Evaluation of motivational interviewing to improve psychotropic medication adherence in adolescents.
Abstract
PROBLEM: Medication adherence rates in adolescents are poor. The World Health Organization identified that those at greatest risk were nonwhite adolescents with depression. Medication nonadherence results in poorer mental health outcomes. OBJECTIVE: The first aim of the study was to investigate if two motivational interviewing (MI) sessions would improve medication adherence in adolescents taking antidepressants and mood stabilizers. The second aim was to evaluate if attitudes toward medication correlated with adherence. The third aim was to determine if self-reported adherence scores were similar to electronic adherence data collected. METHODS: The quasi-experimental study contained an MI intervention, including a baseline and postintervention assessment of adherence over 30 days. A total of 48 adolescents, ranging in age from 12 to 18 years, were recruited from a university mental health center to participate in the study; 41 completed the study. Four nurse practitioners and two child psychiatrists mastered the MI techniques evaluated with standardized measures. The Medication Electronic Monitoring System (MEMS) was the primary measure of medication adherence. The Drug Attitude Inventory (DAI) was used as a secondary measure. Finally, participants completed the client evaluation of MI and a satisfaction survey of MI. RESULTS: At endpoint, 70.7% of the participants were taking their medications between 80% and 100% of the time, as measured over 30 days, compared with 43.9% of participants at baseline. Mean adherence scores significantly improved by 17% after two MI sessions. Mean baseline adherence scores were 63.7%, whereas mean endpoint adherence scores were 80.6% (p < 0.0001). The effect size was 0.65, demonstrating moderate effect. Participants (n = 29) who demonstrated 80% or greater adherence had DAI mean scores of 16.48, whereas those below 80% had a DAI mean of 15.5 (p = 0.73), demonstrating no significant difference on drug attitudes between the two groups at endpoint. DAI baseline mean scores were 14.2, whereas endpoint mean scores were 16.2. There was a significant difference between self-rated adherence and objective data collected from the MEMS caps as participants over-reported medication adherence by an average of 18.4% at baseline (t = 6.84, df = 40, p < 0.001). Participants reported a high degree of satisfaction with MI. CONCLUSIONS: MI is a promising intervention for adolescents to improve psychotropic medication adherence.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
MI can be implemented in a busy schedule as an add-on conversation technique (additional 15-20 minutes) during regular appointments.
“MI can be implemented in a busy schedule as an add-on conversation technique (additional 15–20 minutes) during regular appointments, and can potentially improve treatment attendance31,54,55 and outcomes,56 encourage medication adherence,57,58 facilitate the transition to adult care,59 and reduce risk-taking behaviors.60”
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Intrinsic Motivation and Self-Determination in Human Behavior
Deci, E. L., & Ryan, R. M. (1985) · doi:10.1007/978-1-4899-2271-7 · Cited by 26,772 · see citing works
The Transtheoretical Model of Health Behavior Change.
