Article Details

Research Database: Article Details

Citation:  Douglas P. Gross, PhD, BScPT,a Joanne Park, PhD, MA, BScOT,b,c Fahreen Rayani, MA, BSc Spec Psychology,d Colleen M. Norris, PhD, MScN, BScN,e Shaniff Esmail, PhD, MScOT, BScOTb (2017). Motivational Interviewing Improves Sustainable Return to Work in Injured Workers After Rehabilitation: A Cluster Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 98 (12), 2355-2363.
Title:  Motivational Interviewing Improves Sustainable Return to Work in Injured Workers After Rehabilitation: A Cluster Randomized Controlled Trial
Authors:  Douglas P. Gross, PhD, BScPT,a Joanne Park, PhD, MA, BScOT,b,c Fahreen Rayani, MA, BSc Spec Psychology,d Colleen M. Norris, PhD, MScN, BScN,e Shaniff Esmail, PhD, MScOT, BScOTb
Year:  2017
Journal/Publication:  Archives of Physical Medicine and Rehabilitation
Publisher:  American Congress of Rehabilitation Medicine
DOI:  https://doi.org/10.1016/j.apmr.2017.06.003
Full text: 
Peer-reviewed?  Yes
NIDILRR-funded?  Not reported

Structured abstract:

Background:  Musculoskeletal (MSK) disorders present unique problems for both those injured and for organizations and individuals that serve their needs. Treatment strategies have been limited and persistent psycho-social factors remain a struggle for those seeking continued employment and engagement in the community. Using Motivational Interviewing techniques offers the promise of supporting this population and aiding in the return to work (RTW) for these individuals.
Purpose:  To determine if Motivational Interviewing can positively affect outcomes for people with MSK and support their return to work.
Study sample:  The study sample comes from data gathered between November 17, 2014 and June 30, 2015. All data originated from routine program evaluations. Individuals were excluded under 18 years of age, suffered from traumatic brain or psychological injuries, and/or were non-English speakers. Further, certain individuals were excluded if they faced surgery, comorbid conditions, noncompensable conditions, or noncompliance. Finally, the study selected at least 100 claimants per intervention and control group (job or non-job attached) in the study. 728 claimants made up the two groups (367 intervention and 361 control).
Intervention:  Motivational Interviewing (MI) was used throughout the process and outcomes were measured. MI is a conversational methodology encouraging claimants to evoke “change talk” as a means of having the claimant develop their own path to behavioral change. Researchers measured the different outcomes between the control group and the intervention group.
Data collection and analysis:  Claimants were referred to rehabilitation as they faced extended healing times or were not “functionally improving” in their RTW. MI was added to claimants in the intervention group and clinicians overseeing the intervention group were randomized. Therefore, clinicians were randomly assigned to the intervention or control groups. All clinicians assigned to the intervention group were formally trained in MI best practices. Researchers then met weekly with clinicians and received updates on each claimant. All clinicians in the intervention group made individual decisions on the level of MI intervention for each claimant.
Findings:  Comparisons between the intervention and control groups revealed that those individuals in the intervention group benefitted from MI counseling. Specifically, when measuring primary outcomes based on the number of days receiving wage replacement benefits, those individuals in the intervention group were “more likely to receive partial temporary disability benefits.” Simply put, the claimants in the intervention group found work more often than those in the control group. Further, members of the MI group searched for work more often. Finally, employed individuals in the MI group were “less likely to experience any recurrence” of partial temporary disability benefits after one year.
Conclusions:  The data show that the use of MI in counseling for MSK individuals is beneficial in returning to work or maintaining work after an injury.

Disabilities served:  Mobility impairment
Orthopedic impairments
Spinal cord injury (SCI)
Multiple disabilities
Populations served:  Other
Interventions:  Motivational interviewing
Outcomes:  Return to work
Full-time employment
Part-time employment
Increase in hours worked
Increase in number of months of employment