care visits and 6 million emergency room visits annually. These systems, developed by clinical psychologists, psychiatrists, and AI researchers, are designed to aid in Cognitive Behavioral Therapy (CBT). The main focus of VMHAs is to provide relevant information to mental health professionals (MHPs) and engage in meaningful conversations to support individuals with mental health conditions. However, certain gaps prevent VMHAs from fully delivering on their promise during active communications. One of the gaps is their inability to explain their decisions to patients and MHPs, making conversations less trustworthy. Additionally, VMHAs can be vulnerable in providing unsafe responses to patient queries, further undermining their reliability. In this review, we assess the current state of VMHAs on the grounds of user-level explainability and safety, a set of desired properties for the broader adoption of VMHAs. This includes the examination of ChatGPT, a conversation agent developed on AI-driven models: GPT3.5 and GPT-4, that has been proposed for use in providing mental health services. By harnessing the collaborative and impactful contributions of AI, natural language processing, and the mental health professionals (MHPs) community, the review identifies opportunities for technological progress in VMHAs to ensure their capabilities include explainable and safe behaviors. It also emphasizes the importance of measures to guarantee that these advancements align with the promise of fostering trustworthy conversations.
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Affiliation(s)
- Surjodeep Sarkar
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, Baltimore, MD, United States
| | - Manas Gaur
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore County, Baltimore, MD, United States
| | - Lujie Karen Chen
- Department of Information Systems, University of Maryland, Baltimore County, Baltimore, MD, United States
| | - Muskan Garg
- Department of AI & Informatics, Mayo Clinic, Rochester, MN, United States
| | - Biplav Srivastava
- AI Institute, University of South Carolina, Columbia, SC, United States
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Erschens R, Fahse B, Festl-Wietek T, Herrmann-Werner A, Keifenheim KE, Zipfel S, Fallgatter AJ, Velten-Schurian K. Training medical students in motivational interviewing using a blended learning approach: a proof-of-concept study. Front Psychol 2023; 14:1204810. [PMID: 37546454 PMCID: PMC10400288 DOI: 10.3389/fpsyg.2023.1204810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Background Difficulties in implementing behavior change in patients with chronic diseases are common in clinical practice. Motivational interviewing (MI) helps clinicians to support patients in overcoming ambivalence while maintaining self-determination. The inclusion of MI in German medical training curricula is still rare. Furthermore, the effects of systematic teaching of MI, especially via blended learning, have hardly been investigated. Methods Medical students participated in three curricular events related to MI, consisting of instructional videos and theoretical and practical components in a blended learning format. The aim of the study was to investigate the effect of teaching MI in students' medical education. A controlled, non-randomized study was conducted with an intervention group and a control group. Both groups completed questionnaires on their experience and knowledge related to MI, completed a knowledge test and rated their satisfaction with the course. MI was taught in the 6th semester of medical coursework as part of a psychosomatic course, in the 8th semester during a psychiatry course and in the 9th semester during a weekly psychiatry clerkship. Results Data from the intervention group (n = 35) and control group (n = 14) were analyzed, with 65.7% of students participating in all three parts of the curriculum. Overall interest in learning MI was high, with M = 2.92 (SD = 1.00). The results indicate a greater increase in knowledge over time in the intervention group. The majority (62.86%) stated that the curriculum was relevant to their future career. Free-form text responses indicated a high level of satisfaction with practical relevance. Conclusion This study demonstrates the usefulness of an MI curriculum for medical students. The integration of MI into medical curricula is a promising curricular addition to improve doctor-patient communication. Future research should address patient perceptions of MI competencies and the persistence of acquired competencies.
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Affiliation(s)
- Rebecca Erschens
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Bettina Fahse
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
- Tübingen Institute for Medical Education (TIME), Faculty of Medicine, Tübingen, Germany
| | - Teresa Festl-Wietek
- Tübingen Institute for Medical Education (TIME), Faculty of Medicine, Tübingen, Germany
| | - Anne Herrmann-Werner
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
- Tübingen Institute for Medical Education (TIME), Faculty of Medicine, Tübingen, Germany
| | - Katharina E. Keifenheim
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Stephan Zipfel
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
- German Center for Mental Health (DZPG), Tuebingen, Germany
| | - Andreas J. Fallgatter
- German Center for Mental Health (DZPG), Tuebingen, Germany
- Tübingen Center for Mental Health, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Kerstin Velten-Schurian
- Tübingen Center for Mental Health, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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White K, Belachew B. Role of Psychologists in Pediatric Subspecialties: Integrated Psychological Services Overarching Concepts Across Pediatric Subspecialties. Pediatr Clin North Am 2022; 69:825-837. [PMID: 36207095 DOI: 10.1016/j.pcl.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article addresses, in more general terms, the overarching concepts of the role of integrated psychologists and how their services are incorporated in the medical home with the use of provider consultation, administering assessments in identifying common mental health concerns, providing interventions for treatment adherence and providing short-term therapy within pediatric subspecialties.
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Affiliation(s)
- Katie White
- Division of Pediatric Psychology, Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
| | - Bethelhem Belachew
- Division of Pediatric Psychology, Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
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Macnamara A, Mishu MP, Faisal MR, Islam M, Peckham E. Improving oral health in people with severe mental illness (SMI): A systematic review. PLoS One 2021; 16:e0260766. [PMID: 34852003 PMCID: PMC8635332 DOI: 10.1371/journal.pone.0260766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Those with severe mental illness (SMI) are at greater risk of having poor oral health, which can have an impact on daily activities such as eating, socialising and working. There is currently a lack of evidence to suggest which oral health interventions are effective for improving oral health outcomes for people with SMI. AIMS This systematic review aims to examine the effectiveness of oral health interventions in improving oral health outcomes for those with SMI. METHODS The review protocol was registered with PROSPERO (ID CRD42020187663). Medline, EMBASE, PsycINFO, AMED, HMIC, CINAHL, Scopus and the Cochrane Library were searched for studies, along with conference proceedings and grey literature sources. Titles and abstracts were dual screened by two reviewers. Two reviewers also independently performed full text screening, data extraction and risk of bias assessments. Due to heterogeneity between studies, a narrative synthesis was undertaken. RESULTS In total, 1462 abstracts from the database search and three abstracts from grey literature sources were identified. Following screening, 12 studies were included in the review. Five broad categories of intervention were identified: dental education, motivational interviewing, dental checklist, dietary change and incentives. Despite statistically significant changes in plaque indices and oral health behaviours as a result of interventions using dental education, motivational interviewing and incentives, it is unclear if these changes are clinically significant. CONCLUSION Although some positive results in this review demonstrate that dental education shows promise as an intervention for those with SMI, the quality of evidence was graded as very low to moderate quality. Further research is in this area is required to provide more conclusive evidence.