Prochaska, J. O., & Velicer, W. F. (1997) · American Journal of Health Promotion · doi:10.4278/0890-1171-12.1.38 · Cited by 7,782 · see citing works
Medication Adherence: Its Importance in Cardiovascular Outcomes
Ho, P. M., Bryson, C. L., & Rumsfeld, J. S. (2009) · Circulation · doi:10.1161/circulationaha.108.768986 · Cited by 1,488 · see citing works
A Meta-Analysis of Motivational Interviewing: Twenty-Five Years of Empirical Studies
Lundahl, B. W., Kunz, C., Brownell, C., Tollefson, D., & Burke, B. L. (2010) · Research on Social Work Practice · doi:10.1177/1049731509347850 · Cited by 1,086 · see citing works
Hogan, T. P., Awad, A. G., & Eastwood, R. (1983) · Psychological Medicine · doi:10.1017/s0033291700050182 · Cited by 1,027 · see citing works
(2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.10.1132 · Cited by 752 · see citing works
Interventions to Improve Medication Adherence in Schizophrenia
Zygmunt, A., Olfson, M., Boyer, C. A., & Mechanic, D. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.10.1653 · Cited by 541 · see citing works
A Multicenter Randomized Controlled Trial of Motivational Interviewing in Teenagers With Diabetes
Channon, S., Huws-Thomas, M. V., Rollnick, S., Hood, K., Cannings-John, R. L., Rogers, C. E., & Gregory, J. W. (2007) · Diabetes Care · doi:10.2337/dc06-2260 · Cited by 338 · see citing works
The Relationship Between Antidepressant Prescription Rates and Rate of Early Adolescent Suicide
Gibbons, R. D., Hur, K., Bhaumik, D. K., & Mann, J. J. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.11.1898 · Cited by 289 · see citing works
A brief motivational intervention to improve dietary adherence in adolescents
Berg-Smith, S. (1999) · Health Education Research · doi:10.1093/her/14.3.399 · Cited by 252 · see citing works
Pescosolido, B. A., Perry, B. L., Martin, J. K., McLeod, J. D., & Jensen, P. S. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.5.613 · Cited by 234 · see citing works
Gau, S. S. F., Shen, H.-Y., Chou, M.-C., Tang, C.-S., Chiu, Y.-N., & Gau, C.-S. (2006) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2006.16.286 · Cited by 148 · cited 1× · see citing works
“Medication adherence rates tend to decline during adolescence due to increased autonomy and decreased parental involvement with medication management (Gau et al. 2006; Dean et al. 2011).”
D’Amico, E. J., Tucker, J. S., Miles, J. N. V., Zhou, A. J., Shih, R. A., & Green, H. D. (2012) · Prevention Science · doi:10.1007/s11121-011-0269-7 · Cited by 148 · see citing works
D’Amico, E. J., Hunter, S. B., Miles, J. N. V., Ewing, B. A., & Osilla, K. C. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.06.005 · Cited by 102 · see citing works
Risk factors for non-adherence to antidepressant treatment in patients with mood disorders
Cuevas, C. D. L., Peñate, W., & Sanz, E. J. (2013) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-013-1582-9 · Cited by 87 · see citing works
Mullins, C. D., Shaya, F. T., Meng, F., Wang, J., & Harrison, D. J. (2005) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.25.5.660.63590 · Cited by 78 · see citing works
Verbeek-Heida, P. M., & Mathot, E. F. (2006) · Chronic Illness · doi:10.1177/17423953060020020801 · Cited by 75 · see citing works
Hamrin, V., McCarthy, E., & Tyson, V. (2010) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/j.1744-6171.2010.00237.x · Cited by 68 · see citing works
Self-citationBrain, C., Allerby, K., Sameby, B., Quinlan, P. S., Joas, E., Karilampi, U., Lindström, E., Eberhard, J., Burns, T., & Wærn, M. (2013) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2013.09.001 · Cited by 62 · see citing works
Seid, M., D'Amico, E. J., Varni, J. W., Munafo, J. K., Britto, M. T., Kercsmar, C. M., Drotar, D., King, E. C., & Darbie, L. (2012) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsr107 · Cited by 62 · see citing works
Rosengren, D. B., Hartzler, B. J., Baer, J. S., Wells, E. A., & Dunn, C. W. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.03.018 · Cited by 61 · see citing works
D’Amico, E. J., Osilla, K. C., & Hunter, S. B. (2010) · Alcoholism Treatment Quarterly · doi:10.1080/07347324.2010.511076 · Cited by 59 · see citing works
Madson, M. B., Mohn, R. S., Zuckoff, A., Schumacher, J. A., Kogan, J. N., Hutchison, S. L., Magee, E., & Stein, B. D. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.08.015 · Cited by 51 · see citing works
Woldu, H., Porta, G., Goldstein, T. R., Sakolsky, D. J., Perel, J. M., Emslie, G. J., Mayes, T. L., Clarke, G. N., Ryan, N. D., Birmaher, B. B., et al. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.01.018 · Cited by 51 · see citing works
Nakonezny, P. A., Byerly, M., & Rush, A. J. (2007) · Psychiatry Research · doi:10.1016/j.psychres.2007.05.001 · Cited by 45 · see citing works
Predictors of medication adherence in children receiving psychotropic medication
Dean, A. J., Wragg, J. A., Draper, J., & McDERMOTT, B. M. (2011) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2010.01985.x · Cited by 37 · see citing works
Adolescent attitudes toward psychiatric medication: the utility of the Drug Attitude Inventory
Townsend, L. D., Floersch, J. E., & Findling, R. L. (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2009.02113.x · Cited by 36 · see citing works
Bleser, L. D., Geest, S. D., Vandenbroeck, S., Vanhaecke, J., & Dobbels, F. (2010) · Sensors · doi:10.3390/s100301652 · Cited by 36 · see citing works
Medication Noncompliance in Adolescents with Psychiatric Disorders
Ghaziuddin, N., King, C. A., Hovey, J. D., Zaccagnini, J., & Ghaziuddin, M. (1999) · Child Psychiatry & Human Development · doi:10.1023/a:1021950301932 · Cited by 30 · see citing works
Assessing motivational interviewing integrity for group interventions with adolescents.
