Objective: Community integration is a key outcome for individuals with a history of homelessness after they attain permanent housing. The goals of finding purpose, meaning, and belonging in one's community-despite their importance in predicting mental well-being and housing stability-are frequently elusive for recently housed individuals. This study aimed to evaluate a novel psychosocial intervention that combines two evidence-based practices, motivational interviewing (MI) and cognitive-behavioral therapy (CBT), to improve motivation and functional outcomes related to community integration.
Methods: Sixty veterans with a recent history of homelessness who were admitted to a U.S. Department of Veterans Affairs supportive housing program in the past year were included in a randomized controlled trial comparing the 12-session MI-CBT treatment with treatment as usual. Participants were assessed at four time points during the study period, which included 24 weeks of active treatment and 12 weeks of follow-up. The primary outcome measures were motivational deficits (negative symptoms), level of behaviors consistent with motivational change, and social and work functioning.
Results: Compared with participants in the control group, participants who received MI-CBT showed significantly greater improvement (p<0.05) in motivational deficits over the 12-week acute treatment period. Their gains relative to baseline were maintained at follow-up.
Conclusions: MI-CBT yields improvements in motivational deficits. Implications for future studies and for improving generalizability of the motivational negative symptom gains to daily functioning domains are discussed.
Keywords: Homeless Mentally Ill; Rehabilitation/Psychosocial; Veterans’ Issues.