Engaging, Retaining, and Providing Transdiagnostic Integrated Cognitive-Behavioral Therapy and Motivational Interviewing for Underserved People With HIV

Audrey Harkness, Brooke G. Rogers, Marc Puccinelli, Ivan Ivardic, Gail Ironson, Steven A. Safren

Research output: Contribution to journalArticle


People with HIV experience elevated levels of co-occurring psychosocial concerns, which can interfere with HIV-related self-care behaviors, such as medication adherence. We recently developed transdiagnostic, integrated cognitive- behavioral therapy and motivational interviewing psychotherapy to address interrelated psychosocial problems (syndemics) that can interfere with medication adherence and selfcare among people with uncontrolled HIV (i.e., a detectable viral load). Through completion of a field trial that included development, clinical supervision, treatment, and administrative coordination of this project, we identified recommendations for engaging, retaining, and delivering transdiagnostic cognitive-behavioral therapy/motivational interviewing to individuals with HIV and experiencing psychosocial and structural barriers to mental and physical health. We describe these recommendations, which include (a) building the relationship; (b) addressing HIV in the context of syndemics; (c) attending to the impact of stigma on health; (d) being flexible in delivering the treatment; (e) managing emergent crises with relevant skill material; (f) tailoring the treatment to education, language, and sociocultural context; (g) implementing problem-solving skills for structural barriers; (h) scheduling flexibly and following up; (i) colocating mental health services and coordinating among providers; and (j) providing a comfortable and affirming physical space. In addition to describing these recommendations, we provide clinical examples and highlight empirical research to illustrate and support using these recommendations.

Original languageEnglish (US)
StateAccepted/In press - Jan 1 2019



  • Cognitive- behavioral therapy
  • Engagement in care
  • Motivational interviewing HIV
  • Transdiagnostic

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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