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Winter 2009/10 | Vol 13 No 2

Research update

Mark de la Hey

Motivational interviews improve effectiveness of CBT for anxiety

Research at York University in Toronto has found that people with generalized anxiety disorder (GAD) respond much better to cognitive-behavioural therapy (CBT) when they are given motivational interviews prior to therapy. The researchers recruited 76 people with GAD, 38 of whom were assigned to receive CBT preceded by four weekly motivational interview sessions, while another 38 received CBT alone after a four-week waiting period. The motivational interviews were designed to increase participants’ motivation by reducing their ambivalence about changing their patterns of worrying. Six participants dropped out of treatment with CBT alone, while only four dropped out when given pre-treatment with motivational interviews. At the end of treatment, those given motivational interviews showed significantly lower scores on the Penn State Worry Questionnaire than those who received CBT alone. Ninety-two per cent of those who received pre-treatment had normal worry scores after completing the therapy, compared with 71 per cent of those given CBT alone. Not only did those given pre-treatment benefit more from the CBT, but the motivational interviews alone provided some reduction in their worry scores even before they began CBT. Those with high levels of worry showed the greatest benefit from motivational interviews. Among this subgroup, 81 per cent of those who received pre-treatment no longer met diagnostic criteria for GAD after completing CBT, compared with 56 per cent of those who received CBT alone. The authors conclude that further research into augmenting CBT with motivational interviewing is warranted for people with severe levels of anxiety.

Journal of Anxiety Disorders, 2009, doi:10.1016/j.janxdis.2009.07.014. Henny A Westra et al., Department of Psychology, York University, Toronto, Ontario.