OBJECTIVES: To examine whether the addition of motivational enhancement treatment (MET) to conventional physical therapy (PT) produces better outcomes than PT alone in people with chronic low back pain (LBP). DESIGN: A double-blinded, prospective, randomized, controlled trial. SETTING: PT outpatient department. PARTICIPANTS: Participants (n = 76) with chronic LBP were randomly assigned to receive 10 sessions of either MET plus PT or PT alone. INTERVENTION: MET included motivational interviewing strategies and motivation-enhancing factors. The PT program consisted of interferential therapy and back exercises. MAIN OUTCOME MEASURES: Motivational-enhancing factors, pain intensity, physical functions, and exercise compliance. RESULTS: The MET-plus-PT group produced significantly greater improvements than the PT group in 3 motivation-enhancing factors; proxy efficacy (p < 0.001), working alliance (p < 0.001), and treatment expectancy (p = 0.011). Furthermore, they performed significantly better in lifting capacity (p = 0.015), 36-Item Short Form Health Survey General Health subscale (p = 0.015), and exercise compliance (p = 0.002) than the PT group. A trend of a greater decrease in visual analog scale and Roland-Morris Disability Questionnaire scores also was found in the MET-plus-PT group than the PT group. CONCLUSION: The addition of MET to PT treatment can effectively enhance motivation and exercise compliance and show better improvement in physical function in patients with chronic LBP compared with PT alone.

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