ABSTRACT
People know that smoking causes lung cancer, heart disease, and other life-threatening medical conditions. They also know that overeating, in combination with a sedentary lifestyle, can cause obesity and a host of comorbidities. Some care providers might think telling the patient “Stop doing this to yourself” is sufficient to help them change their behavior. This approach is often unsuccessful, because ambivalence gets in the patient’s way. Motivational interviewing is a communication technique shown to break through ambivalence and increase confidence to help patients make needed change. It is a toolkit of patient-centered counseling techniques that got its start more than 30 years ago in the substance abuse and addiction fields, where changing long-term client behavior is critical to success. As chronic conditions have become more prevalent in our population, motivational interviewing has been increasingly engaged to improve patient involvement in care processes. Chapter 7 introduces four nonlinear processes of motivational interviewing—engaging, focusing, evoking, and planning—along with five nonconfrontational counseling techniques that are often employed in motivational interviewing—expressing empathy, developing discrepancy, avoiding argumentation, rolling with resistance, and supporting self-efficacy.
