Motivational Interviewing in Health Care: Helping Patients Change Behavior by Stephen Rollnick, William R. Miller, Christopher C. Butler

Synopsis

Much of health care today involves helping patients manage conditions whose outcomes can be greatly influenced by lifestyle or behavior change. Written specifically for health care professionals, this concise book presents powerful tools to enhance communication with patients and guide them in making choices to improve their health, from weight loss, exercise, and smoking cessation, to medication adherence and safer sex practices. Engaging dialogues and vignettes bring to life the core skills of motivational interviewing (MI) and show how to incorporate this brief evidence-based approach into any health care setting. Appendices include MI training resources and publications on specific medical conditions.

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Reviewer:Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description:This book describes motivational interviewing, a concept developed in 1983 in order to help increase patient motivation and enhance behavioral change. Though initially used in dealing with alcoholism, motivational interviewing is now being used with other medical and psychological problems.
Purpose:As stated in the preface, "the book is for any health care practitioner who spends time encouraging patients to consider behavior change." Later, in chapter one, the authors note, "This book was written to help you have productive conversations with patients about behavior change. In particular, we describe a gentle form of counseling known as motivational interviewing, which has been found effective in fostering change across a wide range of health behaviors."
Audience:The target audience is broad, including nurses, doctors, dieticians, psychologists, counselors, health educators, dentists, dental hygienists, social workers, physical and occupational therapists, podiatrists, and "sometimes even people who answer the office telephones," according to the authors. All of the authors have published extensively. Dr. Rollnick is professor of health care communications at Cardiff University, Dr. Miller is emeritus distinguished professor of psychology and psychiatry at the University of New Mexico, and Dr. Butler is professor of primary care medicine and head of the Department of Primary Care and Public Health at Cardiff University.
Features:The four guiding principles of motivational interviewing are: to resist the righting reflex;to understand and explore the patient's own motivations; to listen with empathy; and to empower the patient, encouraging hope and optimism. Motivational interviewing has been shown effective with substance abuse and other physical and psychological disorders such as cardiovascular disease, diabetes, diet, hypertension, psychosis, pathological gambling, and HIV infection. This book is a step-by-step approach to learning motivational interviewing and it begins with theory, presents the core skills, and then shows how to integrate these skills in a clinical setting. Chapter eight is wonderful in presenting three case studies on how to use the method. There are also clinical examples in other chapters as well. Other nice features are the epilogue, which provides more information on the process, appendix A, aids to learning, and appendix B, a topical bibliography. The bibliography is helpful because readers can turn right to the disorder they want more research/information on. The book is easy to read and practical and the tables and figures are instructional. This is the kind of book that you can read and use the information soon after in a clinical situation. However, appendix A does contain dozens of references for more training in motivational interviewing.
Assessment:This is a practical, easy to read book that is useful with both psychiatric and physical disorders. It has a solid research base since its development in 1983. Though concise, it can help clients consider making important behavioral changes in their lives which can affect both their psychological and physical functioning. Healthcare providers will find it to be a welcome addition to their libraries, both in terms of having another set of techniques to assist clients and because of its low cost.

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Biography

Stephen Rollnick, PhD, is a clinical psychologist and Professor of Health Care Communication in the Department of Primary Care and Public Health at Cardiff University, UK. He practiced in a primary care setting for 16 years and then became a teacher and researcher on the subject of communication. Dr. Rollnick has written books on motivational interviewing and health behavior change and has a special interest in challenging consultations in health and social care. He has published widely in scientific journals and has taught practitioners and trainers in many countries throughout the world.

 

William R. Miller, PhD, is Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico, where he joined the faculty in 1976. He served as Director of Clinical Training for UNM's American Psychological Association-approved doctoral program in clinical psychology and as Codirector of UNM’s Center on Alcoholism, Substance Abuse, and Addictions. Dr. Miller’s publications include 35 books and more than 400 articles and chapters. He introduced the concept of motivational interviewing in a 1983 article. The Institute for Scientific Information names him as one of the world's most cited scientists.

 

Christopher C. Butler, MD, is Professor of Primary Care Medicine and head of the Department of Primary Care and Public Health at Cardiff University, UK. He trained in medicine at the University of Cape Town and in clinical epidemiology at the University of Toronto. For his doctoral work, under the direction of Stephen Rollnick, he developed and evaluated behavior change counseling and conductedqualitative research into patients’ perceptions of advice against smoking from clinicians. Dr. Butler has published more than 70 papers, mainly on health behavior change and common infections. He has a general medical practice in a former coal-mining town in south Wales.