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Clinical Case Studies, Vol. 2, No. 4, 306-322 (2003)
DOI: 10.1177/1534650103256277

Motivational Enhancement Therapy in Two Cases of Anxiety Disorder

New Responses to Treatment Refractoriness

H. A. Westra

London Health Sciences Centre, London, Ontario, westrah{at}lhsc.on.ca

E. Phoenix

London Health Sciences Centre, London, Ontario

Although cognitive behavioral therapy (CBT) has been consistently supported as highly efficacious in the management of various anxiety disorders, a significant number of individuals fail to respond to treatment. In this article, the authors present an attempt to operationalize and implement alternative interventions in two cases of CBT non-responsiveness for anxiety management. Both cases were identified as CBT nonresponsive through repeated psychometric assessment of symptoms, and the focus of therapy was shifted to motivational enhancement techniques. These alternative interventions were conceptualized using the Stages of Change Model, which advocates stage-matched interventions based on individual differences in readiness for change. In the first case of generalized anxiety disorder, motivational enhancement interventions were associated with marked improvement in anxiety symptomatology, whereas the second case of social phobia failed to respond to these interventions. Discussion is focused on possible mediators of differential treatment response to motivational interventions with a view to proposing future application and evaluations of these novel techniques.

Key Words: motivation • motivational enhancement • anxiety • treatment nonresponse


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J. D. Buckner, D. R. Ledley, R. G. Heimberg, and N. B. Schmidt
Treating Comorbid Social Anxiety and Alcohol Use Disorders: Combining Motivation Enhancement Therapy With Cognitive-Behavioral Therapy
Clinical Case Studies, June 1, 2008; 7(3): 208 - 223.
[Abstract] [PDF]