AIMS:The aim of this pilot randomized study was to investigate the feasibility of early motivational interviewing, for reducing mood after acute stroke. BACKGROUND:Depression is a frequent consequence of stroke that can adversely affect recovery. METHODS:DESIGN: Pilot randomized study. Intervention group patients received 3, individual motivational interviewing sessions by nurses or social workers prior to hospital discharge. PARTICIPANTS:Adult patients with acute stroke during 2013 to 2014. BLINDING:Research assistant who collected data was blind to group assignment. OUTCOMES:Data were collected at 3 time points: baseline, 1-month, and 3-month follow-up. Outcome measures (anxiety, depression, quality of life) were analysed by descriptive statistics. RESULTS:Forty-eight patients were enrolled, and 79% retention was achieved at 3 months. Eight participants withdrew (16.7%), and 2 were unable to participate (death: 2.1% and new onset aphasia: 2.1%), leaving 38 participants in the final cohort (Intervention: N = 18, Control: N = 20). Anxiety, depression, and quality of life measures did not alter significantly in the study period. CONCLUSIONS:Carefully designed studies are required to investigate the effectiveness of early motivational interviewing for improving mood after stroke. The therapy can be administered by nurses, but significant resources are required in terms of training and fidelity.