Combining motivational interviewing and cognitive-behavioral therapy to increase treatment efficacy for generalized anxiety disorder

(from the chapter) Resistance and the underlying ambivalence that often gives rise to it are common clinical realities in cognitive-behavioral therapy (CBT) and other therapies. Because the quality of the client's engagement with treatment is among the most critical contributors to treatment outcomes, it is likely that effective ways of reducing resistance, and increasing engagement may hold significant promise for improving the efficacy of CBT. One approach known as motivational interviewing (MI) may hold promise for reducing resistance when combined with other therapies such as CBT. In this chapter, we examine how MI has been added to CBT (i.e., as a pretreatment) or integrated with it (i.e., blended with CBT to form a unified treatment) to reduce resistance and to improve outcome in the treatment of generalized anxiety disorder (GAD). We describe MI and the rationale for applying it to GAD. This discussion is followed by an extended clinical example of the use of MI as a pretreatment to CBT for GAD. Finally, we present empirical work evaluating the impact of MI used with CBT in the treatment of anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)