Effects of early motivational interviewing on post-stroke depressive symptoms: a pilot randomised controlled trial of the Good Mood Intervention program.

Intervention group patients will receive early motivational interviewing (MI), provided by facilitators (nurses or social workers) during the acute in-patient hospitalisation after presentation with stroke. Facilitators will have completed a full-day workshop and completed an online training module. MI will comprise 3, 30-minute individual sessions, performed prior to hospital discharge from the acute episode.. Generally, the sessions will occur on 3 separate and consecutive days. The rationale for using multiple sessions is (a) due to the complexity of the problems of stroke and depression, and (b) there is a significant positive relationship between the amount of MI a person receives and treatment outcomes. A summary of the 3 sessions follows: 1: Setting agenda and encouraging patient to talk about adjustment to stroke; 2: Eliciting realistic goals for recovery, and barriers to achieving goals; and, 3: Identifying ambivalence about achieving goals; supporting patient’s optimism and self-efficacy, and identifying solutions to problems. Fidelity will be assessed for all facilitators on an individual basis after review of recorded interviews. Further training will be provided for facilitators who do not demonstrate appropriate technique for MI.