Changing health behaviors through the medical interview

Presents a selective review of the literature on the clinical evidence supporting recent theories of behavioral change. There is ample evidence that changing health behaviors is an important part of the physician's role, especially that of the primary care physician. There is also evidence that physicians can be effective in helping patients to change health behaviors. Two recent theories on behavioral change have proven helpful in directing the author's clinical and teaching efforts in "motivational interviewing." These are the theory of Transtheoretical Model of Change development by Prochaska and Di Clemente. These investigators studied people who have changed problem behaviors such as smoking, drinking, using drugs, etc. without help from counselors in order to determine the natural history of the process. The research of Deci, Ryan and Williams supports another useful theory for understanding how patients change health behaviors. This theory, called Self Determination, states that human beings evolve by seeking to meet challenges in response to internally generated forces. The author has found that these theories provide a model to use in counseling patients on behavioral change and highlights the importance of the medical interview in patient-physician communication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)