Motivational Interviewing in Primary Care

Thames Valley University, London, UK.
Journal of Clinical Psychology in Medical Settings (Impact Factor: 1.49). 04/2009; 16(1):87-93. DOI: 10.1007/s10880-009-9155-x
Source: PubMed


Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long term conditions. One goal of these efforts is the coproduction of activated, informed, engaged and motivated patients and citizens. The clinical, public health and financial benefits of achieving such a goal may be dramatic. Motivational Interviewing (MI) is a proven and practical front-line approach which can help deliver this goal whilst also helping to deliver such policy objectives and intermediate outcomes as increased levels of patient centered care, participatory or shared decision making, evidence-based healthcare and improved clinician-patient relationships. Until now, MI has been passively diffusing through the system as a result of the innovation and early uptake by insightful individuals and organizations. If healthcare systems want to breakthrough to higher levels of performance, investment in the conscious and deliberate implementation of MI into front-line settings may prove helpful.

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    • "Evidence-based interventions such as MI fit well within pediatric health care settings (Erickson, Gerstle, & Feldstein, 2005). MI is considered an evidencedbased , frontline approach to reducing substance use and negative health outcomes through increased levels of patient-centered care, shared decision making, and improved clinician–patient relationships (Anstiss, 2009; Rollnick, Miller, & Butler, 2008). Findings regarding efficacy of MI with racial and ethnic minority groups generally indicate that MI is an appropriate intervention for diverse populations. "
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    ABSTRACT: Close peer networks can affect adolescents’ health behaviors by altering their social environments, and thus their risk for and protection against substance use involvement. We tested a 20 minute intervention named Peer Network Counseling that integrates Motivational Interviewing and peer network strategies with 119 urban adolescents who reported occasional or problem substance use. Adolescents presenting at primary care clinic were randomized to intervention or control conditions and followed for 6 months. Mixed-effect latent growth models were used to evaluate intervention effects on trajectories of alcohol and marijuana use, offers to use substances, and moderation models to test for interactions between intervention condition and peer network characteristics. A significant intervention effect was found for boys for offers to use alcohol from friends (p<.05), along with a trend significant effect for alcohol use (p<.08). Intervention was more effective in reducing marijuana use, vs. control, for participants with more peer social support (p<.001) and with more peer encouragement for prosocial behavior (school, clubs, sports, religious activities); however, intervention did not affect these network characteristics. Results provide support to continue this line of research to test brief interventions that activate protective peer network characteristics among at-risk adolescents, while also raising some interesting gender-based intervention questions for future research.
    Journal of Substance Abuse Treatment 01/2015; DOI:10.1016/j.jsat.2015.06.013 · 3.14 Impact Factor
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    • "There is also the danger that in a mutual participation model, where patients are assigned more responsibility , the responsibility of the health professional is abrogated and more intensive strategies are precluded. There is great appeal in motivational interviewing being a practical front-line approach that is consistent with the call for more patient-centred approaches in health care where the health practitioner and patient relationship is seen as a partnership (Emmons & Rollnick 2001, Antiss 2009). However, there are some gaps in the evidence base that need to be addressed before it can be applied with confidence in routine practice. "
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    ABSTRACT: To review and synthesise, systematically, the research findings regarding motivational interviewing and to inform education, research and practice in relation to cardiovascular health. Motivational interviewing is designed to engage ambivalent or resistant clients in the process of health behaviour change, and it has been widely used in different clinical conditions such as substance abuse, dietary adherence and smoking cessation. Motivational interviewing has also been proposed as a method for improving modifiable coronary heart disease risk factors of patients. Systematic review. Eligible studies published in 1999-2009 were identified from the following databases: CINAHL, Medline, PsycINFO, Cochrane Library, EBSCO, Web of Science, Embase and British Nursing Index. A manual search was conducted of bibliographies of the identified studies and relevant journals. Two researchers independently reviewed the studies. Four meta-analyses, one systematic review and three literature reviews of motivational interviewing and five primary studies of motivational interviewing pertaining to cardiovascular health were identified. Despite a dearth of primary studies in cardiovascular health settings, there appears to be strong evidence that motivational interviewing is an effective approach focusing on eliciting the person's intrinsic motivation for change of behaviour. Motivational interviewing is an effective approach to changing behaviour. It offers promise in improving cardiovascular health status. This review indicates that motivational interviewing is a useful method to help nurses improve health behaviour in people with coronary risk factors.
    Journal of Clinical Nursing 05/2011; 20(9-10):1236-44. DOI:10.1111/j.1365-2702.2010.03558.x · 1.26 Impact Factor
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    • "Evidence-based interventions such as motivational interviewing (MI) fit well within pediatric health care settings (Erickson, Gerstle, & Feldstein, 2005). MI is considered an evidenced-based, frontline approach to reducing substance use and negative health outcomes through increased levels of patient-centered care, shared decision making, and improved clinician–patient relationships (Anstiss, 2009; Rollnick, Miller, & Butler, 2008). Research demonstrates promising effects of brief interventions with adolescents in primary care settings. "
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    ABSTRACT: This study tested the efficacy of a brief preventive intervention for substance use and associated risk behaviors among female adolescent patients of an urban primary care health clinic. We integrated an evidenced-based motivational interviewing (MI) approach with a social network component to develop a 20-minute session, a social network intervention delivered in an MI-consistent style. Female adolescents (N = 28) 14 to 18 years old were recruited, provided consent/assent, were screened, and were randomly assigned to the treatment or control (no treatment) condition. The sample was 82% African American and 18% mixed race, with 32% living below the U.S. poverty line. At 1-month follow-up, teens in the treatment condition reported less trouble due to alcohol use, less substance use before sexual intercourse, less social stress, less offers for marijuana use, and increased readiness to start counseling compared with the teens in the control condition. Results provide support for socially based brief interventions with at-risk urban adolescents.
    Journal of substance abuse treatment 04/2011; 41(2):148-55. DOI:10.1016/j.jsat.2011.02.009 · 2.90 Impact Factor
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