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Affiliation(s)
- Alexandra Macnamara
- The University of York and Hull York Medical School, Castle Hill Hospital, York, United Kingdom
| | | | | | - Mohammed Islam
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Emily Peckham
- Department of Health Sciences, The University of York, York, United Kingdom
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Khazanov GK, Forbes CN, Dunn BD, Thase ME. Addressing anhedonia to increase depression treatment engagement. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:255-280. [PMID: 34625993 DOI: 10.1111/bjc.12335] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/30/2021] [Indexed: 12/14/2022]
Abstract
Anhedonia, or reward system dysfunction, is associated with poorer treatment outcomes among depressed individuals. The role of anhedonia in treatment engagement, however, has not yet been explored. We review research on components of reward functioning impaired in depression, including effort valuation, reward anticipation, initial responsiveness, reward learning, reward probability, and reward delay, highlighting potential barriers to treatment engagement associated with these components. We then propose interventions to improve treatment initiation and continuation by addressing deficits in each component of reward functioning, focusing on modifications of existing evidence-based interventions to meet the needs of individuals with heightened anhedonia. We describe potential settings for these interventions and times at which they can be delivered during the process of referring individuals to mental health treatment, conducting intakes or assessments, and providing treatment. Additionally, we note the advantages of using screening processes already in place in primary care, workplace, school, and online settings to identify individuals with heightened anhedonia who may benefit from these interventions. We conclude with suggestions for future research on the impact of anhedonia on treatment engagement and the efficacy of interventions to address it. PRACTITIONER POINTS: Many depressed individuals who might benefit from treatment do not initiate it or discontinue early. One barrier to treatment engagement may be anhedonia, a core symptom of depression characterized by loss of interest or pleasure in usual activities. We describe brief interventions to improve treatment engagement in individuals with anhedonia that can be implemented during the referral process or early in treatment. We argue that interventions aiming to improve treatment engagement in depressed individuals that target anhedonia may be particularly effective.
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Affiliation(s)
- Gabriela K Khazanov
- Mental Illness Research, Education, and Clinical Center of the Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | | | | | - Michael E Thase
- Mental Illness Research, Education, and Clinical Center of the Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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Sugiyama C, Koseki S, Niikawa Y, Ito D, Takahashi F, Ishikawa R. Applied Improvisation Enhances the Effects of Behavioral Activation on Symptoms of Depression and PTSD in High School Students Affected by the Great East Japan Earthquake. Front Psychol 2021; 12:687906. [PMID: 34512446 PMCID: PMC8426506 DOI: 10.3389/fpsyg.2021.687906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background The education system can serve as a community-based resource to support the provision of long-term follow-up care after large-scale disasters. While school-based interventions conducted after a disaster have been confirmed to reduce symptoms of depression and posttraumatic stress disorder (PTSD), adolescents often exhibit low treatment motivation. Traditional methods used to encourage treatment motivation include fun activities, such as applied improv (AIM). This study evaluated the intervention effects and improved motivation of an intervention program combining AIM with the behavioral activation approach (BAA). Methods Participants were 253 tenth graders, who were in fifth grade at the time the Great East Japan Earthquake of 2011, and 239 students were included in the analyses. Participants were divided into two groups: the BAA and AIM + BAA groups. Students in each group participated in one class-wide intervention session, which lasted 60 min. Depression, PTSD symptoms, behavioral activation, avoidance, and resilience were evaluated using psychological scales. A participant's evaluations of the intervention were confirmed using the impression sheet consisting of six items that measure comprehension, difficulty, efficacy, generalization, confirmation of a specific situation, and motivation. Results A two-way analysis of variance (ANOVA) conducted using data from the psychological scale did not reveal a significant effect from the intervention program. However, the Mann-Whitney U-test, which used data from the impression sheet, showed a significant effect on comprehension (p = 0.001), generalization (p = 0.023), and motivation (p = 0.025). Conclusion This study did not confirm the effectiveness of the BAA in reducing symptoms of depression and PTSD in adolescents. Regarding treatment motivation, the AIM + BAA group reported higher motivation than the BAA group. Thus, one session of AIM may contribute to improved treatment motivation in adolescents. AIM creates a safe environment and encourages engagement and participation in interventions. Treatment motivation is an important issue in adolescent therapy, and AIM may help solve this problem.
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Affiliation(s)
- Chikaze Sugiyama
- Graduate School of International Studies, J. F. Oberlin University, Machida, Japan
| | - Shunsuke Koseki
- Faculty of Psychology and Education, J. F. Oberlin University, Machida, Japan
| | - Yoko Niikawa
- Graduate School of Psychology, J. F. Oberlin University, Machida, Japan
| | - Daisuke Ito
- Graduate School of Education, Hyogo University of Teacher Education, Kato, Japan
| | | | - Rie Ishikawa
- Graduate School of Psychology, J. F. Oberlin University, Machida, Japan
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Romano M, Peters L. The effect of motivational interviewing on ambivalence in social anxiety disorder. Behav Cogn Psychother 2021; 49:1-12. [PMID: 33736745 DOI: 10.1017/s1352465821000138] [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: 11/07/2022]
Abstract
BACKGROUND One reason that motivational interviewing (MI) is thought to translate well to a variety of treatment domains is due to the focus on client ambivalence. AIMS Therefore, the current study aimed to explore the construct of ambivalence in the context of MI and cognitive behavioural therapy (CBT) for social anxiety disorder (SAD). METHOD Participants were 147 individuals diagnosed with SAD who were randomised to receive either MI or supportive counselling prior to receiving group CBT for SAD. RESULTS The results suggested that MI was not related to decreases in general ambivalence or treatment ambivalence, although an indicator of treatment ambivalence was found to predict worse treatment outcome. CONCLUSIONS The findings suggest that three sessions of MI prior to CBT may not decrease ambivalence in participants with SAD, which may underscore the potential importance of tackling ambivalence as it arises during CBT.
