Motivational interviewing

Motivational interviewing is an approach to behaviour change that addresses the emotional as well as the cognitive aspects of a person’s behaviour, making it useful in addressing problematic habits that impact on their health.

Key points 

  • The most common causes of mortality are modifiable health behaviours such as smoking, physical inactivity, poor diet, and harmful alcohol consumption.
  • Because primary healthcare practitioners are likely to see patients presenting with these issues, primary care is an optimal place to target modifiable health behaviours.
  • Motivational interviewing is an effective approach to addressing problematic health behaviours that has been found to be effective in the primary care setting with smoking cessation, hazardous driving, physical activity, nutrition and chronic disease.
  • General practitioners report that motivational interviewing is efficient and about as time-consuming as traditional approaches to advice giving.
  • Research has found that motivational interviewing has a greater effect for ethnocultural groups, particularly those groups who have experienced marginalisation and societal pressure.

What is motivational interviewing?

Motivational interviewing is a collaborative conversational approach to behaviour change that is designed to strengthen a patient’s commitment to and motivation for change.

It’s designed to help someone move from feeling ambivalent about needing to change a behaviour, to believing they need to change the behaviour, to believing they can change the behaviour.

Underpinning motivational interviewing is a model of change that goes from pre-contemplation to contemplation, planning, action, maintenance, and, usually, relapse on several occasions before the new behaviour is integrated. Identifying where a person is in this cycle helps ensure the motivational interviewing is well targeted to their needs.

When is motivational interviewing useful?

Motivational interviewing is particularly useful when someone is reluctant or ambivalent about change, but the change would improve their health outcomes. It is widely used in addiction counselling, and helpful with lifestyle changes around smoking, drinking, eating and exercise. Motivational interviewing can also be useful to help manage medication use and attending appointments, tests and screenings.

What are the key skills and competencies for motivational interviewing?

Rather than providing advice or telling someone they need to change a behaviour, the approach uses skills such as:

  • open-ended questions
  • affirmations
  • reflective listening, and
  • summaries.

Where can clinicians learn how to become skilled with motivational interviewing?

Get started with the online video courses under resources in the side bar. Also, see more information about motivational interviewing in the brochures, videos and books in the side bar.

References

  1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States 2000. Journal of the American Medical Association. 2004;291:1238–1245. doi: 10.1001/jama.291.10.1238.
  2. Midboe AM, Cucciare MA,Trafton JA, Ketroser N, Chardos JF. Implementing motivational interviewing in primary care: the role of provider characteristics Transl Behav Med. 2011 Dec; 1(4): 588–594. doi:10.1007/s13142-011-0080-9
  3. Motivational interviewing Best Practice Journal. 2008 Oct
  4. Rubak S, Sandboek A, Lauritzen T, Borch-Johnsen K, Christensen B. An education and training course in motivational interviewing: GP’s professional behaviour Denmark. British Journal of General Practice. 2006;56:429–436
  5. Britt E, Gregory D, Tohiariki T, Huriwai, T. Takitaki Mai: A guide to motivational interviewing for Māori Matua Raki, 2014
  6. Transtheoretical model of behaviour change Pro-charge Behaviour Systems
  7. Stewart EE, Fox C. Encouraging patients to change unhealthy behaviours with motivational interviewing Fam Pract Manag. 2011 May-June;18(3):21-25.
Credits: Editorial team.