Background:A substantial proportion of patients receiving cognitive behavioural therapy (CBT) do not achieve remission, and drop-out is considerable. Motivational interviewing (MI) may influence non-response and drop-out. Previous research shows that MI as a pre-treatment to CBT produces moderate effects compared with CBT alone. Studies integrating MI with CBT (MI-CBT) are scarce.Aims:To test the feasibility of MI-CBT in terms of therapist competence in MI and various participant measures, including recruitment and retention. In addition, separate preliminary evaluations were conducted, exploring the effects of CBT alone for anxiety disorders and depression, and of MI-CBT for anxiety disorders, depression and unhealthy lifestyle behaviours.Method:Using a randomised controlled parallel trial design, participants were recruited in routine psychiatric care and allocated to CBT alone or MI-CBT. Means in feasibility measures and within-condition Hedges’ g effect sizes in treatment outcome measures were calculated. Authors were not blind to treatment allocation, while independent raters were blind.Results:Seventy-three patients were assessed for eligibility, and 49 were included. Participant perceptions of treatment credibility, expectancy for improvement, and working alliance were similar for both conditions. Overall, effect sizes were large across outcome measures for both conditions, including anxiety and depressive symptoms and functional impairment. However, therapists did not acquire sufficient competence in MI and the drop-out rate was high.Conclusions:MI-CBT proved feasible in some respects, but the present study did not support the progression to a randomised controlled trial designed to assess the effectiveness of MI-CBT. Additional pilot studies are needed.

中文翻译：

---

将动机性访谈与认知行为疗法相结合，治疗焦虑症、抑郁症和共病不健康的生活方式行为：一项随机对照试验

背景：很大一部分接受认知行为疗法（CBT）的患者没有达到缓解，并且辍学率相当高。动机性访谈 (MI) 可能会影响无回应和辍学。先前的研究表明，与单独的 CBT 相比，MI 作为 CBT 的预处理产生中等效果。将 MI 与 CBT (MI-CBT) 相结合的研究很少。目的：测试 MI-CBT 在 MI 治疗师能力和各种参与者措施方面的可行性，包括招募和保留。此外，还进行了单独的初步评估，探索单独 CBT 对焦虑症和抑郁症的影响，以及 MI-CBT 对焦虑症、抑郁症和不健康生活方式行为的影响。方法：使用随机对照平行试验设计，参与者在常规精神科护理中被招募，并被分配到单独的 CBT 或 MI-CBT。可行性措施和条件内对冲的手段G计算了治疗结果测量中的效应大小。作者对治疗分配不视而不见，而独立评估者是盲的。结果：对 73 名患者的资格进行了评估，其中 49 人被纳入。两种情况下，参与者对治疗可信度、改善期望和工作联盟的看法相似。总体而言，在这两种情况下，包括焦虑和抑郁症状以及功能障碍在内的结果测量中，效应量都很大。然而，治疗师在 MI 方面没有获得足够的能力，并且辍学率很高。结论：MI-CBT 在某些方面证明是可行的，但本研究不支持进展为旨在评估其有效性的随机对照试验。 MI-CBT。需要进行额外的试点研究。