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Affiliation(s)
- Mia Romano
- Centre for Emotional Health, Department of Psychology, Macquarie University, NSW 2109, Australia
| | - Lorna Peters
- Centre for Emotional Health, Department of Psychology, Macquarie University, NSW 2109, Australia
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Tobon JI, Zipursky RB, Streiner DL, Colvin E, Bahl N, Ouimet AJ, Burckell L, Jeffs L, Bieling PJ. Motivational Enhancement as a Pretreatment to a Transdiagnostic Intervention for Emerging Adults with Emotion Dysregulation: A Pilot Randomized Controlled Trial. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2020; 29:132-148. [PMID: 32774397 PMCID: PMC7391867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 02/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE New approaches are needed to help the large number of emerging adults (EA) presenting with early-stage mental health problems. The goal of this pilot study was to carry out a randomized controlled trial to investigate whether motivational enhancement therapy (MET) improved the treatment effects of a 12-week psychological intervention, Dialectical Behaviour Therapy Skills Training (DBT-ST), for EA presenting in the early stages of mental health difficulties. Participants were recruited from the Youth Wellness Centre at St. Joseph's Healthcare Hamilton and McMaster University's Student Wellness Centre in Hamilton, Canada. METHODS Seventy-five participants were randomized to receive MET followed by DBT-ST or to DBT-ST alone. We assessed psychological distress, emotion dysregulation, and depression and anxiety symptoms as outcomes. RESULTS We found that both treatment groups had significant reductions in emotional dysregulation, psychological distress, depression, and anxiety at post-treatment and at the three-month follow-up. Participants assigned to MET pre-treatment experienced greater improvement in psychological distress at the end of treatment. CONCLUSION This pilot study provides preliminary evidence of the potential augmentation of DBT-ST using MET in a real-world setting. Future studies should examine whether MET uniquely augments DBT-ST through the use of a comparable pre-treatment control group.
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Affiliation(s)
- Juliana I Tobon
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - Robert B Zipursky
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Eamon Colvin
- School of Psychology, University of Ottawa, Ottawa, Ontario
| | - Nancy Bahl
- School of Psychology, University of Ottawa, Ottawa, Ontario
| | | | - Lisa Burckell
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Borderline Personality Disorder Service, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - Lisa Jeffs
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - Peter J Bieling
- Youth Wellness Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, Hamilton, Ontario
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Waite I, Grant D, Mayes J, Greenwood S. Can a brief behavioural change intervention encourage hospital patients with low physical activity levels to engage and initiate a change in physical activity behaviour? Physiotherapy 2020; 108:22-28. [PMID: 32693239 DOI: 10.1016/j.physio.2020.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Indexed: 10/24/2022]
Abstract
BACKGROUND Regular physical activity (PA) reduces risk factors for chronic disease. This novel study evaluates self-reported engagement with PA in recently discharged patients, identified as having low PA levels, who agreed to participate in an in-patient behaviour change intervention. METHOD This exploratory study invited hospital in-patients, who were classified as 'moderately inactive' or 'inactive', to participate in a brief individual physiotherapy-led motivational interviewing (MI) behavioural change intervention. Patients were encouraged to set individual exercise and activity goals, and an appropriate programme referral was identified and agreed upon. RESULTS Three hundred and forty-two of 526 patients, who were screened between January 2017 and March 2018, were classified 'inactive' or 'moderately inactive'. Seventy-seven percent of patients consented to participate in the brief MI intervention (n=58 'moderately active', n=206 'inactive'). One hundred percent participants who received the brief intervention agreed to attend a PA programme. At telephone follow-up, 66% self-reported engagement in community exercise or independent PA initiatives. CONCLUSION This exploratory study demonstrates that a brief, MI-facilitated, behaviour change intervention is feasible and has the potential to aid PA engagement for hospital patients with low PA levels upon discharge from hospital. Considering that the 'first-step' with engagement in PA is often the biggest challenge for patients, this initiative has promise to improve PA behaviour and could be rolled out across the National Health Service (NHS).
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Affiliation(s)
- I Waite
- Department of Physiotherapy and Cardiology, Kings College Hospital, London SE59RS, England, United Kingdom.
| | - D Grant
- Department of Physiotherapy, Kings College Hospital, London SE59RS, England, United Kingdom
| | - J Mayes
- Department of Physiotherapy and Renal Medicine, Kings College Hospital, London SE59RS, England, United Kingdom
| | - S Greenwood
- Department of Physiotherapy and Renal Medicine, Kings College Hospital, London SE59RS, England, United Kingdom; Renal Medicine, Division of Transplantation Immunology & Mucosal Biology, King's College London, England, United Kingdom
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Beck CD, Soucy JN, Hadjistavropoulos HD. Mixed-method evaluation of an online motivational intervention as a pre-treatment to internet-delivered cognitive behaviour therapy: Immediate benefits and user feedback. Internet Interv 2020; 20:100311. [PMID: 32154118 PMCID: PMC7052510 DOI: 10.1016/j.invent.2020.100311] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/13/2020] [Accepted: 02/19/2020] [Indexed: 11/19/2022] Open
Abstract
•An online MI intervention was recently developed to complement ICBT.•Intervention consists of videos, exercises, feedback to better simulate face-to-face MI.•Study evaluated intervention impact on motivation and perceptions of MI.•Ratings of motivation and MI perceptions significantly increased from pre- to post-MI.•Future research should explore longer term impact of online MI on ICBT.
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Affiliation(s)
- Cynthia D. Beck
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Joelle N. Soucy
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
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Nasstasia Y, Baker AL, Lewin TJ, Halpin SA, Hides L, Kelly BJ, Callister R. Differential treatment effects of an integrated motivational interviewing and exercise intervention on depressive symptom profiles and associated factors: A randomised controlled cross-over trial among youth with major depression. J Affect Disord 2019; 259:413-423. [PMID: 31610998 DOI: 10.1016/j.jad.2019.08.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/23/2019] [Accepted: 08/17/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Exercise is increasingly recognised as an efficacious intervention for major depressive disorder (MDD) but to our knowledge differential treatment effects on depressive symptom profiles (cognitive, somatic and affective) and associated changes in psychological, physiological and behavioural factors have not been examined among youth with MDD. METHODS Sixty-eight participants (mean age 20.8) meeting DSM-IV diagnostic criteria for MDD were randomised to an Immediate intervention or Control/delayed condition (n = 34 per group). The integrated intervention comprised an initial session of motivational interviewing (MI) followed by a 12-week, multi-modal exercise program. Changes in depressive symptom profiles were assessed with the Beck Depression Inventory-II (BDI-II) total score and factorial symptom subscales. RESULTS There were significant differential improvements in BDI-II total scores post-treatment among intervention participants, which were also observed across the cognitive and affective subscales. Individual BDI-II items from the cognitive subscale showing significant differential improvement related to negative self-concept, while those from the affective subscale related to interest/activation; the energy item within the somatic subscale also revealed significant differential improvement. Significant differential improvements were also observed in exercise participation, negative automatic thoughts, behavioural activation and bench press repetitions among intervention participants, which correlated significantly with depression improvements. LIMITATIONS The exercise intervention was delivered in a supervised, group format and potential social meditators of change cannot be excluded. CONCLUSIONS Exercise differentially effects depressive symptom profiles with similar antidepressant effects as would be expected from psychological therapies improving negative cognition and emotional health.
