This conversation explores Motivational Interviewing (MI), a clinical communication style designed to help patients resolve ambivalence and find internal motivation for healthy behavior changes. The discussion contrasts MI’s collaborative guiding style with the counterproductive “fixing reflex,” where providers mistakenly try to pressure or dictate solutions to patients. We outline the four core processes – engaging, focusing, evoking, and planning – while emphasizing the use of OARS skills: open-ended questions, affirmations, reflections, and summaries. A significant portion of the discussion provides practical strategies for neuropsychologists to adapt these techniques for patients with cognitive impairments or during feedback sessions. Ultimately, we highlight how MI is a humanistic approach that respects patient autonomy and aligns recommendations with an individual’s personal values.
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Guest disclosures: None.
About Dan
Daniel Mullin, PsyD, MPH is the Director of the Center for Integrated Primary Care, a Professor in the Department of Family Medicine and Community Health at UMass Chan Medical School, and a Professor the Tan Chingfen Graduate School of Nursing.
Dr. Mullin is a clinician, educator, and researcher focused on the integration of behavioral health and primary care services. He maintains a clinical practice embedded in the Barre Family Health Center, a rural family medicine residency practice in Massachusetts. Dr. Mullin is a member of the Motivational Interviewing Network of Trainers and provides training in Motivational Interviewing to healthcare providers. He is a developer of the Practice Integration Profile, a measure of the integration of behavioral and primary care services.
Resources
Motivational Interviewing Network of Trainers (MINT)
UMass Chan Medical School Motivational Interviewing Course
References
Bilgin, A., Muz, G., & Yuce, G. E. (2022). The effect of motivational interviewing on metabolic control and psychosocial variables in individuals diagnosed with diabetes: Systematic review and meta-analysis. Patient Education and Counseling, 105(9), 2806-2823.
Boom, S. M., Oberink, R., Zonneveld, A. J., van Dijk, N., & Visser, M. R. (2022). Implementation of motivational interviewing in the general practice setting: a qualitative study. BMC primary care, 23(1), 21.
Cole, S. A., Sannidhi, D., Jadotte, Y. T., & Rozanski, A. (2023). Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors. Progress in cardiovascular diseases, 77, 86-94.
Huang, X., Xu, N., Wang, Y., Sun, Y., & Guo, A. (2023). The effects of motivational interviewing on hypertension management: a systematic review and meta-analysis. Patient education and counseling, 112, 107760.
McDaniel, C. C., Kavookjian, J., & Whitley, H. P. (2022). Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials. Patient education and counseling, 105(4), 805-820.
Miller, W. R. (2023). The evolution of motivational interviewing. Behavioural and Cognitive Psychotherapy, 51(6), 616-632.
Papus, M., Dima, A. L., Viprey, M., Schott, A. M., Schneider, M. P., & Novais, T. (2022). Motivational interviewing to support medication adherence in adults with chronic conditions: systematic review of randomized controlled trials. Patient Education and Counseling, 105(11), 3186-3203.
