The challenge that lay ahead of us was to help each other adjust the angles of our respective lenses so that our visions could come into common focus. Otherwise, we’d slip into futile haranguing.

I don’t know if this physician has ever learned MI, but she clearly practices in the spirit of MI.  A great example of what it looks like in the real world – asking, listening, informing, negotiating *with* the patient toward better health.

Doctor Priorities vs. Patient Priorities – NYTimes.com.

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    This workbook is designed to help the beginning MI practitioner learn MI skills step-by-step, aided by clear explanations of key concepts, ample case examples, and worksheets for use in sessions with service users. Published in 2008, the Toolkit is based on the first 2 editions of the Miller and Rollnick MI text, but the content remains quite relevant to the practitioner. The authors, who have extensive experience in corrections and who wrote the first edition of the Toolkit for the UK Probation Service, also add some additional material borne out of real-world experience. For example, the authors add to the familiar 4 principles of MI a fifth principle of “Clarify Contracts” – a skill especially relevant to doing MI in settings where the service user, referral source, and agency providing the service may not share the same agenda and priorities.

    Relative to Rosengren’s Building Motivational Interviewing Skills, A Toolkit of Motivational Skills provides somewhat simpler explanations, more basic instruction in the basic counseling skills underlying MI, and more practical tools (as suggested by the title) for structuring behavior change discussions. It may be of particular interest to those who have not had prior training in counseling skills or who work outside of what are typically considered “counseling” settings.

    Learn more about A Toolkit of Motivational Skills at Amazon.com

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      “…choosing to endure rather than desist is a choice that must be effortfully sustained over time…”

      Traditionally, Motivational Interviewing has focused on helping people prepare for and commit to behavior change as if it were a one-time event, but anyone who has ever made a New Year’s resolution knows that’s not the case! Research on the personality trait of perseverance, or “grit,” gives insight into the kinds of motivational and volitional processes we need to evoke in order to help our clients commit to lasting change. It also provides some insight on when it might be appropriate to switch or hand-off from MI to action- and maintenance-stage approaches.

      Big Questions Online: Can Perseverance Be Taught?

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        …So I have come to believe that the right answer to the question, “If this were your mother, doctor…” is: “Tell me more about your mother.”

        No mention, or probably even thought, of MI – just a beautiful example of a health care conversation in the spirit of compassion, acceptance, collaboration and evocation. Maybe a model of MI in equipoise?

        Well: “If this were your mother, Doctor…”

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          The most common concern raised in my trainings with physicians and nurses is how to fit Motivational Interviewing – or any patient-centered efforts at helping patients better manage their own health – into their busy schedule. Training in MI is only the beginning: Usually providers find that they can make some independent changes in their own practice, but that the office as a whole may need to make changes in order to support their efforts as well as those of their patients.

          The solutions that providers come up with are as diverse as the clinical practices themselves. AAFP News Now profiles a family practice clinic in Wisconsin that changed clinic protocols to stress pre-visit planning and expanded the role of nurses, allowing physicians as well as the entire treatment team to spend more time focusing on patient self-management.

          AAFP News Now: Team-based Care Fuels Patient Self-management Success

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            MINT member Bill Matulich has updated this brief and inexpensive guide to conducting an MI session to include concepts from the most recent edition of the Miller and Rollnick Motivational Interviewing text. If you’ve read the Miller and Rollnick book or attended a short workshop, and aren’t quite sure how to put the concepts into practice, this is the book for you.

            The current edition of How To Do Motivational Interviewing maintains the focus on what to do, when. The author outlines strategies most likely to be helpful at the beginning, middle, and end of a session. This e-book continues to be a valuable adjunct to other learning experiences focusing on theory or general skill-building.

            Learn more about How To Do Motivational Interviewing at Amazon.com

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              One of the most common questions I hear from clinicians is, “can you do MI in groups?” With the publication of Motivational Interviewing in Groups, the answer is “yes, and now there is a comprehensive guide to help you.” Together, authors Chris Wagner and Karen Ingersoll bring a wealth of clinical, research, and teaching experience to present a truly integrative approach to MI groups.

              The book starts with separate brief overviews of therapeutic groups and MI, before moving on to an overview of MI groups that outlines general principles and spirit of MI groups and describes how MI processes and core skills are incorporated into MI group practice. The introductory section of the book also includes a review of the empirical evidence for MI groups. The heart of the book is a detailed guide to designing, implementing, and conducting MI groups, including guiding principles as well as practical advice and clinical case examples. Finally, an edited section includes 9 chapters on MI groups with specific client populations.

              In contrast to some of the other group resources listed here, MI in Groups is better viewed as a textbook than a workbook. You can open to almost any page and find ideas for improving your group practice and even detailed instructions for specific activities, but you won’t find session outlines or reproducible handouts.  Rather, you will find yourself being mentored through the process of becoming an MI group therapist.  If you are willing to invest some time and thought, you will be amply rewarded.

              Learn more about Motivational Interviewing in Groups at Amazon.com

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                The new third edition of the classic Miller and Rollnick text Motivational Interviewing retains the readability and clinical grounding of prior editions, while presenting a much more comprehensive framework for understanding MI.

                Readability and accessibility to diverse audiences begins with presentation of not one, but three, definitions of MI – each applicable to a specific purpose.  Clinical relevance is enhanced by a new framework that emphasizes a set of four processes in the course of MI, and deeper consideration of ethical issues in MI and even MI in “equipoise” or when the emphasis of the intervention is on making a decision, rather influence toward a particular course of action.

                I was skeptical at first of a reformulation that jettisoned the old familiar principles of MI, but was won over by the new four processes of MI.  To me, the processes were instantly recognizable and quite helpful as a clinical roadmap and teaching/supervision tool.  I have to admit, I’m still not sure what to make of MI in equipoise, but that may be a function of my own experience in addiction treatment and health-related behavior intervention.  Let me know what you think.

                The clinical practice of MI as outlined in the third edition is essentially the same as in the prior edition; only the explanatory constructs have changed.  So there is no need to regret a recent purchase of the second edition!  But, if you haven’t read any of the core MI texts yet, or want to be familiar with the most up-to-date ideas in MI, this is the place to start.
                Learn more about the 3rd edition of Motivational Interviewing at Amazon.com

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                  In Motivational Interviewing in the Treatment of Anxiety, Westra presents a truly integrative model for addressing the ambivalence that can be such a common barrier to treatment of anxiety disorders. She includes ample clinical illustrations of the usefulness of such an approach, and covers practical matters such as how to integrate a more supportive, less-structured approach such as MI with the more structured and directive approaches typical of empirically-supported treatments for anxiety.

                  Learn more about Motivational Interviewing in the Treatment of Anxiety at Amazon.com.

                    The inaugural issue of Motivational Interviewing: Training, Research, Implementation, Practice (MITRIP; the journal of the Motivational Interviewing Network of Trainers) is now available online.  An open-access, “author-friendly” journal, MITRIP accepts submissions of all kinds related to motivational interviewing (MI) practice, training, implementation, and research: qualitative as well as quantitative studies, case presentations, descriptions of innovations in MI practice or training, and theoretical or conceptual articles, as well as informal contributions related to the activities of MINT members worldwide. Submissions are invited from any author, regardless of affiliation, who wishes to contribute to the ongoing conversation about MI.

                    Motivational Interviewing: Training, Research, Implementation, Practice.

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