Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-25T10:02:46.764Z Has data issue: false hasContentIssue false
  • English
  • Français

Motivational interviewing to enhance adolescent mental health treatment engagement: a randomized clinical trial

Published online by Cambridge University Press:  05 April 2016

S. Dean ,
E. Britt ,
E. Bell ,
J. Stanley  and
S. Collings
S. Dean*
Affiliation:
Social Psychiatry & Population Mental Health Research Unit, University of Otago, Wellington, New Zealand
E. Britt
Affiliation:
Department of Psychology, University of Canterbury, Christchurch,New Zealand
E. Bell
Affiliation:
Department of Psychological Medicine, University of Otago, Wellington,New Zealand Rehabilitation Teaching and Research Unit, University of Otago, Wellington,New Zealand
J. Stanley
Affiliation:
Department of Public Health, University of Otago, Wellington,New Zealand
S. Collings
Affiliation:
Social Psychiatry & Population Mental Health Research Unit, University of Otago, Wellington, New Zealand
*
*Address for correspondence: S. Dean, Dean's Department, Social Psychiatry & Population Mental Health Research Unit, University of Otago, Wellington, New Zealand. (Email: shaystah.dean@postgrad.otago.ac.nz)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The prevalence of anxiety and mood disorders in adolescents is a growing public health concern worldwide. Given the high rates of drop-out and limited resources available in psychiatric settings, the importance of engaging adolescents in evidence-based treatments cannot be understated. The aim of the study was to determine the efficacy of motivational interviewing (MI), as a brief pre-treatment intervention, to enhance treatment engagement in a standard therapy setting (group cognitive behavioral therapy; gCBT) for adolescents with anxiety and mood disorders.

Method

Ninety-six adolescents (13–18 years) with a principal diagnosis of an anxiety or mood disorder participated in a trial conducted at two publicly funded outpatient services. Participants were randomly assigned to individual MI for treatment engagement prior to gCBT (MI + gCBT), or to an individually administered active control (befriending) prior to gCBT (befriending + gCBT). Eight pairs of gCBT were run in parallel. Outcome measures were the mean number of gCBT sessions attended, treatment initiation, and ratings of readiness for treatment.

Results

Participants randomized to MI as a pretreatment intervention attended significantly more group therapy sessions compared to those in the active control condition. The MI group also demonstrated greater treatment initiation, and ratings of treatment readiness were significantly higher for those randomized to MI.

Conclusions

MI, used as a pre-treatment intervention, enhanced group treatment engagement in adolescents diagnosed with anxiety and mood disorders compared to the active control condition. MI is a promising intervention to facilitate engagement in adolescent mental health settings.

