Training Primary Care Providers in Motivational Interviewing and Alliance During Treatment of Depression: A Randomized Trial

This study sought to determine whether training primary care providers (PCPs) in Motivational Interviewing (MI) would improve patient-provider alliance during treatment for depression, therefore helping to inform primary care practices. The data used in this study came from a cluster randomized controlled trial (RCT) of PCPs trained in MI (n=10) and not trained (n=15) to treat depression at 7 clinics (randomized to 3 MI, 4 control) in an urban setting (Keeley et al., 2014). The National Institute of Mental Health and the National Institutes of Health/National Center for Advancing Translational Sciences Colorado provided funding for the primary study (Keeley et al., 2014). All patients (MI N = 86, control N = 80) were recruited after being diagnosed with major depression (Keeley et al., 2014). PCPs in the intervention group were trained in MI during at least one 8-hour session, with further training available (Keeley et al., 2014). Patient treatment conditions were determined by clinic assignments, to which they were blinded. Contrary to hypotheses, patient-provider alliance was not significantly higher among patients of MI trained PCPs at any point in time; however, there was evidence of a significant difference in change over time between conditions. There was a decrease in patient-provider alliance for patients who received depression treatment from PCPs who were not trained in MI; in contrast, patients of MI trained PCPs maintained patient-provider alliance over the course of 12 weeks of treatment. The findings presented in this study are discussed with respect to limitations and suggestions for further research