Motivational interviewing and treatment adherence among psychiatric and dually diagnosed patients

The effect of motivational interviewing on outpatient treatment adherence a mong psychiatric and dually diagnosed inpatients was investigated. Subjects were 121 psychiatric inpatients, 93 (77%) of whom had concomitant substanc e abuse/dependence disorders, who were randomly assigned to: a) standard tr eatment (ST), including pharmacotherapy, individual and group psychotherapy , activities therapy, milieu treatment, and discharge planning; or b) ST pl us motivational interviewing (ST+MI), which involved 15 minutes of feedback on the results of a motivational assessment early in the hospitalization, and a 1-hour motivational interview just before discharge. Interviewers uti lized motivational techniques described in Miller and Rollnick (1991), such as reflective Listening discussion of treatment obstacles, and elicitation of motivational statements. Results indicated that the proportion of patie nts who attended their first outpatient appointment was significantly highe r for the ST+MI group (47%) than far the ST group (21% chi(2) = 8.87, df = 1, p < .01) overall, and for dually diagnosed patients (42% for ST+MI vs. 1 6% for ST only; chi(2) = 7.68, df = 1, p < .01). Therefore, brief motivatio nal interventions show Promise in improving outpatient; treatment; adherenc e among psychiatric and dually diagnosed patients.