An evaluation of the efficacy of motivational interviewing (MI) in increasing commitment language (CL) in interviews with clients with spinal cord injury (SCI) : a thesis in partial fulfilment of the requirements for the degree of Master of Philosophy in Rehabilitation at Massey University, Palmerston North, New Zealand

Abstract

The purpose of this study was to compare Motivational Interviewing (MI) as an intervention that differed from other best practice interviewing techniques in that it increased the level of Commitment Language (CL) expressed by clients. Clients with spinal cord injury (SCI) were selected for this study because the use of MI with acute onset disabilities has not received research attention. It was proposed that Motivational Interviewing increased CL expressed in utterances from clients that identified intrinsic motivators or alternatively possible barriers to engage in the rehabilitation process. The level of CL was seen as a predictor of the client’s motivation towards rehabilitation initiatives and identified behavioural change towards adherence to rehabilitation or barriers preventing adherence. The increase in CL depends on the interviewing process. How CL is expressed in interviews depends on the interviewer’s ability to recognise positive or negative direction in the client’s response. The ability to measure CL may assist in identifying what it is that MI does in the interviewing process to increase CL. Elevated levels of CL recorded in interviews may be defined as low, medium or high and either positive or negative. The key elements of this study are whether MI increases the level of CL expressed by clients compared with base line best practice strength based assessment questioning (SBAQ). Recognising MI as an intervention to increase CL may assist clients in engaging or adhering to rehabilitation initiatives. The use of conversational analysis (CA) indicates that CL is a measurable component of MI that differentiates it from other interviewing techniques. Further research is required to promote CL as a predictor of behaviour change. Identifying the integrity of MI principles in studies that can show the relationship of MI to outcomes and compare these with recognised alternative treatments is required to enhance the delivery of the intervention.