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Updated: May 16, 2025

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
Published on: August 11, 2015
Mechanisms of Action of Combination Motivational Interviewing-Cognitive Behavior Therapy for Reversing Medication
Rachel Schoor1, Jared M Bruce2, Vincent S Staggs3,4
1Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA.
Objective:
Despite disease modifying therapies' (DMT) demonstrated efficacy for treating relapsing MS, around 40% of patients discontinue use. This study aimed to understand the mechanism of action of Motivational Interviewing plus cognitive behavioral therapy (MI-CBT) in a previously conducted randomized controlled trial in which the MI-CBT intervention successfully promoted DMT re-initiation of participants compared to a treatment as usual (TAU) condition.
Methods:
This secondary analysis (N = 91) explored changes in motivation (a single item motivation "ruler" [Mot∆], and the Brief Motivation Scale [BMS∆]), autonomous motivation (AR∆), personal control (PC∆), treatment control (TC∆), and confidence to reinitiate (Con∆) as potential mediators of the treatment effect, using logistic regression.
Results:
Logistic regression analysis including all potential mediators as predictors of initiation indicated the BMS∆ was the only statistically significant predictor (OR = 1.61, p = 0.010). When BMS∆ was removed Mot∆ (OR = 1.22, p = 0.002) and PC∆ (OR = 1.67, p = 0.002) were statistically significant predictors of initiation.
Conclusion:
The MI-CBT intervention appeared to work primarily by increasing motivation to initiate DMT.
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