Motivational interviewing and clinical psychiatry

[Correction Notice: An erratum for this article was reported in Vol 50(11) of Canadian Journal of Psychiatry (see record 2006-11299-013). Due to a printing error, some copies of Volume 50(9), 2005 replaced pages 553 and 554 with repeats of pages 550 and 549. The article was reprinted in Vol 50(11), 2005.] Objective: Our objectives were as follows: 1) to survey the literature on motivational interviewing (MI), "a client-centered yet directive method for enhancing intrinsic motivation to change by exploring and resolving client ambivalence" and a well-established method of brief intervention, especially in the field of addictions treatment; 2) to review hypotheses about its mode of action; and 3) to discuss its possible impact on clinical psychiatry, in particular, on teaching communications skills. Method: Literature reviews and metaanalyses of numerous clinical trials of MI for addictions treatment have already been published and are briefly summarized. So far, no literature survey exists for MI applied to psychiatric patients. This review is limited to a synthesis of the articles relevant to psychiatry and to comments based on our team's experiences with MI. Results: There is no evidence that MI achieves better results than other established techniques for treating addictions; it may simply work faster. The explanation for the method's rapid effectiveness remains speculative. Outcomes concerning the application of MI to psychiatric patients, although preliminary, are promising. Methods of assessing the integrity of MI treatment are more developed than in most psychotherapies, which permits the learning progress of trainees to be measured. Conclusion: MI offers a complement to usual psychiatric procedures. It may be worthwhile to teach it, not only for addictions but also for other broad treatment issues, such as enhancing patients' medication compliance and professionals' communication skills. Questions remain concerning MI's feasibility in psychiatry settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)