Motivational Interviewing in Health Promotion and Behavioral Medicine

Motivational Interviewing in Health Promotion and Behavioral Medicine
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健康促进和行为医学中的动机访谈

DOI:
10.1002/9780470979952.ch25
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发表时间:
2011
期刊:
影响因子:
37.8
通讯作者:
S. Rollnick
S. Rollnick
中科院分区:
医学1区
文献类型:
--
作者:
K. Resnicow;S. Rollnick

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动机访谈(MI),一种最初用于治疗成瘾的咨询技术,已越来越多地应用于公共卫生(PH),医疗和健康促进环境。本章提供了一个概述MI,其哲学方向和基本策略,重点是它的应用,促进健康和慢性病预防。MI被定义为一种人际取向:一种平等主义的、移情的“存在方式”,通过特定的技术和策略来体现,例如,反思性倾听、议程设置和引发变革谈话。MI的一个基本要素是帮助个人解决他们对行为改变的矛盾心理,并让客户探索他们目前的健康行为如何影响他们实现生活目标或实现核心价值观的能力。我们比较MI系统的动机咨询(SMC)和其他模式的行为改变,如跨理论模型,并讨论区分其用于修改非成瘾行为的细微差别,以及它在医疗和PH设置中的应用如何不同于传统的心理治疗和成瘾咨询。这些包括行为本身的性质差异以及在这些环境中提供MI咨询的限制,例如有限的客户接触时间和从业人员培训。我们回顾了MI用于改变慢性疾病行为的主要结果研究,并总结了未来的研究方向。
Motivational interviewing (MI), a counseling technique initially used to treat addictions, has increasingly been applied in public health (PH), medical, and health promotion settings. This chapter provides an overview of MI, and its philosophic orientation and essential strategies, with an emphasis on its application to health promotion and chronic disease prevention. MI has been defined as an interpersonal orientation: an egalitarian, empathetic,“way of being” that manifests through specific techniques and strategies, eg, reflective listening, agenda setting, and eliciting change talk. An essential element of MI is assisting individuals to work through their ambivalence about behavior change and having clients explore how their current health behavior affects their ability to achieve their life goals or live out their core values. We compare MI to Systematic Motivational Counseling (SMC) and other models of behavior change, such as the Transtheoretical Model, and discuss the nuances that distinguish its use for modifying nonaddictive behaviors and how its application in medical and PH settings differs from traditional psychotherapy and addiction counseling. These include differences in the nature of the behaviors themselves as well as constraints on providing MI counseling in these settings, such as limited client contact time and practitioner training. We review major outcome studies where MI has been used to modify chronic disease behaviors and then conclude with future research directions.
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