Motivational Interviewing: A Guide for Medical Trainees

by Antoine Douaihy

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Author: Antoine Douaihy

Publisher: Oxford University Press

Paperback:
ISBN 10: 0199958181
ISBN 13: 978-0199958184

This may be the single most important book you ever buy during your medical training. Rotations come and go, exams come and go, but regardless of specialty, patient-care will be at the heart of your practice. It is no exaggeration to say that motivational interviewing (MI) has transformed the way doctors engage with patients, families, and colleagues alike. MI is among the most powerful tools available to promote behavior change in patients. In an age of chronic diseases (diabetes, hypertension, heart disease, obesity), behavior change is no longer limited to substance use or the field of psychiatry - maladaptive choices and behaviors that negatively impact health outcomes are rampant. There is an explosion of research projects using MI or adaptations of MI in the behavioral health medicine field in the past decade. Hospitalizations can't make people change. How marvelous is it that an evidence-based health behavior change approach (MI) can help people change the outcomes of their illnesses and the course of their lives.

This therapeutic approach is not a form of psychotherapy and is not the stuff of cobwebs and old leather couches. MI is readily integrated into regular ward rounds and office visits and provides an effective and efficient approach to patients clinical encounters.

Written by experts in the field and medical trainees across medicine, this is the first MI guide of its kind. Its explores how MI enhances contact with patients from every level of training, following an accessible, succinct approach. This book covers the application of MI method and skills into practice and also includes numerous clinical scenarios, personal reflections and online animated clinical vignettes (video clips) that share the challenges and successes the authors have focused.

Furthermore this book is endorsed by the pioneers of MI: William R. Miller & Stephen Rollnick.

Review

"This is a unique collaboration between three seasoned clinicians, educators and researchers and a diverse group of medical trainees in a broad range of practice settings. They have produced an exceptional book on Motivational Interviewing (MI) to help medical trainees understand and implement MI concept, skills, and techniques. The breadth and richness of the chapters empower the reader with remarkable skills to strengthen the patient-doctor relationship. It is filled with skillfully crafted clinical scenarios, tools, tips, and personal reflections of trainees illustrating the experiences and challenges of experiencing, learning, and implementing MI in medical encounters. This guide is inevitably destined to become a classic in medical training." --Dennis C. Daley, Ph.D., Professor of Psychiatry & Social Work, University of Pittsburgh School of Medicine Department of Psychiatry

"This is an outstanding book about Motivational Interviewing that is very clear, easy to read, and engaging. The interesting and appropriate cases grab you. The book is full of examples of words, phrases, questions and statements to use, and will be valuable to practicing health care practitioners, not just the medical trainees to whom the book is geared. The practical advice is invaluable, and I think it will help prevent burn out in any health care practitioner who uses it." --Patricia K. Kokotailo, MD, MPH, Professor of Pediatrics, Wisconsin School of Medicine and Public Health

"This important book, for the first time, provides a guide to Motivational Interviewing that is specifically designed for physicians. Motivational Interviewing is a critical skill for helping patients to change their health behaviors toward healthier habits. Most physicians will confront problems every day with their patients' health behaviors-poor adherence to medications, to diet or lifestyle recommendations, or recommendations to quit smoking or moderate drinking, to name some examples. Yet, physicians have typically received little training in this essential technique. This book should be required reading for all physicians in training, and one also hopes that it will become the foundation of courses of study on Motivational Interviewing during medical training." --Edward Nunes MD, Professor of Clinical Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute

"Motivational Interviewing: A Guide for Medical Trainees provides a straightforward guide for medical students and residents of all clinical specialties, and should be required reading in medical school and post-graduate training. Physicians already out in practice will also benefit greatly from this very clear and concise training manual." --Marshall Forstein, MD, Associate Professor of Psychiatry, Harvard Medical School, Director of Residency Program in Psychiatry

"This evidence-based and theory-informed guide provides excellent, practical instruction for practitioners to cease inflicting help and instead, connect with patients in a manner that helps them want to receive help and actually change behaviors. With practical examples for all types of practice situations and patient populations, this guide helps practitioners embrace the essence of Motivational Interviewing with the understanding that helping patients through dialogue does not always require hours. The authors excel at creating the experience about which they write - the reader will want to learn from each chapter, change practice behaviors, and dive into the next chapter's teachings with a new outlook. All health practitioners would do well in reading and learning from this well-crafted book." --Jennifer D Irwin, PhD, Faculty of Health Sciences, Western University

