Category: Schizophrenia / Psychotic Disorders

Symposium

Factors Impacting Efficacy of Motivational Interviewing in Improving Treatment Adherence

Saturday, November 18
12:00 PM - 1:30 PM
Location: Aqua Salon E & F, Level 3, Aqua Level

Keywords: Psychosis / Psychotic Disorders | Motivation | Treatment Integrity / Adherence / Compliance
Presentation Type: Symposium

Motivational interviewing (MI) and related interventions have successfully been used to enhance treatment-specific motivation in various psychiatric populations. We recently found that MI can be used to improve the notoriously poor treatment adherence (attendance) in individuals with psychosis undergoing a behavioral intervention (n=60). Specifically, we examined the impact of 2 sessions of MI versus 2 sessions of a control interview (CI) on adherence to a subsequently available computerized cognitive training intervention. We found that number of sessions attended was significantly higher for MI than for CI condition. For the sample as a whole, we also found that number of sessions attended was significantly predicted by both amount of motivation change that occurred pre-post interviews as well as post-interview (immediately pre-training) motivation level.


 


In the current analyses, we focused on individuals who were randomized to receive MI (n=32) and examined baseline factors that might potentially impact the efficacy of MI interviews in enhancing motivation in this population. Baseline demographic, symptom and cognitive variables were examined for their impact on: 1) amount of motivation change occurring pre-post MI interview, and 2) post interview (pre-training) motivation level.


Improvement in motivation (pre-post MI change score) was predicted by number of prior hospitalizations (r= -.375) and self-reported problems with memory (r= -.411, p=.02) and executive function (r=-.405, p=.022). Significant correlations were also found with baseline PANSS total (r=.430 p=.01), PANSS positive factor (r=.50, p=.004) and PANSS emotional discomfort factor (r=.43, p=.015). Post-interview (pre-training) motivation level was positively correlated with cognitive insight (r=.45, p=.01). Age, education, GAF score, premorbid IQ estimate, current IQ, baseline objective cognitive performance, and performance on a medication management functional capacity assessment did not predict change in motivation nor post-interview motivation level.

Joanna Fiszdon

Yale University

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