Implementing Motivational Interviewing for Exercise with Depressed Adults

Abstract

Background: Depression can negatively impact all aspects of life including physical health, financial stability, and job security. Motivational Interviewing (MI) reflects a counseling style based on five general principles: reflective listening, developing a discrepancy between the patient’s goals, values and their current behavior, avoiding argument and direct confrontation, adjusting to client resistance instead of opposing directly, and finally, supporting self-efficacy and optimism. Exercise can improve mood, lessen the course of depression, and can provide benefits in addition to antidepressants. However, many with mental illness do not get enough exercise and this can compound their illness. Objective: The purpose of this DNP project was to determine the barriers and facilitators of employing Motivational Interviewing (MI) for exercise in an outpatient mental health clinic in Northern Arizona Methodology: Patients were interviewed pre and post MI intervention, as well as administered PHQ-9 pre and post MI intervention. Written responses were analyzed for commonalities in their survey questions. Setting: West Yavapai Guidance Clinic in Prescott Valley, AZ. Participants: There were five patients that met project guidelines for depression during the convenience sampling period. Results: Response rate among participants was 60%, with 80% female and 20% male. The PHQ-9 scores was lower at the one month follow up after the MI intervention for two participants and stayed the same for the third. Commonalties that were identified were “relaxed,” “peaceful,” and “nature,” as well as “dogs.” Barriers were “time” and “weather.” Conclusion: The five participants reported depression and were identified as having depression on the PHQ-9. The three who followed up reported that they thought of exercise more frequently, and linked it to their mental health. With this small sample size there exhibited a positive association between targeting people’s behavior via MI on exercise, and subsequent improvement in PHQ-9 scores, as well as positive thoughts regarding mental health and exercise.