Keywords

Adolescent mental healthmotivational interviewingtreatment engagement
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 9 , July 2016 , pp. 1961 - 1969
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, JC (1994). Epidemiological issues. In International Handbook of Phobic and Anxiety Disorders in Children and Adolescents (ed. Ollendick, T. H., King, N. J. and Yule, W.), pp. 43–65. Springer: US.CrossRefGoogle Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision). American Psychiatric Association: Washington, DC.Google Scholar
Arkowitz, H, Westra, H, Miller, WR, Rollnick, S (2015). Motivational Interviewing in the Treatment of Psychological Problems. Guilford Publications: New York.Google Scholar
Barlow, DH, Farchione, TJ, Fairholme, CP, Ellard, KK, Boisseau, CL, Allen, LB, May, JTE (2011). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. Oxford University Press: USA.Google Scholar
Barnett, E, Sussman, S, Smith, C, Rohrbach, LA, Spruijt-Metz, D (2012). Motivational Interviewing for adolescent substance use: a review of the literature. Addictive Behaviors 37, 1325–1334.Google Scholar
Bendall, S, Killackey, E, Jackson, H, Gleeson, J (2003). Befriending Manual. Oxygen Research Centre: Melbourne, Australia.Google Scholar
Biener, L, Abrams, DB (1991). The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psychology 10, 360.Google Scholar
Bilek, EL, Ehrenreich-May, J (2012). An open trial investigation of a transdiagnostic group treatment for children with anxiety and depressive symptoms. Behavior Therapy 43, 887–897.Google Scholar
Blackburn, I-M, James, IA, Milne, DL, Reichelt, FK, Garland, A, Baker, C, Standart, S, Claydon, A (2001). Cognitive Therapy Scale – Revised (CTS-R). Newcastle-upon-Tyne: Newcastle Cognitive and Behavioural Therapies Centre.Google Scholar
Bradshaw, T, Haddock, G (1998). Is befriending by trained volunteers of value to people suffering from long-term mental illness? Journal of Advanced Nursing 27, 713–720.CrossRefGoogle ScholarPubMed
Campbell, M, Donner, A, Klar, N (2007). Developments in cluster randomized trials and statistics in medicine. Statistics in Medicine 26, 2–19.CrossRefGoogle ScholarPubMed
Channon, SJ, Huws-Thomas, MV, Rollnick, S, Hood, K, Cannings-John, RL, Rogers, C, Gregory, JW (2007). A multicenter randomized controlled trial of motivational interviewing in teenagers with diabetes. Diabetes Care 30, 1390–1395.CrossRefGoogle ScholarPubMed
Chanut, F, Brown, TG, Dongier, M (2005). Motivational interviewing and clinical psychiatry. Canadian Journal of Psychiatry 50, 548–554.CrossRefGoogle ScholarPubMed
Costello, EJ, Egger, HL, Angold, A (2005). The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child and Adolescent Psychiatric Clinics of North America 14, 631–648.Google Scholar
Daley, DC, Salloum, IM, Zuckoff, A, Kirisci, L, Thase, ME (1998). Increasing treatment adherence among outpatients with depression and cocaine dependence: results of a pilot study. American Journal of Psychiatry 155, 1611–1613.Google Scholar
de Haan, AM, Boon, AE, de Jong, JTVM, Hoeve, M, Vermeiren, RRJM (2013). A meta-analytic review on treatment dropout in child and adolescent outpatient mental health care. Clinical Psychology Review 33, 698–711.CrossRefGoogle ScholarPubMed
Ehrenreich-May, J, Chu, BC (eds) (2014). Transdiagnostic Treatments for Children and Adolescents: Principles and Practice. Guilford Publications: New York.Google Scholar
Gayes, LA, Steele, RG (2014). A meta-analysis of motivational interviewing interventions for pediatric health behavior change. Journal of Consulting and Clinical Psychology 82, 521–535.CrossRefGoogle ScholarPubMed
Gearing, RE, Schwalbe, CS, Dweck, P, Berkowitz, J (2012). Investigating adherence promoters in evidence-based mental health interventions with children and adolescents. Community Mental Health Journal 48, 63–70.CrossRefGoogle ScholarPubMed
Grote, NK, Zuckoff, A, Swartz, H, Bledsoe, SE, Geibel, S (2007). Engaging women who are depressed and economically disadvantaged in mental health treatment. Social Work 52, 295–308.Google Scholar
Gulliver, A, Griffiths, KM, Christensen, H (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 10, 113.CrossRefGoogle ScholarPubMed
Hanghøj, S, Boisen, KA (2014). Self-reported barriers to medication adherence among chronically Ill adolescents: a systematic review. Journal of Adolescent Health 54, 121–138.Google Scholar
Heather, N, Smailes, D, Cassidy, P (2008). Development of a readiness ruler for use with alcohol brief interventions. Drug and Alcohol Dependence 98, 235–240.CrossRefGoogle ScholarPubMed
Hettema, J, Steele, J, Miller, WR (2005). Motivational interviewing. Annual Review of Clinical Psychology 1, 91–111.CrossRefGoogle ScholarPubMed
Hofmann, SG, Asnaani, A, Vonk, IJ, Sawyer, AT, Fang, A (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive Therapy and Research 36, 427–440.CrossRefGoogle ScholarPubMed
Jensen, CD, Cushing, CC, Aylward, BS, Craig, JT, Sorell, DM, Steele, RG (2011). Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: a meta-analytic review. Journal of Consulting and Clinical Psychology 79, 433.Google Scholar