D’Amico, E. J., Osilla, K. C., Miles, J. N. V., Ewing, B. A., Sullivan, K., Katz, K., & Hunter, S. B. (2012) · Psychology of Addictive Behaviors · doi:10.1037/a0027987 · Cited by 29 · see citing works
Nakonezny, P. A., Hughes, C. W., Mayes, T. L., Sternweis-Yang, K. H., Kennard, B. D., Byerly, M., & Emslie, G. J. (2010) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2009.0108 · Cited by 20 · see citing works
Adherence of antidepressants during pregnancy: MEMS compared with three other methods
Bosman, J., ter Horst, P. G. J., Smit, J. P., Dijkstra, J. R., Beekhuis, H. R., Slingersland, R. J., & Hospes, W. (2013) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125313511486 · Cited by 17 · see citing works
Yang, J.-W., Yoon, B.-M., Lee, M., Joe, S.-H., Jung, I., & Kim, S. (2012) · Psychiatry Investigation · doi:10.4306/pi.2012.9.3.263 · Cited by 16 · see citing works
Bhowmik, D., Aparasu, R. R., Rajan, S. S., Sherer, J. T., Ochoa‐Perez, M., & Chen, H. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.04.034 · Cited by 13 · see citing works
Brent, D. A. (2009) · The Canadian Journal of Psychiatry · doi:10.1177/070674370905400204 · Cited by 8 · see citing works
Davies, S., Asghar, S., Cooper, V., Lange, A., Robertson, C., Vrijens, B., & White, D. (2010) · Journal of the International AIDS Society · doi:10.1186/1758-2652-13-s4-p120 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Motivational interviewing and the clinical science of Carl Rogers.
