Motivational interviewing in health promotion: It sounds like something is changing.

Abstract

Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been applied in public health, medical, and health promotion settings. This article provides an overview of MI, outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed, nuances associated with the use of MI in health promotion and chronic disease prevention are described, and future directions are offered.

Motivational Interviewing: Improving Patient Education

“…Miller (1983) and elaborated upon by Miller and Rollnick (1991), is consistent with the stages of change and offers a practical, brief counseling method for helping families increase their motivation or readiness to change (Berg-Smith et al, 1999). The main goals of MI are to assist the family in working through its ambivalence about behavior change; assessing the importance of change, their confidence in making change, and readiness for change; and planning for change if they are ready (Resnicow et al, 2002;Rollnick et al, 1999). MI outlines approaches that can be used for patients and families in all stages of readiness for change.…”

“…The strategy is to offer their professional opinion about the health consequences of the behavior in a nonjudgmental fashion and leave the door open for discussion in the future if they change their minds. Other strategies include assessing interest and confidence in change, eliciting change talk from the family, and improving self-efficacy (Resnicow et al, 2002;Schwartz, 2005). These strategies reflect the paradigm shift from the NP being the authoritarian expert who gives advice and information to the family verbalizing the need for change and their preference for the approach to the change.…”

“…This strategy is called "eliciting the change talk" from the family members, which increases the likelihood that the family members will act on what they have verbalized. The more they defend a position, the greater their commitment to it (Resnicow et al, 2002).…”

“…Build confidence in the ability to change. In a nonconfrontational and supportive climate in which families feel comfortable expressing both positive and negative aspects of their current behavior, families are asked to elicit the pros and cons of change (Resnicow et al, 2002; see Table 2). As the family members verbalize the reasons for change, they are more likely to make the changes.…”

“…Ideally, the family rather than the NP makes the argument for change and describes the course of action (Rollnick et al, 1999). If the family needs more information about the impact of current behavior on health, the NP asks the family's permission to share information, presents the information in a neutral manner, and leaves the interpretation of the information up to the family (Resnicow et al, 2002).…”