Motivational interviewing: Difference between revisions
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'''[[Motivatio]]nal [[interview]]ing''' is a "client-centered, directive method for eliciting intrinsic motivation to change using open-ended [[question]]s, reflective [[listening]], and decisional balancing. This nonjudgmental, nonconfrontational interviewing style is designed to minimize a patient's resistance to change by creating an interaction that supports open discussion of risky or problem behavior."<ref>{{MeSH}}</ref><ref name="pmid20423957">{{cite journal| author=Rollnick S, Butler CC, Kinnersley P, Gregory J, Mash B| title=Motivational interviewing. | journal=BMJ | year= 2010 | volume= 340 | issue= | pages= c1900 | pmid=20423957 | doi=10.1136/bmj.c1900 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20423957 }} </ref> | |||
==Effectiveness== | ==Effectiveness== | ||
===Teaching practitioners=== | |||
{| class="wikitable" | {| class="wikitable" | ||
|+ Studies of the effectiveness of teaching motivational learning<ref name="pmid22370769">{{cite journal| author=Cucciare MA, Ketroser N, Wilbourne P, Midboe AM, Cronkite R, Berg-Smith SM et al.| title=Teaching motivational interviewing to primary care staff in the Veterans Health Administration. | journal=J Gen Intern Med | year= 2012 | volume= 27 | issue= 8 | pages= 953-61 | pmid=22370769 | doi=10.1007/s11606-012-2016-6 | pmc=PMC3403134 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22370769 }} </ref><ref name="pmid22910139">{{cite journal| author=Childers JW, Bost JE, Kraemer KL, Cluss PA, Spagnoletti CL, Gonzaga AM et al.| title=Giving residents tools to talk about behavior change: a motivational interviewing curriculum description and evaluation. | journal=Patient Educ Couns | year= 2012 | volume= 89 | issue= 2 | pages= 281-7 | pmid=22910139 | doi=10.1016/j.pec.2012.08.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22910139 }} </ref><ref name="pmid18592322">{{cite journal| author=Bell K, Cole BA| title=Improving medical students' success in promoting health behavior change: a curriculum evaluation. | journal=J Gen Intern Med | year= 2008 | volume= 23 | issue= 9 | pages= 1503-6 | pmid=18592322 | doi=10.1007/s11606-008-0678-x | pmc=PMC2518029 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18592322 }} </ref> | |+ Studies of the effectiveness of teaching motivational learning<ref name="pmid22370769">{{cite journal| author=Cucciare MA, Ketroser N, Wilbourne P, Midboe AM, Cronkite R, Berg-Smith SM et al.| title=Teaching motivational interviewing to primary care staff in the Veterans Health Administration. | journal=J Gen Intern Med | year= 2012 | volume= 27 | issue= 8 | pages= 953-61 | pmid=22370769 | doi=10.1007/s11606-012-2016-6 | pmc=PMC3403134 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22370769 }} </ref><ref name="pmid22910139">{{cite journal| author=Childers JW, Bost JE, Kraemer KL, Cluss PA, Spagnoletti CL, Gonzaga AM et al.| title=Giving residents tools to talk about behavior change: a motivational interviewing curriculum description and evaluation. | journal=Patient Educ Couns | year= 2012 | volume= 89 | issue= 2 | pages= 281-7 | pmid=22910139 | doi=10.1016/j.pec.2012.08.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22910139 }} </ref><ref name="pmid18592322">{{cite journal| author=Bell K, Cole BA| title=Improving medical students' success in promoting health behavior change: a curriculum evaluation. | journal=J Gen Intern Med | year= 2008 | volume= 23 | issue= 9 | pages= 1503-6 | pmid=18592322 | doi=10.1007/s11606-008-0678-x | pmc=PMC2518029 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18592322 }} </ref><ref name="pmid17786734">{{cite journal| author=White LL, Gazewood JD, Mounsey AL| title=Teaching students behavior change skills: description and assessment of a new Motivational interviewing curriculum. | journal=Med Teach | year= 2007 | volume= 29 | issue= 4 | pages= e67-71 | pmid=17786734 | doi=10.1080/01421590601032443 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17786734 }} </ref><ref name="pmid17269949">{{cite journal| author=Martino S, Haeseler F, Belitsky R, Pantalon M, Fortin AH| title=Teaching brief motivational interviewing to Year three medical students. | journal=Med Educ | year= 2007 | volume= 41 | issue= 2 | pages= 160-7 | pmid=17269949 | doi=10.1111/j.1365-2929.2006.02673.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17269949 }} </ref> | ||
! rowspan="2"|Trial!!rowspan="2"| Patients!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="2"|Results!!rowspan="2"|Comment | ! rowspan="2"|Trial!!rowspan="2"| Patients!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="2"|Results!!rowspan="2"|Comment | ||
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responses to the vignettes | responses to the vignettes | ||
