A randomized controlled trial of telephone motivational interviewing to enhance mental health treatment engagement in Iraq and Afghanistan veterans

Karen H. Seal*, Linda Abadjian, Nicole McCamish, Ying Shi, Gary Tarasovsky, Kenneth Weingardt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Objective: To test the efficacy of telephone-administered motivational interviewing (MI) to enhance treatment engagement in Iraq and Afghanistan veterans with mental health (MH) problems. Method: Between April 23, 2008, and February 25, 2011, 73 Iraq and Afghanistan veterans who screened positive for ≥ 1 MH problem(s) on telephone-administered psychometric assessment, but were not engaged in treatment, were randomized to either personalized referral for MH services and four sessions of telephone MI or standard referral and four neutral telephone check-in sessions (control) at baseline, 2, 4 and 8 weeks. Blinded assessment occurred at 8 and 16 weeks. Results: In intent-to-treat analyses, 62% assigned to telephone MI engaged in MH treatment compared to 26% of controls [relative risk (RR)=2.41, 95% confidence interval (CI)=1.33-4.37, P=.004], which represented a large effect size (Cohen's h=0.74). Participants in the MI group also demonstrated significantly greater retention in MH treatment than controls [MI mean visits (S.D.)=1.68 (2.73) and control mean visits (S.D.)=0.38 (0.81), incidence rate ratio (IRR)=4.36, 95% CI=1.96-9.68, P<.001], as well as significant reductions in stigma and marijuana use at 8 weeks (P<.05). Conclusions: Telephone MI enhances MH treatment engagement in Iraq and Afghanistan veterans with MH problems.

Original languageEnglish (US)
Pages (from-to)450-459
Number of pages10
JournalGeneral Hospital Psychiatry
Volume34
Issue number5
DOIs
StatePublished - Sep 1 2012

Keywords

  • Motivational interviewing
  • Posttraumatic stress disorder
  • Treatment engagement
  • Trial
  • War veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health

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