Body
Linda Ehrlich-Jones, PhD, RN, Associate Director, Center for Rehabilitation Outcomes Research at Shirley Ryan AbilityLab, has received a three-year, $550,000 grant from the Craig H. Neilsen Foundation in the Fall of 2023 to investigate whether physical and occupational therapists trained in the use of motivational interviewing can improve rehabilitation outcomes for people with spinal cord injuries (SCI).
Motivational interviewing is an evidence-based behavior change counseling style used in healthcare settings and has been shown to improve patient motivation and adherence to treatment.
“During rehabilitation, a therapist will help a patient improve functionality based on the patient’s goals. But the therapist does much more than lead the patient through a series of exercises – there is a strong counseling component built into rehabilitation therapy, and that’s where motivational interviewing comes into play,” says Ehrlich-Jones, who is also a Research Professor in the Department of Physical Medicine & Rehabilitation in Northwestern University’s Feinberg School of Medicine. Ehrlich-Jones is an expert in the use of motivational interviewing to improve outcomes in patients with physical disabilities and other long-term health problems.
“Motivational interviewing often leads to greater engagement in the rehabilitation process, and we know more active participation is linked to better outcomes,” says Ehrlich-Jones.
The new grant will enable Ehrlich-Jones to build on the findings of her previous pilot project, also funded by the Neilsen Foundation. In that study, patients with SCI who worked with therapists trained in motivational interviewing participated more actively in their therapy sessions compared to SCI patients whose rehabilitation therapists were not trained in motivational interviewing.
“Our findings from the pilot study were very encouraging, but we still need to know whether patients who work with therapists trained in motivational interviewing have better functional, social and occupational or educational outcomes," explains Ehrlich-Jones. "We’re also interested in what happens if the therapists receive more intensive training in motivational interviewing – will patient outcomes further improve over what we saw in our pilot study?”
With the new funding, Ehrlich-Jones and colleagues will enroll 126 patients with SCI receiving inpatient rehabilitation services at Shirley Ryan AbilityLab or Baylor Scott & White Institute for Rehabilitation in Fort Worth, Texas. Six therapists (either OTs or PTs) at Shirley Ryan AbilityLab and six at Baylor will participate in the study with half getting training in motivational interviewing. Therapists trained in motivational interviewing will undergo initial training and receive ongoing motivational interviewing skills coaching. Simon Driver, PhD, Research Center Director for Baylor Scott & White Institute for Rehabilitation, will lead the study at the Baylor site.
The researchers will test whether patients treated by therapists trained in motivational interviewing have greater participation in therapy sessions and better functional, social, educational or occupational outcomes relative to patients treated by therapists without motivational interviewing training. They will also look at outcomes such as discharge to home, functional status and community participation after discharge from inpatient rehabilitation.
The aims of this project are:
1. To determine whether inpatients with SCI/D treated by PTs and OTs who receive Motivational Interviewing (MI) and coaching demonstrate greater therapy participation compared to those treated by therapists who do not receive MI training and coaching.
2. To determine whether inpatients with SCI/D treated by PTs and OTs who receive MI training and coaching demonstrate greater functional improvement at discharge from inpatient rehabilitation and greater community reintegration at 6 months after discharge compared to those treated by therapists who do not receive MI training and coaching.
3. To document an effect of training and coaching on MI skills and explore potential moderators and mediators of the effect of the intervention on therapy participation.