|- | |- | ||
| Childers<ref name="pmid22910139"/><br/>2012 || Medical residents (third year of training)|| "Groups of two to four residents met for a half-day session weekly for four weeks with a faculty internist trained in MI." 12 hours||Not applicable in this before-after study|| Helpful Responses Questionnaire|| || || Increased residents’ use of core MI communication skills | | Childers<ref name="pmid22910139"/><br/>2012 || Medical residents (third year of training)|| "Groups of two to four residents met for a half-day session weekly for four weeks with a faculty internist trained in MI." 12 hours||Not applicable in this before-after study|| Helpful Responses Questionnaire<ref name="pmid2066417">{{cite journal| author=Miller WR, Hedrick KE, Orlofsky DR| title=The Helpful Responses Questionnaire: a procedure for measuring therapeutic empathy. | journal=J Clin Psychol | year= 1991 | volume= 47 | issue= 3 | pages= 444-8 | pmid=2066417 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2066417 }} </ref>|| || || Increased residents’ use of core MI communication skills | ||
|- | |- | ||
| Bell<ref name="pmid18592322"/><br/>2008 || Medical students|| four 2-h sessions||Not applicable in this before-after study|| • Video Assessment of Simulated Encounters-Revised (VASE-R)<br/>• Commitment to Change (CTC) statements<ref name="pmid12823654">{{cite journal| author=Green ML, Gross CP, Kernan WN, Wong JG, Holmboe ES| title=Integrating teaching skills and clinical content in a faculty development workshop. | journal=J Gen Intern Med | year= 2003 | volume= 18 | issue= 6 | pages= 468-74 | pmid=12823654 | doi= | pmc=PMC1494873 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12823654 }} </ref>|| || || Improved knowledge, confidence, and skills | | Bell<ref name="pmid18592322"/><br/>2008 || Medical students|| four 2-h sessions||Not applicable in this before-after study|| • Video Assessment of Simulated Encounters-Revised (VASE-R)<br/>• Commitment to Change (CTC) statements<ref name="pmid12823654">{{cite journal| author=Green ML, Gross CP, Kernan WN, Wong JG, Holmboe ES| title=Integrating teaching skills and clinical content in a faculty development workshop. | journal=J Gen Intern Med | year= 2003 | volume= 18 | issue= 6 | pages= 468-74 | pmid=12823654 | doi= | pmc=PMC1494873 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12823654 }} </ref>|| || || Improved knowledge, confidence, and skills | ||
|- | |- | ||
| | | White<ref name="pmid17786734"/><br/>2007|| Medical students|| Unclear number and duration of sessions.||Not applicable in this before-after study|| Motivational Interviewing Treatment Integrity scoring tool (MITI)<ref name="pmid15723728">{{cite journal| author=Moyers TB, Martin T, Manuel JK, Hendrickson SM, Miller WR| title=Assessing competence in the use of motivational interviewing. | journal=J Subst Abuse Treat | year= 2005 | volume= 28 | issue= 1 | pages= 19-26 | pmid=15723728 | doi=10.1016/j.jsat.2004.11.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15723728 }} </ref>|| || || As compared to professional counselors, "students reached a proficiency level on the rate of reflections, were just below proficiency in assessment of empathy and motivational interviewing spirit and substantially below proficiency in the percent of open ended questions." | ||
|- | |- | ||
| | | Martino<ref name="pmid17269949"/><br/>2007 || Medical students||Single 2-hour training session of 'brief motivational interviewing' (BMI||Not applicable in this before-after study|| Helpful Response Questionnaire<ref name="pmid2066417">{{cite journal| author=Miller WR, Hedrick KE, Orlofsky DR| title=The Helpful Responses Questionnaire: a procedure for measuring therapeutic empathy. | journal=J Clin Psychol | year= 1991 | volume= 47 | issue= 3 | pages= 444-8 | pmid=2066417 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2066417 }} </ref>|| || || Students increased their knowledge, interest, confidence, and BMI-consistent behaviours | ||
|- | |- | ||
| || || || | | || || || || || || || | ||
|} | |} | ||
===Effect on behavior change in clients=== | |||
Trials have yielded both positive<ref name="pmid18654123">{{cite journal| author=Ogedegbe G, Chaplin W, Schoenthaler A, Statman D, Berger D, Richardson T et al.| title=A practice-based trial of motivational interviewing and adherence in hypertensive African Americans. | journal=Am J Hypertens | year= 2008 | volume= 21 | issue= 10 | pages= 1137-43 | pmid=18654123 | doi=10.1038/ajh.2008.240 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18654123 }} </ref><ref name="pmid21692966">{{cite journal| author=Armstrong MJ, Mottershead TA, Ronksley PE, Sigal RJ, Campbell TS, Hemmelgarn BR| title=Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. | journal=Obes Rev | year= 2011 | volume= 12 | issue= 9 | pages= 709-23 | pmid=21692966 | doi=10.1111/j.1467-789X.2011.00892.