Motivational Interviewing Improves Poststroke Outlook and Survival

Stroke survivors who participated in motivational interviewing (MI) with therapists within 1 month of their stroke had higher rates of survival and experienced less depression than those who did not receive talk therapy. During interviews, patients set goals and developed strategies for overcoming obstacles during recovery. MI is based on positive psychology, is generally used with individuals for changing health behaviors and is a central feature of many coaching styles. This study’s purpose was to determine whether MI could benefit patients’ mood and mortality following a stroke. Depression, a common issue among stroke survivors, interferes with recovery, survival and return to normal life.

In this randomized controlled trial, 48% of therapy patients maintained a normal mood, compared with 37.7% of those in the control group. The death rate was 6.5% for therapy group members and 12.8% for control subjects. The study included 411 patients with an average age of 70; slightly more than half were men. No subjects had severe cognitive or communication problems.

In MI sessions, therapists asked stroke survivors about their thoughts for the future, what obstacles they expected to face during recovery and how confident they were in their ability to overcome these barriers. Patients were encouraged to brainstorm solutions to problems that they anticipated.

“Prior studies targeting depressed stroke patients have had limited success, but the depression may have already interfered with rehabilitation and recovery,” said Caroline Watkins, PhD, lead study author and professor of stroke and older people’s care at the University of Central Lancashire in England. “We found that early intervention helped people set realistic expectations for recovery [and] avoid some of the misery associated with life after stroke. [MI] may even help them live longer. The simplicity and brevity of this intervention makes it inexpensive to deliver, and yet it has the potential to give huge benefits to its recipients,” said Watkins. “These results imply a strong association between mood following a stroke and mortality within 1 year, but we believe it should be examined in a much larger study.”

The study was published in Stroke: Journal of the American Heart Association (2011; 42, 1956–61).