ArticleFrontiers in psychiatry2020
Active Ingredients and Mechanisms of Change in Motivational Interviewing for Medication Adherence. A Mixed Methods Study of Patient-Therapist Interaction in Patients With Schizophrenia.
Article in Frontiers in psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 26 citations in OpenAlex.
- Qualitative Experience with an Adherence Promotion Intervention Among Individuals with Bipolar Disorder: What Is Helpful and Unhelpful?Medicina (Kaunas, Lithuania) · 2026Trial
- Effect of Motivational Interviewing on Exclusive Breastfeeding in Working Mothers: A Randomized Controlled Trial.Journal of primary care & community healthTrial
- Motivational Interviewing Produces Change Talk in Smokers with Serious Mental Illness.Journal of dual diagnosisTrial
- Advances in implementation strategies for treatment adherence in schizophrenia: a narrative review.Frontiers in psychiatry · 2026Review
- The Language of Change Among Individuals With Mild Intellectual Disability or Borderline Intellectual Functioning: Client Responses to Therapist Motivational Interviewing Skills.Journal of applied research in intellectual disabilities : JARID · 2026Article
- Prediabetes Awareness Barriers and Enablers: National Health and Nutrition Examination Survey 2011-2020.AJPM focus · 2025Article
- Motivational Interviewing in Patients with Acute Psychosis: A Feasibility Study.Schizophrenia bulletin open · 2025Article
- How do hospital providers perceive and experience the information-delivery process? A qualitative exploratory study.PEC innovation · 2023Article
- Review
- Active Ingredients and Mechanisms of Change in Motivational Interviewing for Smoking Cessation in Patients With Coronary Artery Disease: A Mixed Methods Study.Frontiers in psychology · 2021Article
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrials studying Motivational Interviewing (MI) to improve medication adherence in patients with schizophrenia showed mixed results. Moreover, it is unknown which active MI-ingredients are associated with mechanisms of change in patients with schizophrenia. To enhance the effect of MI for patients with schizophrenia, we studied MI's active ingredients and its working mechanisms.
methodsFirst, based on MI literature, we developed a model of potential active ingredients and mechanisms of change of MI in patients with schizophrenia. We used this model in a qualitative multiple case study to analyze the application of the active ingredients and the occurrence of mechanisms of change. We studied the cases of fourteen patients with schizophrenia who participated in a study on the effect of MI on medication adherence. Second, we used the Generalized Sequential Querier (GSEQ 5.1) to perform a sequential analysis of the MI-conversations aiming to assess the transitional probabilities between therapist use of MI-techniques and subsequent patient reactions in terms of change talk and sustain talk.
resultsWe found the therapist factor "a trusting relationship and empathy" important to enable sufficient depth in the conversation to allow for the opportunity of triggering mechanisms of change. The most important conversational techniques we observed that shape the hypothesized active ingredients are reflections and questions addressing medication adherent behavior or intentions, which approximately 70% of the time was followed by "patient change talk". Surprisingly, sequential MI-consistent therapist behavior like "affirmation" and "emphasizing control" was only about 6% of the time followed by patient change talk. If the active ingredients were embedded in more comprehensive MI-strategies they had more impact on the mechanisms of change.
conclusionsMechanisms of change mostly occurred after an interaction of active ingredients contributed by both therapist and patient. Our model of active ingredients and mechanisms of change enabled us to see "MI at work" in the MI-sessions under study, and this model may help practitioners to shape their MI-strategies to a potentially more effective MI.
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