The Effectiveness of Motivational Interviewing
Many professionals who combine health coaching with fitness training use motivational interviewing, a method intended to stimulate a client’s active problem-solving capacities. The first large randomized clinical trial evaluating the use of MI has now demonstrated its effectiveness in helping patients to change health behaviors in ways that directly resulted in fewer hospitalizations. Mayo Clinic investigators in Rochester, Minnesota, conducted the study to test the feasibility and effectiveness of MI for patients with chronic obstructive pulmonary disease.
“We tested an intervention that primarily aimed to promote patient activation and mindful communication, two critical and perhaps underrated aspects of care that we firmly believe are at the heart of practicing the art of medicine,” said lead study author Roberto Benzo, MD, MS, of the Mayo Clinic in an American Thoracic Society news release. “This coaching style emphasizes autonomy and choice in what the patient wanted to work on. It is a process that happens with a patient; it is not something the coach does to a patient.”
To assess the impact of MI, researchers randomly assigned 215 male and female study participants who had been hospitalized for COPD to either a control group, which received treatment-as-usual, or a health coaching group. Coaching group participants received one MI session in the hospital and one session after discharge, followed by weekly telephone sessions for 3 months and then monthly sessions until the 1-year follow-up. Researchers collected data from all subjects when hospitalized, 1 month later and at quarterly intervals after hospitalization up to the 1-year mark. The data addressed COPD symptoms, quality of life, hospitalization rates, attendance at pulmonary rehabilitation, physical activity and emotional well-being.
Data analysis showed that MI group members had lower hospitalization rates and higher attendance in pulmonary rehabilitation at every measurement interval. In addition, MI participants experienced significant improvement in disease-specific quality of life. “Only individuals in the intervention group showed decreased hospitalization, suggesting that the mindful attention—not any attention—like that received in health coaching may matter; health coaching may motivate people to behaviors like attending pulmonary rehab that translate into the improvement of ‘hard’ outcomes like hospitalizations,” said Benzo.
The study was presented at the 2016 American Thoracic Society International Conference, held in San Francisco.