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Affiliation(s)
- Yasmina Nasstasia
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Amanda L Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Terry J Lewin
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Sean A Halpin
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Brian J Kelly
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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Reimer J, Kuhn J, Wietfeld R, Janetzky W, Leopold K. [Motivational interviewing : A possibility for doctor-patient communication in schizophrenia?]. DER NERVENARZT 2019; 90:1144-1153. [PMID: 30941459 DOI: 10.1007/s00115-019-0702-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Motivational interviewing (MI) has become established nowadays as an approach for a cooperative style of conversation to promote intrinsic motivation for change by exploring and resolving ambivalences. The change of addictive behavior is no longer sought by exerting pressure or lecturing/converting attempts of convincing or persuasion but by activating existing but "buried" or newly acquired self-motivation to change. The MI is now also used to change the treatment of other health-related behavior and chronic diseases, including schizophrenic disorders. Compared to the efficacy of MI in the addiction area, the data situation in schizophrenic patients is still insufficient. According to the available studies, MI can positively influence important aspects of disease-related impairments, such as medication adherence, the frequency and severity of psychotic relapses, the duration of hospitalization, the level of function, insight into the disease and cognitive rehabilitation. The practical implementation of MI requires a good knowledge of the method as well as changes in treatment principles and work processes.
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Affiliation(s)
- Jens Reimer
- Zentrum für Psychosoziale Medizin Gesundheit Nord, 28102, Bremen, Deutschland. .,Klinikum Bremen-Ost, Züricher Str. 40, 28325, Bremen, Deutschland. .,Zentrum für Interdisziplinäre Suchtforschung, Universitätsklinikum Hamburg-Eppendorf, Klinik für Psychiatrie und Psychotherapie, Universität Hamburg, Hamburg, Deutschland.
| | - Jens Kuhn
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Johanniter Krankenhaus Oberhausen, Evangelischer Klinikverbund Niederrhein gGmbH, Oberhausen, Deutschland.,Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln, Köln, Deutschland
| | - Rita Wietfeld
- Psychotherapie, Praxis Neurologie und Psychiatrie, Witten, Deutschland
| | | | - Karolina Leopold
- Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum am Urban, Berlin, Deutschland
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Kramer Schmidt L, Moyers TB, Nielsen AS, Andersen K. Is fidelity to motivational interviewing associated with alcohol outcomes in treatment-seeking 60+ year-old citizens? J Subst Abuse Treat 2019; 101:1-11. [PMID: 31174708 DOI: 10.1016/j.jsat.2019.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/07/2019] [Accepted: 03/12/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Part of the variability in treatment outcomes for Motivational Interviewing (MI) may be explained by differences in the fidelity to MI. The Motivational Interviewing Treatment Integrity manual version 4 (MITI 4) is an improved measure of fidelity to elements of MI. It is not known whether the fidelity to MI, as measured by the MITI 4, is related to treatment outcome. OBJECTIVES To examine whether fidelity to MI is associated with alcohol use outcomes - predictive validity of the MITI 4. METHOD Twenty percent of the recorded sessions at the Danish sites of the Elderly Study were randomly drawn and coded for fidelity to MI with the MITI 4. The Elderly Study was an international, randomized controlled trial, in which people 60 years or older with Alcohol Use Disorders received either four weeks of Motivational Enhancement Therapy (MET) or four weeks of MET combined with up to eight additional sessions of the Community Reinforcement Approach- Senior (MET+CRA-S). Elements of MI and summary scores of the MITI 4 were used as predictors in a mixed effects regression analysis. Treatment outcomes were use of alcohol and consequences of drinking at 26-weeks follow-up. RESULTS In total, 423 sessions representing 238 participants were randomly drawn and coded for fidelity to MI. Mean values of the treatment elements indicated high fidelity to MI, with higher fidelity to MI in the MET sessions, as compared to CRA-S sessions. None of the predictors in the multilevel model analyses were associated with outcome at follow-up. Exploratory analysis indicated reverse associations between one measure of MI-fidelity and drinking outcomes in the combined treatment (CRAS). CONCLUSION The fidelity of the MI intervention, received by participants in this study, did not predict better treatment outcomes. MI may be less effective in populations which are already committed to change behavior. As expected and validating for the MITI 4, fidelity to MI-elements was lower in the combination of MI with other treatment approaches. Additionally, the timing of MI in these combined settings might be important for effectiveness.
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Affiliation(s)
- Lotte Kramer Schmidt
- Unit of Clinical Alcohol Research, University of Southern Denmark, J.B. Winsløwsvej 18, entrance 220B, 5000 Odense C, Denmark.
| | - Theresa B Moyers
- Center on Alcoholism, Substance Abuse, and Addictions, MSC11 6280, 1 University of New Mexico, Albuquerque, NM 87131, United States.
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, University of Southern Denmark, J.B. Winsløwsvej 18, entrance 220B, 5000 Odense C, Denmark; OPEN Odense Patient data Explorative Network, Denmark.
| | - Kjeld Andersen
- Unit of Clinical Alcohol Research, University of Southern Denmark, J.B. Winsløwsvej 18, entrance 220B, 5000 Odense C, Denmark; Department of Mental Health, Region of Southern Denmark, Denmark.
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Park S, Choi J, Lee S, Oh C, Kim C, La S, Lee J, Suh B. Designing a Chatbot for a Brief Motivational Interview on Stress Management: Qualitative Case Study. J Med Internet Res 2019; 21:e12231. [PMID: 30990463 PMCID: PMC6488959 DOI: 10.2196/12231] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/30/2019] [Accepted: 02/17/2019] [Indexed: 02/06/2023] Open
Abstract
Background In addition to addiction and substance abuse, motivational interviewing (MI) is increasingly being integrated in treating other clinical issues such as mental health problems. Most of the many technological adaptations of MI, however, have focused on delivering the action-oriented treatment, leaving its relational component unexplored or vaguely described. This study intended to design a conversational sequence that considers both technical and relational components of MI for a mental health concern. Objective This case study aimed to design a conversational sequence for a brief motivational interview to be delivered by a Web-based text messaging application (chatbot) and to investigate its conversational experience with graduate students in their coping with stress. Methods A brief conversational sequence was designed with varied combinations of MI skills to follow the 4 processes of MI. A Web-based text messaging application, Bonobot, was built as a research prototype to deliver the sequence in a conversation. A total of 30 full-time graduate students who self-reported stress with regard to their school life were recruited for a survey of demographic information and perceived stress and a semistructured interview. Interviews were transcribed verbatim and analyzed by Braun and Clarke’s thematic method. The themes that reflect the process of, impact of, and needs for the conversational experience are reported. Results Participants had a high level of perceived stress (mean 22.5 [SD 5.0]). Our findings included the following themes: Evocative Questions and Clichéd Feedback; Self-Reflection and Potential Consolation; and Need for Information and Contextualized Feedback. Participants particularly favored the relay of evocative questions but were less satisfied with the agent-generated reflective and affirming feedback that filled in-between. Discussing the idea of change was a good means of reflecting on themselves, and some of Bonobot’s encouragements related to graduate school life were appreciated. Participants suggested the conversation provide informational support, as well as more contextualized feedback. Conclusions A conversational sequence for a brief motivational interview was presented in this case study. Participant feedback suggests sequencing questions and MI-adherent statements can facilitate a conversation for stress management, which may encourage a chance of self-reflection. More diversified sequences, along with more contextualized feedback, should follow to offer a better conversational experience and to confirm any empirical effect.
