Motivational interviewing to enhance treatment attendance in mental health settings: A systematic review and meta-analysis

Introduction: The stages of change model suggests that individuals seeking treatment are in the preparation or the action stage of change, which is the desired outcome of successful Motivational Interviewing (MI) interventions. MI is known to enhance treatment attendance among individuals with mental health problems. Aim: This study examined the published research on MI as a pre-treatment to enhance attendance among individuals treatment-seeking and non-treatment-seeking for mental health issues. Methods: Fourteen randomized controlled trials were identified, and MI efficacy was examined dichotomously: attendance or non-attendance for post-MI therapy. Subgroup analysis investigated treatment-seeking and non-treatment-seeking groups. Results: Despite wide variations in sample sizes, blinding and monitoring, intervention fidelity was absent in the majority of published studies. Meta-analysis revealed that MI pre-treatment improved attendance relative to comparison groups. Conclusions: Individuals not seeking treatment for mental health issues benefited the most from MI. Despite differences in MI treatment intensity, short interventions were as effective as longer interventions, whereas two MI sessions for as little as 15 min were effective in enhancing treatment attendance. Implications for Practice: Motivational interviewing is a useful tool for clinicians in all therapeutic interactions to help motivate patients to seek assistance for mental health issues.