Enhancing Rehabilitation Participation in Patients With SCI/D Using Motivational Interviewing

January 16, 2026 updated by: Linda Ehrlich-Jones, PhD, Shirley Ryan AbilityLab

Enhancing Rehabilitation Participation in Patients With Spinal Cord Injury or Disorder Using Motivational Interviewing

The purpose of this multi-site clinical trial is to see whether people with spinal cord injury or disorder (SCI/D) demonstrate higher level of participation in rehabilitation sessions and other outcomes when their therapists are trained in a counseling style called motivational interviewing. We want to answer the following questions:

  1. Do inpatients with SCI/D treated by physical therapists (PTs) and occupational therapists (OTs) who receive MI training and coaching demonstrate greater therapy participation compared to those treated by therapists who do not receive MI training and coaching?
  2. Do inpatients with SCI/D treated by PTs and OTs who receive MI training and coaching demonstrate greater functional improvement at discharge from inpatient rehabilitation and greater community integration at 6 months after discharge compared to those treated by therapists who do not receive MI training and coaching?
  3. What are the potential moderators and mediators of the effect of training and coaching on MI skills on therapy participation?

Researchers will compare patient participation level and other outcomes of inpatients with SCI/D treated by PTs and OTs who receive MI training and coaching with those treated by therapists who do not receive MI training and coaching.

Therapist participants will:

  1. Audio record 2 therapy sessions per week with each enrolled SCI patient participant
  2. Half of the therapists will attend a 16-hour training on MI skills and 2 practice therapy session

Patient participants will:

  1. Consent to audio recording of their therapy sessions
  2. Complete one brief survey near the time of their discharge and another survey 6 months later

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

We plan to conduct a multi-site randomized controlled trial of motivational interviewing (MI) training for physical therapists (PTs) and occupational therapists (OTs) who treat people with SCI during inpatient rehabilitation. We will test whether patients treated by MI trained PTs and OTs demonstrate greater participation in therapy sessions and better functional, social, and educational/occupational outcomes relative to patients treated by therapists without MI training. This stage of research is appropriate because a Neilsen Foundation funded pilot study that we recently completed had promising results. Study results showed that SCI patients treated by MI trained PTs and OTs participated significantly more actively in therapy sessions compared to controls. However, the study had several limitations that need to be addressed to produce a more definitive and influential trial. First, the study was conducted at a single site and results may not generalize to other sites. Second, we did not examine whether MI training and improved participation resulted in patients having better clinically meaningful outcomes such as higher likelihood of discharge to home or superior functional, social, or educational/occupational outcomes. Third, therapists trained in MI achieved only minimal competency in MI skills. We hypothesize that if therapists received ongoing coaching to improve their MI skills during the trial the positive impact on patient participation and other outcomes might be even more robust.

Study Type

Interventional

Enrollment (Estimated)

180

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Illinois
      • Chicago, Illinois, United States, 60611
        • Recruiting
        • Shirley Ryan AbilityLab
        • Contact:
        • Contact:
        • Principal Investigator:
          • Linda Ehrlich-Jones, PhD, RN
    • Texas
      • Dallas, Texas, United States, 75246
        • Recruiting
        • Baylor Scott & White Institute for Rehabilitation
        • Contact:
        • Principal Investigator:
          • Dannae Arnold, PT, DPT, ATP
    • Washington
      • Seattle, Washington, United States, 98104
        • Recruiting
        • University of Washington - Harborview Medical Center
        • Principal Investigator:
          • Charles Bombardier, PhD
        • Contact:
          • Charles Bombardier, PhD
          • Phone Number: 206-744-4607
          • Email: chb@uw.edu

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Therapist Inclusion Criteria:

  • Inpatient therapist specializing in spinal cord injury patients for at least 3 months;
  • Practicing at the designated SCI inpatient units at Shirley Ryan AbilityLab, Baylor Scott & White Institute for Rehabilitation and University of Washington-Harborview Medical Center;
  • Willing to audio record conversations during regularly-scheduled rehabilitation therapy sessions with patients;
  • Willing and able to participate in 16 hours of MI training; and
  • Willing to receive feedback on MI skills.

Therapist Exclusion Criteria:

  • Inability to speak and understand English
  • Inpatient therapist specializing in spinal cord injury patients for less than 3 months; and
  • Unwilling or unable to follow the study protocol

Patient Inclusion Criteria:

  • Adults (18+)
  • Presence of a traumatic or non-traumatic spinal cord injury
  • Inpatient in the spinal cord injury unit of the three study sites
  • Has a physical or occupational therapist who is a participant in the study

Patient Exclusion Criteria:

  • Inability to speak and understand English
  • Cognitive deficits
  • Unwilling to allow for therapy sessions to be recorded

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group: Motivational Interviewing
Physical and Occupational Therapists in this group will receive 16 hours of training in Motivational Interviewing and use these techniques during sessions with enrolled patient participants.
Behavioral: Motivational Interviewing
Motivational Interviewing is an evidence-based counseling style that aims to foster positive health behavior change in patients through their desires and actions.
No Intervention: Control Group: Standard Care
Therapists in this group will not participate in additional training and provide standard care to enrolled patient participants.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Therapy Participation Level
Time Frame: From enrollment to the end of 4-week treatment
A blinded assessor will use the Pittsburgh Rehabilitation Participation Scale (PRPS) to measure therapy participation in inpatients with SCI treated by therapists trained in Motivational Interviewing (MI) compared to those treated by therapists not trained to use MI. The PRPS rating ranges from 1 (none) to 6 (excellent), with higher scores indicating higher level of participation
From enrollment to the end of 4-week treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Efficacy of Motivational Interviewing (MI) Training
Time Frame: During 1 year of inpatient rehabilitation
We will use the Motivational Interviewing Treatment Integrity (MITI) to continually evaluate the efficacy of MI training by measuring adherence to MI counseling skills in rehabilitation therapists trained to use MI compared to those not trained to use MI. The ratings are on a 5-point Likert scale from 1 (low) to 5 (high), with higher scores indicating higher level of efficacy.
During 1 year of inpatient rehabilitation
Functional Abilities
Time Frame: At week 4
The Spinal Cord Injury Functional Independence (SCI-FI) will be administered to patient participants within approximately one week of their discharge from inpatient rehabilitation. The response scale range from 1 (unable to do the activity) to 5 (no difficulty), with higher scores indicating higher functional ability.
At week 4
Participation in the Community
Time Frame: At 6 months post-discharge
The Participation Assessment with Recombined Tools-Objective (PART-O) will be administered to patient participants to measure their level of involvement in the community 6 months post discharge. Higher scores indicate higher level of participation.
At 6 months post-discharge

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Shirley Ryan AbilityLab

Collaborators

University of Washington
Baylor Research Institute

Investigators

  • Principal Investigator: Linda Ehrlich-Jones, PhD, RN, Shirley Ryan AbilityLab

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2025

Primary Completion (Estimated)

April 20, 2027

Study Completion (Estimated)

April 20, 2027

Study Registration Dates

First Submitted

October 9, 2025

First Submitted That Met QC Criteria

January 16, 2026

First Posted (Actual)

January 23, 2026

Study Record Updates

Last Update Posted (Actual)

January 23, 2026

Last Update Submitted That Met QC Criteria

January 16, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • STU00219326
  • 973467 (Other Grant/Funding Number: Craig H. Neilsen Foundation)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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