Training Therapists in Motivational Interviewing to Enhance Rehabilitation Participation for Spinal Cord Injury

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This study addresses the problem that patient participation in Spinal Cord Injury (SCI) rehabilitation is not always optimal. Correlational research suggests that therapy participation is linked to important functional and psychosocial outcomes. Therefore, improved therapy participation could lead to better rehabilitation outcomes. Motivational interviewing is an evidence-based counseling style that rehabilitation therapists can learn and that has been used successfully in other rehabilitation and exercise promotion contexts. Yet, to date there are no data showing that MI helps patients with SCI participate optimally during inpatient rehabilitation. The overall aim of this study is to increase participation in rehabilitation therapies, which could lead to improved progress toward functional independence, reduced lengths of stay, and decreased costs. If the results of this pilot study are promising, the next step would be to conduct a fully-powered randomized controlled trial to demonstrate the efficacy of MI counseling to improve participation and other psychosocial outcomes in SCI rehabilitation.

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1. To measure therapy participation in inpatients with SCI treated by rehabilitation therapists trained in MI compared to those treated by therapists not trained to use MI
2. To measure treatment satisfaction in inpatients with SCI treated by rehabilitation therapists trained in MI compared to those treated by therapists not trained to use MI
3. To measure IRF-PAI efficiency in the domains of self-care and mobility in inpatients with SCI treated by rehabilitation therapists trained in MI compared to those treated by therapists not trained to use MI
4. To measure the efficacy of MI training by measuring adherence to MI counseling skills in rehabilitation therapists trained to use MI compared to those not trained to use MI

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This study is a randomized control trial in which the principal investigator will train half of the participating physical and occupational therapists in motivational interviewing. Training consists of monitored use of motivational interviewing skills in therapy sessions with competency assessed by the Motivational Interviewing Treatment Integrity (MITI) 3.1.1. Patients and therapists will rate participation in therapy sessions, and patients will rate treatment satisfaction. Inpatient Rehab Facility-Patient Assessment Instrument (IRF-PAI) will be abstracted from medical records when patients are first enrolled and upon completion of the trial.