Although interest in the use of MI to complement CBT is growing, researchers are just starting to study potential moderators of its effectiveness. The combination ofMI and
CBT, for example, may be effective for clients with substance use disorders, but may or may not be effective for clients who are thinking about suicide. Another issue that may be important to consider, but is not often discussed, is the different strategies for integrating MI and CBT. In most studies, one or two sessions of MI are added before treatment to help clients explore and resolve ambivalence for the desired change. Other, less frequently used strategies include adding a course of MI until the client is motivated to transition to CBT, incorporating one or two sessions of MI into treatment when motivation wanes, and assimilating principles of MI within CBT. Researchers are even starting to study the importance of MI-related principles within CBT (Aharonovich et al., 2008). Because MI has been conceptualized and most often tested as a brief intervention, we will focus on using a brief course of MI before the clients begin CBT or when motivation for living or treatment begins to wane. It is important to note that from an SDT perspective, assimilating MI principles
into CBT is expected to enhance clients' sense of relatedness and autonomy, which may increase their vitality, reduce their suffering, and have a positive effect on their ability to actively engage in CBT exercises.