From the Guidelines
Motivational Interviewing (MI) is a useful tool in enhancing early return to work after illness or injury.
Key Points
- MI can increase health-promoting behaviors and decrease health-damaging behaviors, which can aid in the recovery process and facilitate a quicker return to work 1.
- The goal of MI is to increase intrinsic motivation and self-efficacy for engaging in health-promoting behaviors using patient-centered yet directive communication techniques 1.
- MI has been effective in promoting health behavior change for individuals with and without chronic diseases, which can be beneficial for employees returning to work after an illness or injury 1.
- Technology-delivered adaptations of MI (TAMIs) might increase reach and make MI more accessible to individuals with limited financial or time resources, potentially aiding in the return to work process 1.
Mechanism of Action
MI counselors rely on reflexive listening, strategic questions, affirmations of character strengths, and statements emphasizing patients’ decision-making autonomy to elicit “change talk” 1. This approach encourages personal decision-making about change and provides guidance and support about potential mechanisms of change, which can be applied to the context of returning to work after an illness or injury. By addressing sociocontextual factors that constrain an individual’s choices, MI can help individuals identify and work toward their goals, including returning to work 1.
From the Research
Utility of Motivational Interviewing in Enhancing Early Return to Work
- Motivational Interviewing (MI) has been shown to lead to more sustainable return-to-work outcomes for injured workers undergoing rehabilitation 2.
- The use of MI appears to facilitate transition to modified work duties, with unemployed claimants in the MI group receiving significantly more partial temporary disability benefits 2.
- MI has been adapted with success into brief motivational interventions and has demonstrated improvements in treatment outcome across treatment populations and settings 3.
Key Findings
- A meta-analysis study found that MI applied to individuals with chronic diseases changed their quality of life, with the effect size varying depending on factors such as disease type and age range 4.
- MI has been shown to be effective in enhancing intrinsic motivation and strengthening commitment for change through exploring and resolving ambivalence 5.
- However, barriers to implementing MI as a return-to-work intervention in a social insurance setting have been identified, including lack of support, time and place for practicing, and high workload 6.
Implementation of Motivational Interviewing
- MI fidelity results have shown technical global scores over the threshold for "beginning proficiency", whereas the relational global score was under the threshold 6.
- Sick-listed workers have reported being satisfied with MI sessions, highlighting the potential benefits of MI in enhancing early return to work 6.
- Further research is needed to address the barriers and facilitators to implementing MI in a social insurance setting and to fully realize its potential in enhancing early return to work 2, 6.