Online Motivational Interviewing for Enhancing Internet-Delivered Cognitive Behaviour Therapy
Author | : Joelle Natalie Soucy |
Publisher | : |
Total Pages | : 0 |
Release | : 2021 |
ISBN-10 | : OCLC:1339100438 |
ISBN-13 | : |
Rating | : 4/5 (38 Downloads) |
Book excerpt: While the efficacy of internet-delivered cognitive behaviour therapy (iCBT) for anxiety and depression is well established, not all clients benefit from treatment. Given that the integration of motivational interviewing (MI) and face-to-face therapy for anxiety enhances response and completion rates, combining iCBT with MI may also prove beneficial; however, there is limited research on the combined effects of MI and iCBT. In the current study, a brief, interactive online MI pre-treatment was designed to increase intrinsic motivation to engage in iCBT for anxiety and depression. Once the protocol was developed and piloted, the efficacy of the online MI pre-treatment was evaluated. Clients were randomly assigned to receive iCBT with (n = 231) and without the online MI pre-treatment (n = 249). Intrinsic motivation to engage in iCBT was assessed prior to and following completion of the pre-treatment. Clients were administered primary measures of anxiety and depression pre- and post-treatment and at 3- and 6-month follow-up. Possible differences between groups on symptom change, iCBT engagement, and motivational language during email correspondance were investigated. Results suggest that while clients in the MI plus iCBT group made more motivational statements and had a greater number of days in the course compared to clients in the iCBT only group, they did not demonstrate higher motivation, greater engagement, or improved completion or response rates. Clients in both groups reported high levels of motivation at pre- and post-MI and simiarly reported large reductions in anxiety and depression from pre- to post-treatment (Hedges' g range = 0.96-1.11). Yet during follow-up, cliens in the iCBT only group continued to report small reductions in symptoms of anxiety, whereas clients in the MI plus iCBT group did not. The addition of MI to iCBT was also associated with minor increases in symptoms of depression during the follow-up, wheras symptom improvements were sustained for clients in the iCBT only group. Overall, it is concluded that online MI may not enhance client outcomes when motivation at pre-treatment is high. In some instances, online MI may also be counterproductive, especially among individuals with high motivation to engage in treatment.