Miller, W. R., & Moyers, T. B. (2017) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000179 · Cited by 231 · see citing works
Baweja, R., Soutullo, C., & Waxmonsky, J. G. (2021) · World Journal of Psychiatry · doi:10.5498/wjp.v11.i12.1206 · Cited by 68 · see citing works
Causes of drug discontinuation in patients with major depressive disorder in China
Zhu, Y., Wu, Z., Sie, O., Cai, Y., Huang, J., Liu, H., Yao, Y., Niu, Z., Wu, X., Shi, Y., et al. (2019) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2019.109755 · Cited by 63 · see citing works
Recovery-Oriented Practices in Community-based Mental Health Services: A Systematic Review
Mousavizadeh, S. N., & Jandaghian-Bidgoli, M. (2023) · Iranian Journal of Psychiatry · doi:10.18502/ijps.v18i3.13013 · Cited by 40 · see citing works
Reinauer, C., Platzbecker, A. L., Viermann, R., Domhardt, M., Baumeister, H., Foertsch, K., Linderskamp, H., Krassuski, L., Staab, D., Minden, K., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.27622 · Cited by 22 · see citing works
COACH consortium, Reinauer, C., Viermann, R., Förtsch, K., Linderskamp, H., Warschburger, P., Holl, R. W., Staab, D., Minden, K., Muche, R., et al. (2018) · Trials · doi:10.1186/s13063-018-2997-5 · Cited by 23 · see citing works
Lodewyk, K., Bagnell, A. L., Courtney, D., & Newton, A. S. (2023) · Child and Adolescent Mental Health · doi:10.1111/camh.12661 · Cited by 18 · see citing works
Niemeyer, L., Schumm, L., Mechler, K., Jennen-Steinmetz, C., Dittmann, R., & Häge, A. (2018) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2018.0072 · Cited by 18 · see citing works
MENTAL HEALTH NEEDS OF ADOLESCENTS AND THE NURSING CARES: INTEGRATIVE REVIEW
Teixeira, L. A., de Freitas, R. J. M., de Moura, N. A., & Monteiro, A. R. M. (2020) · Texto & Contexto - Enfermagem · doi:10.1590/1980-265x-tce-2018-0424 · Cited by 18 · see citing works
The Role of Motivational Interviewing in Children and Adolescents in Pediatric Care
Desai, N. G. (2019) · Pediatric Annals · doi:10.3928/19382359-20190816-01 · Cited by 18 · see citing works
Naderloo, H., Vafadar, Z., Eslaminejad, A., & Ebadi, A. (2018) · PubMed Central · Cited by 16 · see citing works
“Drugs Don’t Work in Patients Who Don’t Take Them”
Mechler, K., & Häge, A. (2019) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000645 · Cited by 14 · see citing works
Research Brief: The Teen ADHD Workshop to Improve Adolescent ADHD Treatment Engagement
Schoenfelder, E. N., McCabe, C. J., Fife, A., Herzig, L., & Ahrens, K. R. (2017) · Journal of Attention Disorders · doi:10.1177/1087054716686184 · Cited by 14 · see citing works
The Natural Course of Adolescent Depression Treatment in the Primary Care Setting
Stafford, A. M., Garbuz, T., Etter, D. J., Adams, Z. W., Hulvershorn, L. A., Downs, S. M., & Aalsma, M. C. (2019) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2019.07.002 · Cited by 13 · see citing works
Waumans, R. C., Muntingh, A., Batelaan, N. M., & van Balkom, A. J. L. M. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1174285 · Cited by 12 · see citing works
Hen-Shoval, D., Weller, A., Weizman, A., & Shoval, G. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010523 · Cited by 9 · see citing works
Lang, A. C., Stevens, J. H., Mara, C. A., Patel, A. D., Schmidt, M., Tenney, J. R., & Modi, A. C. (2023) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2023.109192 · Cited by 8 · see citing works
Medication adherence and attitudes in adolescent psychiatry: Key influences
Bayraktar, İ., Yalçın, N., Nalbant, K., Kültür, S. E. Ç., & Demirkan, K. (2025) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045251316607 · Cited by 5 · see citing works
Psychiatric Inpatient Nurses' Perceptions of Using Motivational Interviewing
Ragaisis, K. M. (2017) · Issues in Mental Health Nursing · doi:10.1080/01612840.2017.1377328 · Cited by 5 · see citing works
Review of clinical medication adherence in patients with schizophrenia