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21692966 }} </ref><ref name="pmid20091612">{{cite journal| author=Lai DT, Cahill K, Qin Y, Tang JL| title=Motivational interviewing for smoking cessation. | journal=Cochrane Database Syst Rev | year= 2010 | volume= | issue= 1 | pages= CD006936 | pmid=20091612 | doi=10.1002/14651858.CD006936.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20091612 }} </ref> and negative<ref name="pmid21455729">{{cite journal| author=Rosenbek Minet LK, Wagner L, Lønvig EM, Hjelmborg J, Henriksen JE| title=The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: a randomised controlled trial. | journal=Diabetologia | year= 2011 | volume= 54 | issue= 7 | pages= 1620-9 | pmid=21455729 | doi=10.1007/s00125-011-2120-x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21455729 }} </ref><ref name="pmid22371876">{{cite journal| author=Solomon DH, Iversen MD, Avorn J, Gleeson T, Brookhart MA, Patrick AR et al.| title=Osteoporosis telephonic intervention to improve medication regimen adherence: a large, pragmatic, randomized controlled trial. | journal=Arch Intern Med | year= 2012 | volume= 172 | issue= 6 | pages= 477-83 | pmid=22371876 | doi=10.1001/archinternmed.2011.1977 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22371876 }} </ref> results. | |||
The efficacy in older studies has been summarized in a [[meta-analysis]].<ref name="pmid14516234">{{cite journal| author=Burke BL, Arkowitz H, Menchola M| title=The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. | journal=J Consult Clin Psychol | year= 2003 | volume= 71 | issue= 5 | pages= 843-61 | pmid=14516234 | doi=10.1037/0022-006X.71.5.843 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14516234 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15107348 Review in: Evid Based Ment Health. 2004 May;7(2):52] </ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 11:37, 16 September 2020
Motivational interviewing is a "client-centered, directive method for eliciting intrinsic motivation to change using open-ended questions, reflective listening, and decisional balancing. This nonjudgmental, nonconfrontational interviewing style is designed to minimize a patient's resistance to change by creating an interaction that supports open discussion of risky or problem behavior."[1][2]
Effectiveness
Teaching practitioners
| Trial | Patients | Intervention | Comparison | Outcome | Results | Comment | |
|---|---|---|---|---|---|---|---|
| After | Before | ||||||
| Cucciare[3] 2012 |
Staff in the United States Veterans Health Administration | "Three sessions—a half-day, in-person workshop, followed by a 60-minute virtual training, followed by a second, half-day, in-person training workshop. Each session was spaced two weeks apart" | Not applicable in this before-after study | Questionnaire asking knowledge, confidence, attitudes, and responses to vignettes | Increases in knowledge, confidence, and written
responses to the vignettes | ||
| Childers[4] 2012 |
Medical residents (third year of training) | "Groups of two to four residents met for a half-day session weekly for four weeks with a faculty internist trained in MI." 12 hours | Not applicable in this before-after study | Helpful Responses Questionnaire[8] | Increased residents’ use of core MI communication skills | ||
| Bell[5] 2008 |
Medical students | four 2-h sessions | Not applicable in this before-after study | • Video Assessment of Simulated Encounters-Revised (VASE-R) • Commitment to Change (CTC) statements[9] |
Improved knowledge, confidence, and skills | ||
| White[6] 2007 |
Medical students | Unclear number and duration of sessions. | Not applicable in this before-after study | Motivational Interviewing Treatment Integrity scoring tool (MITI)[10] | As compared to professional counselors, "students reached a proficiency level on the rate of reflections, were just below proficiency in assessment of empathy and motivational interviewing spirit and substantially below proficiency in the percent of open ended questions." | ||
| Martino[7] 2007 |
Medical students | Single 2-hour training session of 'brief motivational interviewing' (BMI | Not applicable in this before-after study | Helpful Response Questionnaire[8] | Students increased their knowledge, interest, confidence, and BMI-consistent behaviours | ||
Effect on behavior change in clients
Trials have yielded both positive[11][12][13] and negative[14][15] results.
The efficacy in older studies has been summarized in a meta-analysis.[16]
References
- ↑ Anonymous (2024), Motivational interviewing (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Rollnick S, Butler CC, Kinnersley P, Gregory J, Mash B (2010). "Motivational interviewing.". BMJ 340: c1900. DOI:10.1136/bmj.c1900. PMID 20423957. Research Blogging.
