MOTIVATIONAL INTERVIEWING TRAINING FOR MENTAL HEALTH CARE TEAMS: FOCUS ON WEIGHT MANAGEMENT

Background: Individuals with schizophrenia have a high rate of obesity, which contributes to increased health morbidities. Several factors contribute to the weight gain including unhealthy eating habits, sedentary lifestyle, and side effects of antipsychotic medications. Traditional weight loss interventions have been healthy eating and exercise combined with cognitive behavioral therapy. Mental health care providers could be trained to provide motivational interviewing (MI), which is an evidence-based intervention, to individuals for weight gain prevention. Objectives: In this project, the first objective was to develop and implement a brief weight management MI training module for a care team, consisting primarily of psychiatric technicians, at a community-based mental health treatment agency in the County of Los Angeles. The second objective was to evaluate the care team’s level of knowledge and performance in delivering the MI intervention to obese individuals with schizophrenia at their clinics. Methods: A newly developed 4-hour educational training module was given to seven psychiatric technicians who were available from the participating care teams. Participants were surveyed pre- and immediately post-training as well as four-months post-implementation. Results: At baseline, all of the participants agreed that cognitive behavior therapy could be an effective weight loss intervention for individuals with schizophrenia. On the iv knowledge test (10 items), mean total score of correct responses increased from 8.43 (SD = .79) at baseline to 9.29 at immediately post-test (SD = .76), t(6) = -2.121, p = .078. The care team’s performance at four-months displayed changes in participants’ attributions of difficulty with weight gain (more reported side effects from medications and fewer reported poor diet choice) as well as positive responses to continue using MI intervention skills in the clinical setting. Conclusions: This is the first known project to focus on a care team with psychiatric technicians who were taught MI interventions focused on weight loss for obese adult individuals with schizophrenia. Training the care team to provide weight loss MI interventions for obese adult individuals with schizophrenia was achievable, feasible, and possibly effective. Future goals are to provide weight loss MI training to care team members at the other clinics of the community-based mental health agency and to evaluate patient outcomes related to weight.