Zhao, F., Zhong, H., Kang, P.-P., Sun, S., Zhang, T., Cui, S., & Bi, S.-J. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i12.108191 · Cited by 4 · see citing works
Mihalo, J. R., Strickler, A., Wall‐Parker, A., & Valenti, M. W. (2019) · Residential Treatment for Children & Youth · doi:10.1080/0886571x.2019.1669095 · Cited by 3 · see citing works
Jawed, A., & Zaim, N. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20166578 · Cited by 2 · see citing works
Sibley, M. H., Rodriguez, L. M., Lopez, M., Brochu, E. M., Bracho, F. V., Ortiz, M., & Hashimoto, J. (2025) · Journal of Attention Disorders · doi:10.1177/10870547241308632 · Cited by 2 · see citing works
Medication Non-Compliance: Compliance to Psychotropic Medications within Community Mental Health
DePetro, E. (2020) · Cited by 2 · see citing works
Naderloo, H., Vafadar, Z., Eslaminejad, A., & Ebadi, A. (2017) · Critical Care Nursing · doi:10.5812/ccn.10600 · Cited by 2 · see citing works
Benson, C. L., Davis, M. J., Lundahl, B., McDonald, C., & Bowles, M. (2025) · Journal of Technology in Human Services · doi:10.1080/15228835.2024.2448256 · Cited by 1 · see citing works
Potential impact of DNP projects on child mental health services
Delaney, K. R., & Lusk, P. (2018) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.12214
Motivational Interviewing en de klinische opvattingen van Carl Rogers
Miller, W. R., & Moyers, T. B. (2019) · Gezinstherapie Wereldwijd · doi:10.1007/s12440-019-00092-8
Motivational Interviewing with Children and Adolescents: Developmental Perspective and a Case Report
Maršanić, V. B., Maršanić, V. B., Zečević, I., Kordić, A., Flander, M., Croatian Society for Infant, C. A. A. P., Bolfan, L. K., & Paradžik, L. (2018) · Socijalna psihijatrija · doi:10.24869/spsih.2018.181
Psikiyatri Hemşireliğinde Güncel Yaklaşımlar
Yaman, Z., Alaçam, E. Ü., Boğahan, M., Duru, H. A., Türkleş, S., Yalçın, A. S., Bingöl, N., CERİT, E., Ayhan, D., Atak, N. T., et al. (2022) · Akademisyen Kitabevi eBooks · doi:10.37609/akya.1077
Bayraktar, İ., Yalçın, N., Nalbant, K., Karabulut, E., Kültür, S. E. Ç., & Demirkan, K. (2024) · Research Square · doi:10.21203/rs.3.rs-4339327/v1
Dıkeç, G., Bılaç, Ö., Sonkaya, H. İ., & Aydemır, Ö. (2024) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2024.06.019
Lu, T., Zheng, H., Wen, X., Shen, X., Zhang, Q., Zhang, D., Li, F., & Zhong, H. (2026) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-026-01050-3
Robineau, G., Desombre, H., Bréant, V., & Hoegy, D. (2026) · Global Pediatrics · doi:10.1016/j.gpeds.2026.100359
Dhindayal, S., Mbeje, S. S., Lewis, L., Humphries, H., Mansoor, L. E., Potloane, D., Gengiah, T. N., & Karim, Q. A. (2026) · AIDS and Behavior · doi:10.1007/s10461-026-05233-z
Li, I. H., Liu, W., Lai, C. Y., Yang, C., Liu, C., & Dai, Y. (2026) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.70208
Roehrich, L. A., Solmi, M., Cortese, S., Højlund, M., Salazar-de-Pablo, G., Uhlhaas, P. J., & Correll, C. U. (2026) · Drugs · doi:10.1007/s40265-026-02403-0
- Authors
- Hamrin, V., & Iennaco, J. D.
- Affiliations
- Vanderbilt University (US)
- Yale University (US)
- Corresponding author
- Hamrin, Vanya
- Venue
- Journal of Child and Adolescent Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2017-03
- Volume
- 27
- Issue
- 2
- Pages
- 148-159
- ISSN
- 1044-5463 (ISSN-L)
- 1557-8992
- OpenAlex
- W2517100505
- Cited by
- 37
- References
- 37
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 6 · 2018: 5 · 2017: 4
- FWCI
- 6.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child and Adolescent Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- motivational interviewing, medication adherence, adolescents, antidepressants, mood stabilizers, depression, electronic medication monitoring, self-reported adherence, attitudes toward drugs, treatment satisfaction, nurse practitioners, child psychiatrists
- MeSH terms
- Adolescent, Antidepressive Agents, Attitude to Health, Mental Disorders, Child, Female, Humans, Male, Antimanic Agents, Medication Adherence, Motivational Interviewing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
