First AD

Second AD

A. Integrates motivational interviewing and pharmacotherapy into an approach to enhance patients’ participation in treatment

B. Targets patients' ambivalence about engaging in pharmacotherapy

C. Confronts patients' resistance in a didactic way by challenging ideas on meds & providing didactic modules on antidepressants

D. Differs from META by being conducted by prescribers themselves rather than by additional, non-prescribing clinicians

E. Does not substantially increase the duration of the pharmacotherapy sessions

 Motivational interviewing does not directly confronts patients' resistance to change by challenging their preconceived ideas about medications and by providing standardized didactic modules on various antidepressants.

Motivational interviewing (MI) can be very useful for addressing ambivalence about psychopharmacologic issues. Two approaches have been developed that show initial efficacy. The first is to integrate MI directly into the procedures followed by the prescriber. This approach is called motivational pharmacotherapy (MPT). The second approach is to add adjunctive MI sessions by a psychotherapist to the psychopharmacologic regimen. This approach is called motivational enhancement therapy for antidepressants (META).

Adherence successes are highlighted in an attempt to build self-efficacy, and obstacles are identified. Sessions are also used to elicit information about obstacles and how to resolve them, including exploring thoughts about early termination. In addition, sessions include review of medication dosage and collaborative decision-making about the treatment plan. Importantly, this is not done in a didactic way but by eliciting the patient’s opinions as to how to proceed.

Harnessing Patients’ Own Motivation to Engage in Pharmacotherapy

Psychopharmacology

Psychotherapy

Quizzes

Motivational interviewing can be very useful for addressing patients' ambivalence about psychopharmacologic issues. Take the quiz and learn more.

Mini Quiz: Motivational Pharmacotherapy

Roberto Lewis-Fernández, MD

Angela A. Coombs, MD