Motivational interviewing and acquired brain injury

Purpose Brain injury rehabilitation is often complicated or confounded by difficulties with engaging the injured party with the services and input required. Lack of awareness of cognitive and executive impairments is often implicated in this difficulty. Any technique or approach that enhances engagement may then support rehabilitation. The aim of this paper is to examine the current evidence base for the use of motivational interviewing (MI) as a method for increasing engagement by supporting the development of insight. Design/methodology/approach The paper is a literature review, taking as its basis Medley and Powell's conceptual review of MI and then examining the published evidence available. Findings Although attractive to practitioners in the field because the purpose of MI and the goals underpinning acquired brain injury (ABI) rehabilitation are co‐terminus, the theoretical and research findings to date that address the effective application of MI to ABI are inconclusive. The literature presently available suggests there is no conclusive evidence that MI is a more effective approach than any other, and that which is available makes little reference to the specific difficulties of an ABI population that may confound MI's application in this area. Research limitations/implications There is currently no high standard of evidence to support the use of MI with people with ABI. Practical implications There are still very few papers written, or research undertaken, into the effectiveness of MI with people with a brain injury. Most of the work undertaken thus far is concerned with supporting behavioural change in this population when problematic alcohol or drug use is co‐morbid. This paper identifies some of the practical difficulties with the approach whilst recognizing the inherent value in its aims. Originality/value The paper provides an opportunity for practitioners who wrestle with the difficulty of engagement on a daily basis to reflect upon how present practice could be altered to increase the likelihood of supporting engagement