Kaufman, J, Charney, D (2000). Comorbidity of mood and anxiety disorders. Depression and Anxiety 12, 69–76.Google Scholar
Kerry, SM, Bland, JM (1998). Analysis of a trial randomised in clusters. British Medical Journal 316, 54.CrossRefGoogle ScholarPubMed
Kessler, RC, Amminger, GP, Aguilar-Gaxiola, S, Alonso, J, Lee, S, Üstün, TB (2007). Age of onset of mental disorders: a review of recent literature. Current Opinion in Psychiatry 20, 359–364.Google Scholar
Kessler, RC, Avenevoli, S, Ries Merikangas, K (2001). Mood disorders in children and adolescents: an epidemiologic perspective. Biological Psychiatry 49, 1002–1014.Google Scholar
King, NJ, Heyne, D, Ollendick, TH (2005). Cognitive-behavioral treatments for anxiety and phobic disorders in children and adolescents: a review. Behavioral Disorders 30, 241–257.CrossRefGoogle Scholar
LaBrie, JW, Quinlan, T, Schiffman, JE, Earleywine, ME (2005). Performance of alcohol and safer sex change rulers compared with readiness to change questionnaires. Psychology of Addictive Behaviors 19, 112.CrossRefGoogle ScholarPubMed
Livingston, JD, Boyd, JE (2010). Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Social Science & Medicine 71, 2150–2161.Google Scholar
Lofthouse, N, Gilchrist, R, Splaingard, M (2009). Mood-related sleep problems in children and adolescents. Child and Adolescent Psychiatric Clinics of North America 18, 893–916.Google Scholar
Lundahl, B, Burke, BL (2009). The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. Journal of Clinical Psychology 65, 1232–1245.Google Scholar
Lundahl, B, Moleni, T, Burke, BL, Butters, R, Tollefson, D, Butler, C, Rollnick, S (2013). Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Education and Counseling 93, 157–168.Google Scholar
Macgowan, MJ, Engle, B (2010). Evidence for optimism: behavior therapies and motivational interviewing in adolescent substance abuse treatment. Child and Adolescent Psychiatric Clinics of North America 19, 527–545.Google Scholar
Maher, MJ, Wang, Y, Zuckoff, A, Wall, MM, Franklin, M, Foa, EB, Simpson, HB (2012). Predictors of patient adherence to cognitive-behavioral therapy for obsessive-compulsive disorder. Psychotherapy and Psychosomatics 81, 124–126.Google Scholar
McEvoy, PM, Nathan, P, Norton, PJ (2009). Efficacy of transdiagnostic treatments: a review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy 23, 20–33.CrossRefGoogle Scholar
Mead, N, Lester, H, Chew-Graham, C, Gask, L, Bower, P (2010). Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis. The British Journal of Psychiatry 196, 96–101.Google Scholar
Miller, WR, Rollnick, S (2002). Motivational Interviewing: Preparing People for Change. Guilford Press: New York.Google Scholar
Miller, WR, Rollnick, S (2013). Motivational Interviewing: Helping People Change, 3rd edn. Guilford Press: New York.Google Scholar
Moyers, TB, Martin, T, Manuel, JK, Hendrickson, SM, Miller, WR (2005). Assessing competence in the use of motivational interviewing. Journal of Substance Abuse Treatment 28, 19–26.Google Scholar
Naar-King, S, Outlaw, A, Green-Jones, M, Wright, K, Parsons, JT (2009). Motivational interviewing by peer outreach workers: a pilot randomized clinical trial to retain adolescents and young adults in HIV care. AIDS Care 21, 868–873.Google Scholar
Naar-King, S, Parsons, JT, Johnson, AM (2012). Motivational interviewing targeting risk reduction for people with HIV: a systematic review. Current HIV/AIDS Reports 9, 335–343.Google Scholar
Orlinsky, DE, Grawe, K, Parks, BK. (1994). Process and outcome in psychotherapy: Noch einmal. In Handbook of Psychotherapy and Behavior Change, 4th edn, pp. 270–376. John Wiley & Sons: Oxford, UK.Google Scholar
Pine, DS, Cohen, P, Gurley, D, Brook, J, Ma, Y (1998). The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Archives of General Psychiatry 55, 56–64.Google Scholar
Romano, M, Peters, L (2015). Evaluating the mechanisms of change in motivational interviewing in the treatment of mental health problems: a review and meta-analysis. Clinical Psychology Review 38, 1–12.Google Scholar
Rothwell, PM (2005). External validity of randomised controlled trials: to whom do the results of this trial apply? Lancet 365, 82–93.Google Scholar
Sabaté, E (2003). Adherence to Long-term Therapies: Evidence for Action. World Health Organization: Geneva, Switzerland.Google Scholar
Saunders, B, Wilkinson, C, Phillips, M (1995). The impact of a brief motivational intervention with opiate users attending a methadone programme. Addiction 90, 415–424.Google Scholar
Sensky, T, Turkington, D, Kingdon, D, Scott, JL, Scott, J, Siddle, R, O'Carroll, M, Barnes, TR (2000). A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Archives of General Psychiatry 57, 165–172.CrossRefGoogle ScholarPubMed
Shochat, T, Cohen-Zion, M, Tzischinsky, O (2014). Functional consequences of inadequate sleep in adolescents: a systematic review. Sleep Medicine Reviews 18, 75–87.Google Scholar
Supplementary material: PDF

Dean supplementary material

Dean supplementary material 1

Download Dean supplementary material(PDF)
PDF 70.8 KB