What is motivational interviewing?
Motivational interviewing is not a new concept. It was conceived in the early 1980s when American psychologist William R. Miller, PhD, described a therapeutic approach he had used with some success for people with alcohol problems.1 Today, Miller and colleagues describe motivational interviewing as “a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.”2 Essentially, it is a method for changing the direction of a conversation in order to stimulate the patient's desire to change and give him or her the confidence to do so. In contrast to many other change strategies employed by health care professionals (such as education, persuasion and scare tactics), motivational interviewing is more focused, goal directed and patient centered. A critical tenet is that the motivation for change must emanate from the patient rather than the physician. Although the majority of motivational interviewing training and study involves focused therapy, there is evidence that very brief (five-minute) sessions have positive results, particularly when patients are highly resistant to change.3 Thus, motivational interviewing is a strategy with great potential for time-pressed family physicians and their care team members.