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Affiliation(s)
- SoHyun Park
- Human Centered Computing Lab., Seoul National University, Seoul, Republic of Korea
| | - Jeewon Choi
- Human Computer Interaction + Design Lab., Seoul National University, Seoul, Republic of Korea
| | - Sungwoo Lee
- Human Centered Computing Lab., Seoul National University, Seoul, Republic of Korea
| | - Changhoon Oh
- Human Centered Computing Lab., Seoul National University, Seoul, Republic of Korea
| | - Changdai Kim
- Department of Education, Seoul National University, Seoul, Republic of Korea
| | - Soohyun La
- Center for Campus Life and Culture, Seoul National University, Seoul, Republic of Korea
| | - Joonhwan Lee
- Human Computer Interaction + Design Lab., Seoul National University, Seoul, Republic of Korea
| | - Bongwon Suh
- Human Centered Computing Lab., Seoul National University, Seoul, Republic of Korea
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Keifenheim KE, Velten-Schurian K, Fahse B, Erschens R, Loda T, Wiesner L, Zipfel S, Herrmann-Werner A. "A change would do you good": Training medical students in Motivational Interviewing using a blended-learning approach - A pilot evaluation. PATIENT EDUCATION AND COUNSELING 2019; 102:663-669. [PMID: 30448043 DOI: 10.1016/j.pec.2018.10.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/26/2018] [Accepted: 10/30/2018] [Indexed: 05/28/2023]
Abstract
Objectives This study aims to assess medical students' interest in a Motivational Interviewing (MI), the objective need for a special training, and students' satisfaction with and the effectiveness of such a course. Methods A mandatory MI course was implemented for sixth-semester medical students. Their interest in learning MI was evaluated, along with their satisfaction with the course, which was delivered in a blended-learning teaching approach. Participants' baseline MI skills and general communication skills were assessed. MI non-adherent behavior, like persuading and confronting patients, was noted. Successful learning was measured with a multiple-choice test administered before and after the course that assessed subjective knowledge and skills. Results Students were highly interested in learning MI. At baseline, they showed good communication skills but moderate MI skills. Satisfaction with the course was high. The course was effective, as subjective and objective knowledge and skills improved significantly. Conclusions This pilot study suggests that basic MI skills can be successfully taught in a blended-learning teaching approach. Further research should investigate sustainability and transfer to clinical practice. Practice implications Medical schools should consider providing students with special training in MI to help students counsel patients towards behavioral changes.
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Affiliation(s)
- K E Keifenheim
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany.
| | - K Velten-Schurian
- University Hospital for Psychiatry and Psychotherapy, Tuebingen, Germany
| | - B Fahse
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - R Erschens
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - T Loda
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - L Wiesner
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - S Zipfel
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - A Herrmann-Werner
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
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Palma C, Farriols N, Frías A, Cañete J, Gomis O, Fernández M, Alonso I, Signo S. Randomized controlled trial of cognitive-motivational therapy program (PIPE) for the initial phase of schizophrenia: Maintenance of efficacy at 5-year follow up ✰. Psychiatry Res 2019; 273:586-594. [PMID: 30716598 DOI: 10.1016/j.psychres.2019.01.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Abstract
AIM The main goal of this study was to evaluate the effectiveness of a cognitive motivational treatment program. METHOD A randomized, controlled, single-blind clinical trial was carried out. A total of 104 patients were recruited to take part in the trial, of whom ultimately 62 patients were allocated into two groups and finished the study. An initial assessment was carried out before patients were randomly placed in one of two groups for the clinical trial: (a) PIPE program plus routine care; and (b) routine care only. Clinical assessments were performed at baseline at 6 months, 1 year and follow-ups, at 18 months and 5 years). RESULTS MANCOVA analysis of tests repeated 18 months after the start of the intervention detected significant differences between the two groups in terms of clinical variables, everyday functioning and relapses. These differences remained upon follow-up measurements taken five years after the start of the trial. CONCLUSIONS The present study offers scientific evidence for cognitive-motivational therapy's effectiveness as a treatment for clinical symptoms in the early stages of psychosis. PIPE intervention may contribute to long-term clinical improvement and stability.
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Affiliation(s)
- C Palma
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Císter, 34 (08022), Barcelona Spain; Department of Mental health, Hospital de Mataró, Carretera de Cirera s/n (08304), Barcelona Spain.
| | - N Farriols
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Císter, 34 (08022), Barcelona Spain; Department of Mental health, Hospital de Mataró, Carretera de Cirera s/n (08304), Barcelona Spain
| | - A Frías
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Císter, 34 (08022), Barcelona Spain; Department of Mental health, Hospital de Mataró, Carretera de Cirera s/n (08304), Barcelona Spain
| | - J Cañete
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Císter, 34 (08022), Barcelona Spain; Department of Mental health, Hospital de Mataró, Carretera de Cirera s/n (08304), Barcelona Spain
| | - O Gomis
- Department of Psychology, FPCEE Blanquerna, Ramon Llull University, Císter, 34 (08022), Barcelona Spain
| | - M Fernández
- Department of Mental health, Hospital de Mataró, Carretera de Cirera s/n (08304), Barcelona Spain
| | - I Alonso
- Department of Mental health, Hospital de Mataró, Carretera de Cirera s/n (08304), Barcelona Spain
| | - S Signo
- Department of Mental health, Hospital de Mataró, Carretera de Cirera s/n (08304), Barcelona Spain
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Kramer Schmidt L, Andersen K, Nielsen AS, Moyers TB. Lessons learned from measuring fidelity with the Motivational Interviewing Treatment Integrity code (MITI 4). J Subst Abuse Treat 2019; 97:59-67. [DOI: 10.1016/j.jsat.2018.11.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/12/2018] [Accepted: 11/18/2018] [Indexed: 11/26/2022]
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du Mortier JAM, Visser HAD, van Geijtenbeek - de Vos van Steenwijk MFR, van Megen HJGM, van Balkom AJLM. Use of videotaped personal compulsions to enhance motivation in obsessive-compulsive disorder. BJPsych Open 2019; 5:e11. [PMID: 30762503 PMCID: PMC6381413 DOI: 10.1192/bjo.2018.76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/13/2018] [Accepted: 11/09/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Watching videotaped personal compulsions together with a therapist might enhance the effect of cognitive-behavioural therapy in obsessive-compulsive disorder (OCD) but little is known about how patients experience this.AimsTo performed a qualitative study that describes how watching these videos influences motivation for treatment and whether patients report any adverse events. METHOD In this qualitative study, data were gathered in semi-structured interviews with 24 patients with OCD. The transcripts were coded by two researchers. They used a combination of open and thematic coding and discrepancies in coding were discussed. RESULTS The experience of watching videos with personal compulsions helped patients to realise that these compulsions are aberrant and irrational. Patients report increased motivation to resist their OCD and to adhere to therapy. No adverse events were reported. CONCLUSIONS Videos with personal compulsions create more awareness in patients with OCD that compulsions are irrational, leading to enhanced motivation for treatment.Declaration of interestNone.
