Motivational Interviewing: Exploring Predictors of Motivation to Change in Individuals with Borderline Personality Disorder

Background Borderline personality disorder (BPD) is a complex condition in which individuals often face significant challenges with low motivation and high ambivalence in treatment. The present study aimed to qualitatively explore the predictors of motivation to change in females with BPD through motivational interviewing (MI) as an adjunctive, pre-therapy intervention. Purpose In patients with BPD due to sudden shifts in mood there is lack of motivation and poor treatment adherence, resulting in poor prognosis. To enhance the treatment compliance and motivation in BPD patients the present study was designed to explore the predictors of motivation to change in patients with BPD with the help of Motivational Interview as an adjunctive therapy. Methods A qualitative design was employed, utilising Braun and Clarke’s (2006, Qual Res Psychol , 3, 2, 77–101) Thematic Analysis. A purposive sample of five BPD-diagnosed female participants, aged 20–35, was recruited from the Hospital for Mental Health, Ahmedabad, Gujarat. Participants underwent six to eight sessions of MI, followed by semi-structured interviews. Data were transcribed and analysed using an inductive thematic approach. Results and Discussion The analysis yielded a thematic framework of six interconnected themes, with participants moving ‘From Emotional Turmoil to Meaning-Making’, navigating the central conflict of ‘Struggling Between Hope and Helplessness’ (the nature of ambivalence) and contending with ‘Working Through the Wall’ (barriers to change). Forward momentum was driven by ‘Seeds of Motivation’ (internal and external factors) and facilitated by ‘Catalysts of Change’ (supports and small steps). ‘The MI Experience’ was identified as a primary predictor of change. Conclusion MI as a ‘therapeutic bridge’ for individuals with BPD may help them transition from self-blame to self-reflection and from ambivalence to action. It appears to be a valuable adjunct to enhance the effectiveness of intensive therapies.