Motivational interviewing in health promotion and behavioral medicine

(from the chapter) Motivational interviewing (MI), a counseling technique initially used to treat addictions, has increasingly been applied in public health (PH), medical, and health promotion settings. This chapter provides an overview of MI, and its philosophic orientation and essential strategies, with an emphasis on its application to health promotion and chronic disease prevention. MI has been defined as an interpersonal orientation: an egalitarian, empathetic, "way of being" that manifests through specific techniques and strategies, e.g., reflective listening, agenda setting, and eliciting change talk. An essential element of MI is assisting individuals to work through their ambivalence about behavior change and having clients explore how their current health behavior affects their ability to achieve their life goals or live out their core values. We compare MI to Systematic Motivational Counseling (SMC) and other models of behavior change, such as the Transtheoretical Model, and discuss the nuances that distinguish its use for modifying nonaddictive behaviors and how its application in medical and PH settings differs from traditional psychotherapy and addiction counseling. These include differences in the nature of the behaviors themselves as well as constraints on providing MI counseling in these settings, such as limited client contact time and practitioner training. We review major outcome studies where MI has been used to modify chronic disease behaviors and then conclude with future research directions. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)