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Affiliation(s)
| | | | | | | | - Anton J. L. M. van Balkom
- Professor and Psychiatrist, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health and GGZ ingeest, the Netherlands
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Communications Skills in the Pharmacy Profession: A Cross Sectional Survey of UK Registered Pharmacists and Pharmacy Educators. PHARMACY 2018; 6:pharmacy6040132. [PMID: 30545072 PMCID: PMC6306767 DOI: 10.3390/pharmacy6040132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/08/2018] [Accepted: 12/10/2018] [Indexed: 12/14/2022] Open
Abstract
Objectives: To determine UK pharmacists' experiences of their current communication skills and undergraduate training and to identify communication skills training and teaching at UK schools of pharmacy. Methods: Two surveys were developed. The first survey was sent to UK practicing pharmacists examining their current communication skills and interest in behavioural counselling techniques such as Motivational Interviewing (MI). A second survey was sent to all UK Schools of Pharmacy investigating communication skills training and teaching. Results: In the first survey pharmacists reported low satisfaction with their undergraduate communication skills training. A convenience sample of 109 UK pharmacists responded to the first survey. Forty-four per cent (n = 48) of the respondents stated that they continued their professional development in communication skills after an undergraduate degree. Seventy (65.4%) were not familiar with behavioural counselling techniques such as MI. The most common patient consultation delivered by pharmacists was around adherence to medicine 22.4% (n = 50). Pharmacists expressed a need for further training in clinical areas such as mental health 25.7% (n = 80). Results from the second survey to pharmacy schools showed that Schools of Pharmacy response rate was 60% (18/30). All 18 schools stated that they teach health behaviour change consultation skills and this is mostly delivered by a clinical pharmacist. Teaching communication skills was mostly delivered as role play with peers (n = 17). Conclusion: This first national survey of communication skills training in Schools of Pharmacy shows that newer graduates have received more communication training compared to older graduates, however pharmacists' respondents still felt that they were under prepared for behaviour change patient consultations. MI training would be welcomed by those. Practice Implications: Structured courses in communication skills, including behavioural change techniques, are needed for practicing UK pharmacists.
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Schumacher JA, Williams DC, Burke RS, Epler AJ, Simon P, Coffey SF. Brief Report: Competency-Based Supervision in Motivational Interviewing for Advanced Psychology Trainees: Targeting an A Priori Benchmark. TRAINING AND EDUCATION IN PROFESSIONAL PSYCHOLOGY 2018; 12:149-153. [PMID: 30275924 DOI: 10.1037/tep0000177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Motivational interviewing (MI) is an evidence based intervention with considerable support for promoting behavior change across a broad range of health and mental health issues. Despite its effectiveness, challenges associated with learning the approach may limit its full implementation in many clinical settings. The aim of the present study was to evaluate a supervised MI training practicum implemented within a doctoral internship/postdoctoral fellowship training Program. The goal of the practicum was to enable each trainee to achieve expert competence in MI. Participants were 29 psychology doctoral interns and 1 postdoctoral fellow who participated in the training as part of their internship or fellowship program. Training included an initial workshop followed by a supervised practicum during which progress towards an a priori established expert competence benchmark was tracked through the use of an established coding system. Results indicated that trainees were satisfied with the supervision received. Three trainees did not achieve the a priori benchmark due to schedule conflicts. The 27 trainees who achieved the benchmark required between 4 and 20 supervision sessions to do so (mean = 9.22, SD = 3.77). With the exception of reflective listening skill, prior training, baseline skill, and self-reported motivation were not associated with number of supervision sessions required to achieve the benchmark. Implications for training and dissemination of MI in clinical settings are discussed.
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Affiliation(s)
- Julie A Schumacher
- Julie A. Schumacher, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC; Daniel C. Williams, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Randy S. Burke, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Amee J. Epler, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center. Patricia Simon Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC. Scott F. Coffey, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
| | - Daniel C Williams
- Julie A. Schumacher, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC; Daniel C. Williams, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Randy S. Burke, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Amee J. Epler, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center. Patricia Simon Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC. Scott F. Coffey, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
| | - Randy S Burke
- Julie A. Schumacher, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC; Daniel C. Williams, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Randy S. Burke, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Amee J. Epler, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center. Patricia Simon Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC. Scott F. Coffey, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
| | - Amee J Epler
- Julie A. Schumacher, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC; Daniel C. Williams, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Randy S. Burke, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Amee J. Epler, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center. Patricia Simon Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC. Scott F. Coffey, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
| | - Patricia Simon
- Julie A. Schumacher, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC; Daniel C. Williams, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Randy S. Burke, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Amee J. Epler, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center. Patricia Simon Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC. Scott F. Coffey, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
| | - Scott F Coffey
- Julie A. Schumacher, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC; Daniel C. Williams, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Randy S. Burke, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center; Amee J. Epler, G.V. (Sonny) Montgomery VAMC and Department of Psychiatry and Human Behavior, University of Mississippi Medical Center. Patricia Simon Department of Psychiatry and Human Behavior, University of Mississippi Medical Center and G.V. (Sonny) Montgomery VAMC. Scott F. Coffey, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
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Marker I, Norton PJ. The efficacy of incorporating motivational interviewing to cognitive behavior therapy for anxiety disorders: A review and meta-analysis. Clin Psychol Rev 2018; 62:1-10. [DOI: 10.1016/j.cpr.2018.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 11/30/2022]
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Nasstasia Y, Baker AL, Halpin SA, Hides L, Lewin TJ, Kelly BJ, Callister R. Evaluating the efficacy of an integrated motivational interviewing and multi-modal exercise intervention for youth with major depression: Healthy Body, Healthy Mind randomised controlled trial protocol. Contemp Clin Trials Commun 2018; 9:13-22. [PMID: 29696220 PMCID: PMC5898569 DOI: 10.1016/j.conctc.2017.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/22/2017] [Accepted: 11/22/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Recent meta-analytic reviews suggest exercise can reduce depression severity among adults with major depressive disorder (MDD); however, efficacy studies with depressed youth are limited. Few studies have investigated the efficacy of multi-modal exercise interventions in this population, addressed treatment engagement, or explored the differential effects of exercise on depressive symptom profiles. OBJECTIVES This paper describes the study protocol and recruitment pattern for an assessor blinded, two-arm randomised controlled trial investigating the efficacy of an integrated motivational interviewing (MI) and multi-modal exercise intervention in youth diagnosed with MDD. Associations between depressive symptom profiles (cognitive, somatic and affective) and psychological, physiological (fitness), and biological (blood biomarker) outcomes will also be examined. METHODS Participants aged 15-25 years with current MDD were recruited. Eligible participants were randomised and stratified according to gender and depression severity to either an immediate or delayed (control) group. The immediate group received a brief MI intervention followed by a 12-week small group exercise intervention (3 times per week for 1 h), all delivered by personal trainers. The delayed control group received the same intervention 12-weeks later. Both groups were reassessed at mid-treatment or mid-control, post-treatment or post-control, and follow-up (12 weeks post-treatment). RESULTS 68 participants were recruited and randomly allocated to an intervention group. CONCLUSION This trial will increase our understanding of the efficacy of multi-modal exercise interventions for depression and the specific effects of exercise on depressive symptom profiles. It also offers a novel contribution by addressing treatment engagement in exercise efficacy trials in youth with MDD.
