Grant: Operating Grant

Although effective treatments have been developed for anxiety and depression, nonresponse or partial treatment response remain common occurrences. This limited response is at least partly a function of low patient motivation for adhering to recommended treatment procedures. That is, clinicians who are knowledgeable about methods of facilitating change will often find themselves ineffective if they are unable to build client motivation and help clients work through their conflicting and often powerful feelings about change. Motivational Interviewing (MI) is a brief treatment that is strongly supported in increasing internal motivation and commitment to change for substance abuse. But despite widespread calls to add MI to the treatment of anxiety, and promising preliminary data supporting its potential to reduce resistance to change among those with anxiety, no previous study has systematically and rigorously tested its value in augmenting existing anxiety treatments. The proposed project provides a powerful test of the value of adding MI before and during the recommended therapy for excessive worry (Cognitive Behavioural Therapy), among those with severe symptoms who typically do not respond to existing therapies. Moreover, the study also seeks to identify exactly how and why adding MI to existing therapy for anxiety augments treatment response. If successful, the study findings will have significant public health implications by demonstrating that by adding brief interventions to enhance motivation, we can improve adherence and outcomes with existing treatments for the substantial number of individuals living with anxiety disorders. Such findings would also suggest the possibility that MI might enhance treatment response for other problems and other treatments (eg., medication). Finally, we will integrate state of the art methods for translating knowledge into practice throughout the project (including methods for informing training in these treatments).