Motivational Interviewing for Workers with Disabling Musculoskeletal Disorders: Results of a Cluster Randomized Control Trial.
Joanne Park, Shaniff Esmail, Fahreen Rayani and 2 others
PMID 28550417WHAT IT FOUND
Adding motivational interviewing to rehab helped workers without jobs return to work (21.6% vs 9.5%), but not those with jobs.
The benefit depended on therapists actually using the technique correctly, which happened in only 26% of cases.
Key findings
01For claimants without a job to return to, those receiving motivational interviewing had a higher rate of confirmed return to work at discharge (21.6%) compared to the control group (9.5%).
02There was no statistically significant difference in return-to-work rates for job-attached claimants between the intervention (97.1%) and control (94.1%) groups.
03Documented adherence to the motivational interviewing protocol was low (26% overall), but outcomes were better among clinicians who fully adhered to the method.
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
Low adherence to the intervention protocol (26%) limits confidence in the generalizability of the results. The study did not include claimants with traumatic brain injuries or those requiring interpreters, restricting applicability to these populations. Randomization was by clinician cluster, and unequal distribution of job-attached status between groups occurred due to program triage rules. Long-term sustainability of the return-to-work outcomes was not assessed.
Declared interests
Funding was provided by the Workers' Compensation Board of Alberta and the Canadian Occupational Therapy Foundation. The study took place at Millard Health, the primary service provider for the funder, which may introduce bias in data collection or implementation.
The easy way to misread this
Do not assume motivational interviewing is a universally effective add-on for all injured workers. The benefit was primarily seen in those without jobs to return to, and the overall effect was heavily influenced by low clinician adherence. The technique is not a 'plug-and-play' solution; it requires significant training and consistent execution to yield results.