View in EDS

Motivational Interviewing Improves Depression Outcome in Primary Care: A Cluster Randomized Trial.

Saved in:
Bibliographic Details
Title: Motivational Interviewing Improves Depression Outcome in Primary Care: A Cluster Randomized Trial.
Authors: Keeley, Robert D.1,2 robert.keeley@dhha.org, Brody, David S.2, Engel, Matthew3, Burke, Brian L.4, Nordstrom, Kimberly1,2, Moralez, Ernesto5, Dickinson, L. Miriam2, Emsermann, Caroline
Source: Journal of Consulting & Clinical Psychology. Nov2016, Vol. 84 Issue 11, p993-1007. 15p.
Subject Terms: *Mental depression, Motivational interviewing, Cluster randomized controlled trials, Primary care, Therapeutics, Mood (Psychology), Mental health counseling
Abstract: Objective: To examine the effects of Motivational Interviewing (MI) conducted by primary care providers on rates of improvement over time for depressive symptoms and remission among low-income patients with newly diagnosed Major Depressive Disorder. Method: Ten care teams were randomized to MI with standard management of depression (MI-SMD; 4 teams, 10 providers, 88 patients) or SMD alone (6 teams, 16 providers, 80 patients). Patients were assessed at 6, 12 and 36 weeks with the Patient Health Questionnaire-9 (PHQ-9). Treatment receipt was ascertained through patient inquiry and electronic records. Audio-recorded index encounters were evaluated for mediators of improved depressive symptoms (providers' MI ability and patient language favoring participating in treatment or other depression related mood-improving behaviors). Results: In Intention-To-Treat analyses, MI-SMD was associated with a more favorable trajectory of PHQ-9 depressive symptom scores than SMD alone (randomization group X time interaction estimate = 0.13, p = .018). At 36 weeks, MI-SMD was associated with improved depressive symptoms (Cohen's d = 0.41, 95% Cl [0.11, 0.72]) and remission rate (Success Rate Difference = 14.53 [1.79, 27.26]) relative to SMD alone. MI-SMD was not associated with a significant group x time interaction for remission, or with increased receipt of antidepressant medication or specialty mental health counseling. The providers' ability to direct clinical discussions toward treating depression, and the patients' language favoring engagement in mood-improving behaviors, mediated the effects of MI-SMD on depressive symptoms (ps < .05). Discussion: Training providers to frame discussions about depression using MI may improve upon standard management for depression. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Consulting & Clinical Psychology is the property of American Psychological Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
FullText Text:
  Availability: 0
Header DbId: ehh
DbLabel: Education Research Complete
An: 119061352
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Motivational Interviewing Improves Depression Outcome in Primary Care: A Cluster Randomized Trial.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Keeley%2C+Robert+D%2E%22&quot;&gt;Keeley, Robert D.&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt;&lt;i&gt; robert.keeley@dhha.org&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Brody%2C+David+S%2E%22&quot;&gt;Brody, David S.&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Engel%2C+Matthew%22&quot;&gt;Engel, Matthew&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burke%2C+Brian+L%2E%22&quot;&gt;Burke, Brian L.&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nordstrom%2C+Kimberly%22&quot;&gt;Nordstrom, Kimberly&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Moralez%2C+Ernesto%22&quot;&gt;Moralez, Ernesto&lt;/searchLink&gt;&lt;relatesTo&gt;5&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dickinson%2C+L%2E+Miriam%22&quot;&gt;Dickinson, L. Miriam&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Emsermann%2C+Caroline%22&quot;&gt;Emsermann, Caroline&lt;/searchLink&gt;
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+Consulting+%26+Clinical+Psychology%22&quot;&gt;Journal of Consulting &amp; Clinical Psychology&lt;/searchLink&gt;. Nov2016, Vol. 84 Issue 11, p993-1007. 15p.
– Name: Subject
  Label: Subject Terms
  Group: Su
  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Mental+depression%22&quot;&gt;Mental depression&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Motivational+interviewing%22&quot;&gt;Motivational interviewing&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cluster+randomized+controlled+trials%22&quot;&gt;Cluster randomized controlled trials&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Primary+care%22&quot;&gt;Primary care&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Therapeutics%22&quot;&gt;Therapeutics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Mood+%28Psychology%29%22&quot;&gt;Mood (Psychology)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Mental+health+counseling%22&quot;&gt;Mental health counseling&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: To examine the effects of Motivational Interviewing (MI) conducted by primary care providers on rates of improvement over time for depressive symptoms and remission among low-income patients with newly diagnosed Major Depressive Disorder. Method: Ten care teams were randomized to MI with standard management of depression (MI-SMD; 4 teams, 10 providers, 88 patients) or SMD alone (6 teams, 16 providers, 80 patients). Patients were assessed at 6, 12 and 36 weeks with the Patient Health Questionnaire-9 (PHQ-9). Treatment receipt was ascertained through patient inquiry and electronic records. Audio-recorded index encounters were evaluated for mediators of improved depressive symptoms (providers&#39; MI ability and patient language favoring participating in treatment or other depression related mood-improving behaviors). Results: In Intention-To-Treat analyses, MI-SMD was associated with a more favorable trajectory of PHQ-9 depressive symptom scores than SMD alone (randomization group X time interaction estimate = 0.13, p = .018). At 36 weeks, MI-SMD was associated with improved depressive symptoms (Cohen&#39;s d = 0.41, 95% Cl [0.11, 0.72]) and remission rate (Success Rate Difference = 14.53 [1.79, 27.26]) relative to SMD alone. MI-SMD was not associated with a significant group x time interaction for remission, or with increased receipt of antidepressant medication or specialty mental health counseling. The providers&#39; ability to direct clinical discussions toward treating depression, and the patients&#39; language favoring engagement in mood-improving behaviors, mediated the effects of MI-SMD on depressive symptoms (ps &lt; .05). Discussion: Training providers to frame discussions about depression using MI may improve upon standard management for depression. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Journal of Consulting &amp; Clinical Psychology is the property of American Psychological Association and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=119061352
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1037/ccp0000124
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 993
    Subjects:
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Motivational interviewing
        Type: general
      – SubjectFull: Cluster randomized controlled trials
        Type: general
      – SubjectFull: Primary care
        Type: general
      – SubjectFull: Therapeutics
        Type: general
      – SubjectFull: Mood (Psychology)
        Type: general
      – SubjectFull: Mental health counseling
        Type: general
    Titles:
      – TitleFull: Motivational Interviewing Improves Depression Outcome in Primary Care: A Cluster Randomized Trial.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Keeley, Robert D.
      – PersonEntity:
          Name:
            NameFull: Brody, David S.
      – PersonEntity:
          Name:
            NameFull: Engel, Matthew
      – PersonEntity:
          Name:
            NameFull: Burke, Brian L.
      – PersonEntity:
          Name:
            NameFull: Nordstrom, Kimberly
      – PersonEntity:
          Name:
            NameFull: Moralez, Ernesto
      – PersonEntity:
          Name:
            NameFull: Dickinson, L. Miriam
      – PersonEntity:
          Name:
            NameFull: Emsermann, Caroline
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 11
              Text: Nov2016
              Type: published
              Y: 2016
          Identifiers:
            – Type: issn-print
              Value: 0022006X
          Numbering:
            – Type: volume
              Value: 84
            – Type: issue
              Value: 11
          Titles:
            – TitleFull: Journal of Consulting & Clinical Psychology
              Type: main
ResultId 1