- ↑ 3.0 3.1 Cucciare MA, Ketroser N, Wilbourne P, Midboe AM, Cronkite R, Berg-Smith SM et al. (2012). "Teaching motivational interviewing to primary care staff in the Veterans Health Administration.". J Gen Intern Med 27 (8): 953-61. DOI:10.1007/s11606-012-2016-6. PMID 22370769. PMC PMC3403134. Research Blogging.
- ↑ 4.0 4.1 Childers JW, Bost JE, Kraemer KL, Cluss PA, Spagnoletti CL, Gonzaga AM et al. (2012). "Giving residents tools to talk about behavior change: a motivational interviewing curriculum description and evaluation.". Patient Educ Couns 89 (2): 281-7. DOI:10.1016/j.pec.2012.08.001. PMID 22910139. Research Blogging.
- ↑ 5.0 5.1 Bell K, Cole BA (2008). "Improving medical students' success in promoting health behavior change: a curriculum evaluation.". J Gen Intern Med 23 (9): 1503-6. DOI:10.1007/s11606-008-0678-x. PMID 18592322. PMC PMC2518029. Research Blogging.
- ↑ 6.0 6.1 White LL, Gazewood JD, Mounsey AL (2007). "Teaching students behavior change skills: description and assessment of a new Motivational interviewing curriculum.". Med Teach 29 (4): e67-71. DOI:10.1080/01421590601032443. PMID 17786734. Research Blogging.
- ↑ 7.0 7.1 Martino S, Haeseler F, Belitsky R, Pantalon M, Fortin AH (2007). "Teaching brief motivational interviewing to Year three medical students.". Med Educ 41 (2): 160-7. DOI:10.1111/j.1365-2929.2006.02673.x. PMID 17269949. Research Blogging.
- ↑ 8.0 8.1 Miller WR, Hedrick KE, Orlofsky DR (1991). "The Helpful Responses Questionnaire: a procedure for measuring therapeutic empathy.". J Clin Psychol 47 (3): 444-8. PMID 2066417. [e]
- ↑ Green ML, Gross CP, Kernan WN, Wong JG, Holmboe ES (2003). "Integrating teaching skills and clinical content in a faculty development workshop.". J Gen Intern Med 18 (6): 468-74. PMID 12823654. PMC PMC1494873. [e]
- ↑ Moyers TB, Martin T, Manuel JK, Hendrickson SM, Miller WR (2005). "Assessing competence in the use of motivational interviewing.". J Subst Abuse Treat 28 (1): 19-26. DOI:10.1016/j.jsat.2004.11.001. PMID 15723728. Research Blogging.
- ↑ Ogedegbe G, Chaplin W, Schoenthaler A, Statman D, Berger D, Richardson T et al. (2008). "A practice-based trial of motivational interviewing and adherence in hypertensive African Americans.". Am J Hypertens 21 (10): 1137-43. DOI:10.1038/ajh.2008.240. PMID 18654123. Research Blogging.
- ↑ Armstrong MJ, Mottershead TA, Ronksley PE, Sigal RJ, Campbell TS, Hemmelgarn BR (2011). "Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials.". Obes Rev 12 (9): 709-23. DOI:10.1111/j.1467-789X.2011.00892.x. PMID 21692966. Research Blogging.
- ↑ Lai DT, Cahill K, Qin Y, Tang JL (2010). "Motivational interviewing for smoking cessation.". Cochrane Database Syst Rev (1): CD006936. DOI:10.1002/14651858.CD006936.pub2. PMID 20091612. Research Blogging.
- ↑ Rosenbek Minet LK, Wagner L, Lønvig EM, Hjelmborg J, Henriksen JE (2011). "The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: a randomised controlled trial.". Diabetologia 54 (7): 1620-9. DOI:10.1007/s00125-011-2120-x. PMID 21455729. Research Blogging.
- ↑ Solomon DH, Iversen MD, Avorn J, Gleeson T, Brookhart MA, Patrick AR et al. (2012). "Osteoporosis telephonic intervention to improve medication regimen adherence: a large, pragmatic, randomized controlled trial.". Arch Intern Med 172 (6): 477-83. DOI:10.1001/archinternmed.2011.1977. PMID 22371876. Research Blogging.
- ↑ Burke BL, Arkowitz H, Menchola M (2003). "The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials.". J Consult Clin Psychol 71 (5): 843-61. DOI:10.1037/0022-006X.71.5.843. PMID 14516234. Research Blogging. Review in: Evid Based Ment Health. 2004 May;7(2):52