Date Published: 23 March 2016

Combining motivational interviewing with cognitive behavioural therapy to treat anxiety

A recent five-year research study conducted in Toronto (Ontario, Canada), has found that psychotherapists, that is people using 'talking therapies' to help other people to overcome mental or emotional challenges, need to have two important sets of skills. They need to be able to help people to prepare themselves by mentally and/or emotionally getting ready to make a change or changes. Then they also need to be able to help such people actually make the change or changes necessary in order to achieve the desired improvements in their experience of life.

Put simply, the Canadian researchers found that motivating willingness to change is a necessary step to help someone deal with severe anxiety (worry). One way to do this is by integrating motivational interviewing techniques into the already well-known and widely used technique of cognitive behavioural therapy (CBT). According to these scientists, it is not unusual or abnormal to feel conflicted about change. Motivational interviewing is important because it is an effective method by which therapists can help people to understand and deal with their fear of change if this is holding them back in some way.

Prof. Dr. Henny Westra, psychology professor at York University (Toronto, Canada), who led the study explained that:

" The study results suggest that integrating motivational interviewing (MI) with CBT is more effective than CBT alone for long-term improvement."

" ... because MI is focused on listening and drawing out client ideas, patients feel more confidence in coping with issues facing them even after therapy ends in contrast to having to rely on the therapist's expertise", she added.

The study that lead to these conclusions involved a randomized clinical trial during which 85 participants underwent treatment for severe generalized anxiety disorder (GAD). Cognitive behavioral therapy alone was given to 43 participants while the other participants received a combination of CBT and motivational interviewing (MI) from therapists who were trained in the use of both of these techniques.

Overall the participants responded well to both the motivationally enhanced CBT (i.e. with MI) and the standard CBT (without MI) during the 15-week treatment phase. The results indicated that those patients who received the motivationally enhanced treatment (CBT with MI) continued to improve. Follow-up data found that the people who received CBT with MI were five times more likely to be free of the diagnosis of generalized anxiety one year after treatment ended.

Co-author of the study Prof. Dr. Martin Anthony of Ryerson University (Toronto, Canada) explained that:

" this study highlights the importance of studying the long term impact of our treatments, as the enhanced improvements seen in people who received the integrated MI and CBT treatment were greatest sometime after treatment had ended."

Ref. to Paper:
Henny A. Westra, Michael J. Constantino, Martin M. Antony (2016), Integrating Motivational Interviewing With Cognitive- Behavioral Therapy for Severe Generalized Anxiety Disorder: An Allegiance-Controlled Randomized Clinical Trial, Journal of Consulting and Clinical Psychology DOI: 10.1037/ccp0000098. Published online: 17 March 2016.

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