Transdiagnostic internet-delivered cognitive behaviour therapy: utility of a motivational interviewing resource

Abstract

Background: Despite growing evidence for the effectiveness of internet-delivered cognitive behaviour therapy (ICBT), engagement and treatment outcomes are lower for some patients. Online motivational interviewing (MI) has been investigated prior to ICBT to facilitate engagement and outcomes, but only appears to improve engagement. Purpose: This feasibility study investigated the potential use of a MI resource offered during ICBT rather than before, by examining: (1) utilization of the resource; (2) patient and treatment variables associated with utilization; (3) whether use of the resource was associated with improved engagement and outcomes; and (4) how those who used the resource evaluated it. Method: This study used data collected from 763 patients enrolled in an ICBT course. Patients completed an MI resource evaluation measure at post-treatment. Symptoms were assessed at pre- and post-treatment. The website tracked treatment engagement. Results: Approximately 15% of patients used the resource. Patients who were older, had higher education, higher depression, and lower anxiety at pre-treatment were more likely to use the resource. Those who reported using the resource had higher engagement (i.e., more lessons and more messages) in ICBT, but lower improvement in disability. Positive feedback on the MI resource outweighed the negative (94% positive comments; 16% negative comments) and 68% of clients reported making changes in response to the resource. Overall, the MI resource appears to have utility for a small portion of patients who complete ICBT. The study provides insight to who will use the resource. Future research directions related to MI and ICBT are discussed.