Motivational Interviewing Enhances Treatment Engagement in Adolescents with Anxiety and Mood Disorders


In this study by Dean and colleagues, they found that motivational interviewing enhanced group treatment engagement in adolescents diagnosed with anxiety and mood disorders.

Their findings demonstrate that motivational interviewing, as a pre-treatment intervention for engagement, leads to greater average attendance, higher treatment initiation, and higher readiness for treatment ratings compared with an active control (befriending). They suggest that as a brief pre-treatment intervention, motivational interviewing may be a feasible approach to include in adolescent psychiatric settings to support a collaborative relationship with young people, and improve engagement in evidence-based interventions such as cognitive behavioural therapy (CBT).


Article Title: 

Motivational interviewing to enhance adolescent mental health treatment engagement: a randomized clinical trial (Pay Wall)




S. Dean, E. Britt, E. Bell, J. Stanley and S. Collings




University of Otago and University of Canterbury,  New Zealand




The researchers wanted to assess whether motivational interviewing, as a brief engagement session, will enhance treatment engagement in a standard therapy setting (group cognitive behavioural therapy) for adolescents with anxiety and mood disorders. More specifically, the study assessed whether participants receiving motivational interviewing attended a greater average number of standard therapy sessions, initiated attendance more frequently, and rated readiness for treatment more highly than participants in an active control condition (befriending instead of motivational interviewing).





The researchers noted that a recent meta-analysis concluded that treatment engagement may be the way through which motivational interviewing enhances treatment for psychiatric disorders. Past research also suggests readiness to change and motivational interviewing fidelity as key factors in treatment attendance. They remark that few studies have assessing the efficacy of motivational interviewing have measured fidelity to treatment, or used active control groups (delivering standard treatment to those participants not in the experimental condition), and as such it had been difficult to attribute any observed change to motivational interviewing specifically, or to additional contact time in general.




All 96 adolescents diagnosed with either mood or anxiety disorders received usual care as provided by the outpatient child and adolescent mental health service in addition to group cognitive behavioural therapy and the research intervention (motivational interviewing, 46 participants) or active control (befriending, 50 participants).


ScientiFix tip: A strength of this study is that the researchers used an active control for those participants not in the experimental condition. These participants in the control group received befriending, a nonspecific and nondirective intervention focused on neutral topics. Participants in this condition were given an opportunity to ask questions and were provided with information about the group therapy. Using an active control group (where participants complete a standard or alternative treatment) is advantageous as it allows researchers to control for the non-specific aspects of training and study participation, such as amount of time with the experimenter, number of sessions, etc. This makes it easier to determine that any effects were as a result of the intervention or training, and not due to differences emerging from the testing conditions.


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