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Affiliation(s)
- Yasmina Nasstasia
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Sean A. Halpin
- School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia
| | - Terry J. Lewin
- Priority Research Centre for Brain and Mental Health Research, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Brian J. Kelly
- Priority Research Centre for Brain and Mental Health Research, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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Moore M, Flamez B, Szirony GM. Motivational interviewing and dual diagnosis clients: Enhancing self-efficacy and treatment completion. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1388856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Martina Moore
- Mental Health Counseling Department, John Carroll University, University Heights, Ohio, USA
| | - Brandé Flamez
- Department of Counseling and Special Populations, Lamar University, Beaumont, Texas, USA
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Abstract
BACKGROUND Motivational interviewing (MI) is an evidence-based intervention that may help inpatient psychiatric nurses understand patient beliefs about medication while simultaneously strengthening the therapeutic alliance. OBJECTIVE Investigate nurses' perceptions regarding use of motivational interviewing after an educational program. DESIGN A prospective intervention project. RESULTS Agreement with consistent use of MI skills declined at one month. Nurses listened and connected with patients and gained self-awareness of their interactions with other providers. CONCLUSIONS Consistent use of MI was used less often than initially believed but having MI focused conversations were useful. When planning MI training for inpatient psychiatric staff nurses, activities must be timely, realistic, and achievable. Work environment is important to making and sustaining the use of MI.
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Randall CL, McNeil DW. Motivational Interviewing as an Adjunct to Cognitive Behavior Therapy for Anxiety Disorders: A Critical Review of the Literature. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 24:296-311. [PMID: 28871216 PMCID: PMC5580948 DOI: 10.1016/j.cbpra.2016.05.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cognitive behavior therapy (CBT) is efficaciously and effectively used in the treatment of anxiety disorders; however, as CBT for anxiety routinely utilizes exposure components, clients often experience ambivalence about treatment and their clinicians often must deal with resistance. Motivational Interviewing (MI) is a therapeutic strategy that addresses ambivalence about change in clinical interventions. MI has been applied as an adjunct for treatments such as CBT in order to increase motivation for and commitment to the intervention, especially when components of the treatment may be challenging (e.g., exposure, cognitive restructuring). Though researchers have commented specifically on the use of MI as a supplement to CBT for anxiety disorders, no comprehensive review has systematically assessed the strengths and limitations of extant literature on the topic, nor across anxiety disorders. Findings are summarized from 6 case studies and uncontrolled trials and 11 randomized controlled trials published through March 2016. An integrated critique of this literature also is offered. Limitations and the preliminary nature of the work in this area notwithstanding, it appears that it is feasible to supplement or integrate CBT with MI and that doing so has the potential to improve treatment initiation and engagement, as well as clinical outcomes. A number of directions for future research are addressed, such as determining which MI approaches to implement, with whom, when, and in what contexts.
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Freira S, Lemos MS, Williams G, Ribeiro M, Pena F, Machado MDC. Effect of Motivational Interviewing on depression scale scores of adolescents with obesity and overweight. Psychiatry Res 2017; 252:340-345. [PMID: 28327447 DOI: 10.1016/j.psychres.2017.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/02/2017] [Accepted: 03/10/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED The aim of this study was to compare the effect of motivational interview (MI) with conventional care on the depression scale scores of adolescents with obesity/overweight. It was a controlled cluster randomized trial with parallel design, including two groups: intervention group [Motivational Interview Group (MIG)], control group [Conventional Intervention Group (CIG)]. INTERVENTION three face-to-face 30min' interviews three months apart (only MIG interviews were based on MI principles). OUTCOMES change in Children Depression Inventory (CDI) scores. We used a mixed repeated-measures ANOVAs analysis to assess the group vs time interaction. Effect size was calculated for ANOVA with difference of means of the total score (DOMTS). CDI scores were compared by a paired t-test. Eighty-three (84%) adolescents finished the intervention. There was a significant time vs group interaction both groups. While in the CIG scores significantly increased, in the MIG the scores significantly decreased. The DOMTS was significantly different between the two groups. We concluded that MI showed a positive effect on depression scale scores over time relatively to conventional intervention.
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Affiliation(s)
- Silvia Freira
- Department of Pediatrics, Faculty of Medicine, Hospital de Santa Maria, University of Lisbon, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal.
| | - Marina Serra Lemos
- Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen 535, Porto, Portugal.
| | - Geoffrey Williams
- University of Rochester Medical Center, 46 Prince St., Ste 3001, Rochester, NY 14617, United States.
| | - Marta Ribeiro
- Department of Pediatrics, Faculty of Medicine, Hospital de Santa Maria, University of Lisbon, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal.
| | - Fernanda Pena
- Unit of Continuing Care, Largo da Mundet - Bairro Novo, 2840-264 Seixal, Portugal.
| | - Maria do Céu Machado
- Department of Pediatrics, Faculty of Medicine, Hospital de Santa Maria, University of Lisbon, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal.
