stephenrollnick

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Motivational Interviewing Article Published in the British Medical Journal

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The British Medical Journal has today (27.4.10) published a new article entitled 'Motivational Interviewing' by Stephen Rollnick, Chris Butler, Paul Kinnersley, John Gregory and Bob Mash.

The full text is available for free, below.

Key Points from 'Motivational Interviewing'

  • Simply giving patients advice to change is often unrewarding and ineffective
    • Motivational interviewing uses a guiding style to engage with patients, clarify their strengths and aspirations, evoke their own motivations for change, and promote autonomy of decision making

    • You can learn motivational interviewing in three steps: practise a guiding rather than directing style; develop strategies to elicit the patient’s own motivation to change; and refine your listening skills and respond by encouraging change talk from the patient

    • Motivational interviewing has been shown to promote behaviour change in various healthcare settings and can improve the doctor-patient relationship and the efficiency of the consultation

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Creativity at the rough edge of behaviour change

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Yesterday I drove two hours into the heart of the Welsh countryside, to a country hotel, to spend half a day on MI with a senior group of general practitioner trainers. The contrasts were sharp: sparkling green cloudless day, and inside, the challenge: how might we use MI in the rehabilitation of doctors who had entered the last procedure before being struck off for disciplinary offenses? If they don’t change their behaviour and attitudes, they are out. A rough world.

I enjoy looking at MI from the outside in, thinking backwards from everyday practice, and wondering, as those trainers must have, where on earth does this MI stuff fit in?

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What is Motivational Interviewing?

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Bill Miller and I wrote a paper in 1995, and the editor of the journal, Professor Paul Salkovskis has very kindly and supportively agreed to our using this paper on this website. Behavioural and Cognitive Psychcotherapy was the journal that published the very first paper on MI in 1983...

Since 1995 there has been quite a lot of refinement of principles and methods, some new conceptual developments and a lot of research.  A nice way to catch up is to read the following paper, which contains a fluid account of how and why MI was developed:

Miller R, Rose G. Towards a theory of motivational interviewing. Am Psych 2009;64:527-537.

Here below, is the 1995 paper:

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A quote that captures a lot

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Jeanie Suvan, a colleague from the dental field showed me this quote. Thank you.

"After all, when you seek advice from someone it's certainly not because you want them to give it. You just want them to be there while you talk to yourself".
- Terry Pratchett, 1948

If this were to be emitted from a patient or client, this person would be the ideal recpient of motivational interviewing.

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Acts of kindness & just a little bit more

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There’s a lot of talk in the UK at the moment about counselling as a first step before the prescribing of anti-depressants. And the specialist counsellors and psychologists can see lots of work coming their way.

And the general practitioner? Is counselling beyond their competence and context? I heard this story the other day, and it reminds me of the dangers of specialist counsellors plying their trade in primary care and wittingly or unwittingly, reinforcing the illusion that people are best treated by specialists like counsellors. Before people receive fancy treatments like CBT or MI, how about a few simple acts of kindness and just a little bit more, delivered by the general practitioner. What’s the little bit more? Here’s a story that might help.
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Forthcoming Workshops

Motivational Interviewing: Introduction & Update. 2 day workshop - 11th & 12th June 2012, Cardiff
Begin: 11.06.12, 09:00
End: 12.06.12, 17:00
This is a repeat one-off opportunity to learn about motivational interviewing (MI), and the latest developments, from its two co-founders, William R. Miller from Albuquerque, New Mexico & Stephen Rollnick from Cardiff, Wales. Professor Miller will return to Cardiff after a successful workshop in 2011. This will be of interest to both to newcomers and those more familiar with MI. A streaming system will be used to ensure that those relatively new to MI will get good opportunity to practice basic skills. It will provide: - Clarification about the common and unique elements of MI - A focus on client change language and how it guides the practice of MI - An update on theory and research - The presentation of a new 4-process framework for MI that allows for easier integration in diverse settings - Opportunity to practice core skills for evoking motivation to change For further details and application form, visit: www.misr2012.co.uk

Recent Commentary

Motivational Interviewing Article Published in the British Medical Journal
The British Medical Journal has today (27.4.10) published a new article entitled 'Motivational Interviewing' by Stephen...
Creativity at the rough edge of behaviour change
Yesterday I drove two hours into the heart of the Welsh countryside, to a country hotel, to spend half a day on MI with...
What is Motivational Interviewing?
Bill Miller and I wrote a paper in 1995, and the editor of the journal, Professor Paul Salkovskis has very kindly and su...