Motivational interviewing

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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

Studies of the effectiveness of teaching motivational learning[3][4][5][6][7]
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

  1. Anonymous (2015), Motivational interviewing (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 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. 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. 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. 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. 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. 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. 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]
  9. 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]
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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.
  16. 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