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Using Motivational Interviewing to Manage Process Markers of Ambivalence and Resistance in Cognitive Behavioral Therapy. COGNITIVE THERAPY AND RESEARCH 2017. [DOI: 10.1007/s10608-017-9857-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Constantino MJ, Romano FM, Coyne AE, Westra HA, Antony MM. Client interpersonal impacts as mediators of long-term outcome in cognitive-behavioral therapy integrated with motivational interviewing for generalized anxiety disorder. Psychother Res 2017; 28:861-872. [DOI: 10.1080/10503307.2017.1301689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Michael J. Constantino
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Felicia M. Romano
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Alice E. Coyne
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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Madson MB, Mohn RS, Schumacher JA, Landry AS. Measuring Client Experiences of Motivational Interviewing during a Lifestyle Intervention. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2017; 48:140-151. [PMID: 25937700 DOI: 10.1177/0748175614544687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Client Evaluation of Motivational Interviewing was used to assess MI experiences in a predominantly female, African American sample from the Southeastern U.S. who received MI-based feedback during a multi-component lifestyle intervention. MI was experienced differently than a primarily White, male, Northeastern mental health sample.
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Mistler LA, Sheidow AJ, Davis M. Transdiagnostic Motivational Enhancement Therapy to Reduce Treatment Attrition: Use in Emerging Adults. COGNITIVE AND BEHAVIORAL PRACTICE 2016; 23:368-384. [PMID: 28979088 PMCID: PMC5624213 DOI: 10.1016/j.cbpra.2015.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Improving outcomes of youth with mental health (MH) needs as they transition into adulthood is of critical public health significance. Effective psychotherapy MH treatment is available, but can be effective only if the emerging adult (EA) attends long enough to benefit. Unfortunately, completion of psychotherapy among EAs is lower than for more mature adults (Edlund et al., 2002; Olfson, Marcus, Druss, & Pincus, 2002). To target the high attrition of EAs in MH treatment, investigators adapted a developmentally appropriate brief intervention aimed at reducing treatment attrition (TA) in psychotherapy and conducted a feasibility study of implementation. The intervention employs motivational interviewing strategies aimed at engaging and retaining EAs in outpatient MH treatment. Motivational enhancement therapy for treatment attrition, or MET-TA, takes only a few sessions at the outset of treatment as an adjunct to usual treatment. Importantly, it can be used for TA with psychotherapy for any MH condition; in other words, it is transdiagnostic. This article presents the first description of MET-TA, along with a case example that demonstrates important characteristics of the approach, and then briefly describes implementation feasibility based on a small pilot randomized controlled trial.
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Hampson ME, Hicks RE, Watt BD. Exploring the Effectiveness of Motivational Interviewing in Re-engaging People Diagnosed with Severe Psychiatric Conditions in Work, Study, or Community Participation. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2015. [DOI: 10.1080/15487768.2014.954158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Romano M, Peters L. Evaluating the mechanisms of change in motivational interviewing in the treatment of mental health problems: A review and meta-analysis. Clin Psychol Rev 2015; 38:1-12. [DOI: 10.1016/j.cpr.2015.02.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/19/2014] [Accepted: 02/24/2015] [Indexed: 11/29/2022]
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Abstract
Helping parents change key behaviors may reduce the risk of child maltreatment. However, traditional provider-centered approaches to working with the parents of pediatric patients may increase resistance to behavioral change. Motivational interviewing (MI) is a patient-centered communication technique that helps address problems of provider-centered approaches. In this article, evidence for use of MI to address several risk factors for child maltreatment is reviewed, including parental substance abuse, partner violence, depression treatment, harsh punishment, and parental management of children's health. Fundamental components of MI that may be incorporated into clinical practice are presented.
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Affiliation(s)
- Adrienne A Williams
- Department of Family and Community Medicine, University of Maryland School of Medicine, 29 South Paca Street, Lower Level, Baltimore, MD 21201, USA.
| | - Katherine S Wright
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
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Bradizza CM, Stasiewicz PR, Dermen KH. Behavioral Interventions for Individuals Dually-Diagnosed with a Severe Mental Illness and a Substance Use Disorder. CURRENT ADDICTION REPORTS 2014; 1:243-250. [PMID: 25530935 DOI: 10.1007/s40429-014-0032-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The prevalence of substance abuse among severely mentally ill individuals (SMI) with a schizophrenia-spectrum or bipolar disorder is about three times the rate of the general population. However, few effective interventions exist to address the problem. In this paper, we evaluate recent studies of behavioral interventions for substance abuse among SMI individuals. These include cognitive-behavioral, motivational interviewing, and contingency management interventions, as well as combinations thereof. Consistent with prior systematic reviews, ours indicates that no behavioral intervention has clearly demonstrated efficacy beyond that of usual care. Unfortunately, most of the reviewed studies suffer from methodological problems that hamper detection of treatment effects. Also, it can be argued that interventions tested thus far may not be well-suited for this cognitively-impaired population. A programmatic series of studies is needed to further develop and test behavioral interventions for treating substance abuse in this population.
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Affiliation(s)
- Clara M Bradizza
- Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2532 Fax. 716-887-2215
| | - Paul R Stasiewicz
- Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2596 Fax. 716-887-2477
| | - Kurt H Dermen
- Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2492 Fax. 716-887-2477
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Sepulveda AR, Wise C, Zabala M, Todd G, Treasure J. Development and reliability of a Motivational Interviewing Scenarios Tool for Eating Disorders (MIST-ED) using a skills-based intervention among caregivers. Eat Behav 2013; 14:432-6. [PMID: 24183130 DOI: 10.1016/j.eatbeh.2013.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 05/27/2013] [Accepted: 07/15/2013] [Indexed: 10/26/2022]
Abstract
The aims of this study were to develop an eating disorder scenarios tool to assess the motivational interviewing (MI) skills of caregivers and evaluate the coding reliability of the instrument, and to test the sensitivity to change through a pre/post/follow-up design. The resulting Motivational Interview Scenarios Tool for Eating Disorders (MIST-ED) was administered to caregivers (n = 66) who were asked to provide oral and written responses before and after a skills-based intervention, and at a 3-month follow-up. Raters achieved excellent inter-rater reliability (intra-class correlations of 91.8% on MI adherent and 86.1% for MI non-adherent statements for written scenarios and 89.2%, and 85.3% for oral scenarios). Following the intervention, MI adherent statements increased (baseline = 9.4%, post = 61.5% and follow-up 47.2%) and non-MI adherent statements decreased (baseline = 90.6%, post = 38.5% and follow-up = 52.8%). This instrument can be used as a simple method to measure the acquisition of MI skills to improve coping and both response methods are adequate. The tool shows good sensitivity to improved skills.
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Affiliation(s)
- Ana R Sepulveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain.
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Smith AH, Norton PJ, McLean CP. Client Perceptions of Therapy Component Helpfulness in Group Cognitive-Behavioral Therapy for Anxiety Disorders. J Clin Psychol 2012; 69:229-39. [DOI: 10.1002/jclp.21926] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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38
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Moyers TB. Disseminating motivational interviewing in psychiatric and adolescent populations: optimism and a few worries. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:641-2. [PMID: 22114917 DOI: 10.1177/070674371105601101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Theresa B Moyers
- Assistant Professor of Psychology, Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico
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