Motivational interviewing as an integrative framework for the treatment of depression

Upon seeing the title of this chapter, some readers may think: "Another therapy for depression?" We already have a number of treatments that have proven somewhat efficacious. Nevertheless, a significant percentage of clients who receive these therapies show improvement but not remission as well as high relapse rates. Many others are not helped at all. Motivational interviewing (MI) may be one way to enhance the effectiveness of psychotherapy and drug therapy for depression, because it emphasizes two issues that are highly relevant to depression-increasing intrinsic motivation and resolving ambivalence about change. In addition, meta-analyses have found that MI can be used in combination with other therapies and increases client retention in and adherence to other treatments. Many of these other treatments have been cognitive-behavioral in nature. Currently, there appears to be a great deal of interest in combining or integrating MI and cognitive-behavioral therapy (CBT). In this chapter, we will address the integration of these two therapies. However, our discussion will be broader and discuss MI not as another "school" of therapy but as a method that can be flexibly used to enhance treatment outcomes for depression. We propose that MI can be employed as an integrative framework that can incorporate other therapies and that can flexibly be used to enhance treatment outcome in depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)