Motivational Interviewing and Return to Work for People with Musculoskeletal Disorders: A Systematic Mapping Review.
Fiona Aanesen, Rigmor Berg, Ida Løchting and 5 others
PMID 32356223WHAT IT FOUND
Evidence on motivational interviewing for return to work in musculoskeletal disorders is limited and inconsistent.
One small study found no benefit, while a larger study showed improved return to work for those unemployed at baseline. Neither study isolated the effect of motivational interviewing from other rehabilitation components.
Key findings
01A Norwegian study of disability pensioners with back pain found no significant difference in return to work outcomes between the intervention and control groups at one year.
02A Canadian study found that claimants unemployed at baseline who received motivational interviewing plus usual care had higher return to work rates at discharge compared to usual care alone.
03In both studies, motivational interviewing was delivered alongside other interventions, making it impossible to determine its specific contribution to the results.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only two studies met the inclusion criteria, resulting in a very small evidence base. Motivational interviewing was not delivered as a standalone intervention in either study, making it impossible to separate its effect from other components of the rehabilitation programs. The Norwegian study had a high risk of bias due to lack of blinding, small sample size, and high dropout rates. In the Canadian study, MI was only documented as being delivered to 26% of the participants in the experimental group, which may have diluted the intervention's effect. No qualitative studies were identified that explored the experiences of patients or providers using MI for musculoskeletal return to work.
Declared interests
The research was funded by the Research Council of Norway. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret the positive results from the Canadian study as proof that motivational interviewing alone causes return to work. The intervention was delivered alongside usual care, which included comprehensive functional restoration and vocational counselling, and the review explicitly states that the contribution of MI alone cannot be separated from these other components.