Academic Insight: Can Incorporating Motivational Interviewing to Cognitive Behavioral Therapy be Beneficial?

By Charles O'Connor

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Experiencing Anxiety, whether its related to one’s job, personal relationships, or other factors, is a reality of life for most people. However, at times anxiety can become so problematic and debilitating it becomes a clinical disorder. In fact, Anxiety Disorders are one of the most prevalent types of psychological disorders that afflict individuals. In the US alone, anxiety disorders are twice as prevalent than mood disorders, and five times higher than the number of people with substance disorders. These disorders affect many areas of functioning.

Cognitive behavioral therapy is a form of psychotherapy that gives people the encouragement and skills needed to change destructive behaviors or thought patterns. It is widely regarded as an effective treatment for anxiety disorders, regardless of the specific diagnosis. Despite its success, cognitive behavioral therapy does have its limitations. Between 15 and 50 percent of those who engage in cognitive behavioral therapy as a treatment for anxiety do not respond to treatment, and approximately 23% drop out of treatment.

Motivational Interviewing is a generally short-term therapy which helps individuals overcome ambivalence, and increase motivation to change detrimental behaviors; The four basic components of MI are therapist expression of empathy, exploration of discrepancy between a clients behavior and desires, “rolling with resistance,” and encouraging self-efficacy in change and maintenance. Many therapists and researchers have hypothesized that motivational interviewing could be useful in treating anxiety disorders in conjunction with CBT. This is because ambivalence often accompanies anxiety disorders and could be a barrier to engaging in therapy. CBT approaches assume that clients entering treatment are and will stay motivated to change. MI helps to create and maintain motivation for treatment.

In an attempt to more concretely answer whether or not Motivational interviewing can increase the effectiveness of treating an anxiety disorder with CBT, researchers from Monash University in Austrailia conducted a meta-analysis of 12 studies regarding motivational interviewing and cognitive behavioral therapy as a treatment for anxiety. In order to measure the efficiency of the motivational interviewing in the studies chosen for the analysis, the researchers decided to measure drop out rates and symptom reductions amongst the patients.

As the researchers had predicted, Motivational Interviewing when used together with CBT, reduced post-treatment symptoms for anxiety disorders when compared to CBT alone. In their analysis, they found that Motivational Interviewing was effective in reducing post-treatment symptoms. However, researchers found that MI used with CBT did not affect drop out rates in the studies which they analyzed. This led the researchers to suggest that if motivational interviewing was utilized throughout CBT treatment instead of just before CBT (which was the case for the majority of studies that they chose), then perhaps drop out rates would be lower.

The researchers did find some limitations in their analysis. First, they observed many of the selected studies didn’t track participant motivation, treatment engagement, and adherence, so their ability to truly gauge MI’s efficacy when combined with CBT was limited because of this. While their findings overall indicate MI could be beneficial in treating anxiety disorders, it is clear more research is required. A link to the article can be found Here.

 

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