"This superb book provides the clinician in training with a blueprint for enabling these practitioners to adopt a model for therapeutic interactions that enables patients to participate in their care and treatment decision-making. The authors deliver detailed and clear instruction on the methods for conducting motivational interviewing utilizing case-based examples crafted to give the readers the needed information and skills to be able to adopt this approach in their practice. This book is required reading for all clinicians who are part of any treatment team including physicians, nurse practitioners, nurses, physician assistants, social workers, and public health professionals. This book is a toolkit to change the approach to patient care for the adoption of motivational interviewing in health care practice." --Linda Rose Frank, Associate Professor of Public Health, Medicine, & Nursing Graduate School of Public Health University of Pittsburgh

"This fascinating book is an invitation to enter into the medical trainee's world. It's eloquent writing speaks to the central importance of understanding the complexity of patient behavior and highlights the clinical wisdom of the application of motivational interviewing in health behavior change. This rich and scholarly guide is practical, straightforward, and elegantly balanced between up-to-date theoretical perspectives and clinical scenarios that are well synthesized and illustrated with captivating visual tools. Step-by-step the readers learn the concepts and skills of motivational interviewing through abundant and vivid patient-trainee dialogues. This book will become an essential text for the generation of future physicians that will have to undoubtedly deal with the challenges of behavior change in medical practice." --Jean-Bernard Daeppen, MD, Chief of Alcohol Treatment Center
Lausanne University Medical School, Lausanne, Switzerland

"This uniquely informative book provides practical strategies to apply motivational interviewing (MI) from the clinics to the wards. It elucidates the spirit as well as the processes of MI so that medical trainees feel equipped to guide patient in making meaningful changes in their lives. Not only does it incorporate realistic clinical examples of talking to patients about substance use or medication adherence, but it also provides a repertoire of phrases and skills that trainees can use daily among different populations. Learning MI has fundamentally changed the way I engage with patients, and it has taught me that true healing can only begin when you listen to patients. I would strongly recommend this book to all medical trainees who want to feel connected to their patients and make a positive impact in their lives." --Laura Lin, BA, MS3, University of Pittsburgh School of Medicine

"Motivational Interviewing: A Guide for Medical Trainees is a unique manual on interview techniques essential for effective medical practice. In addition to an experienced and knowledgeable group of editors, they have enlisted contributions from medical trainees that represent the next generation of practitioners and provide perspectives from many specialty arenas. This is more than a textbook. Experienced practitioners and trainees alike will be inspired by these stories, perspectives, examples and guidance. This educational program creatively follows its' own advice, asking us to challenge traditional approaches and motivating us to improve our behavior change skills by applying motivational interviewing approaches in our medical practices." --Duncan B. Clark, M.D., Ph.D. University of Pittsburgh School of Medicine

"Motivational Interviewing: A Guide for Medical Trainees is truly an invaluable resource for any trainee in the medical profession. It explores not only the 'what' of MI, but also the 'why.' In an era of constant pressure to perform more patient care in less time, it reminds physicians and medical trainees that the fundamental core of their profession is patient-centered care, which can be delivered empathically and effectively within the time constraints of a short patient visit. No matter what your role within the medical profession, this book will teach you how to make every patient interaction therapeutic. A must-read!" --Melanie J Grubisha MD, PhD, General Adult Psychiatry, PGY-1, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center

"With ever-growing evidence in support of broader use of MI, there has yet to be a guide specifically designed for medical trainees--this is the first. This text explains the fundamental concepts and skills of MI in an approachable, encouraging manner with emphasis on its application in medical settings by providing case examples collected across medical disciplines and personal reflections from aspiring physicians during their training. Mistakenly considered as more of an interpersonal art than something that may be taught, interviewing skill is often covered only superficially in medical school curricula; this book is an essential supplement in that regard and for those seeking to build on the empathy and indomitable humanity that drove us to medicine in the first place." --Ramee Younes, Medical Student 3rd Year, University of Pittsburgh School of Medicine

"Motivational Interviewing is an evidence-based collaborative style of communication that enhances practitioner-patient relationships and greatly increases the likelihood that patients will adhere to treatment recommendations and/or engage in and maintain self-management strategies. Motivational Interviewing: A Guide for Medical Trainees is an important, timely and relevant text that will assist any beginning medical or allied health practitioner to understand and utilize this approach. Written in an easy-to-read, practical and personal style that addresses common challenges in healthcare settings and with case studies and revision quizzes, this is an essential resource that will greatly enhance medical trainee's confidence and effectiveness in their everyday interactions with patients." --Suzanne Habib, PhD, Senior Health Psychologist, Pacific Centre for Motivation and Change-Australia

"Motivational Interviewing: A Guide for Medical Trainees is perfectly pitched to a medical trainee audience in that the authors clearly explain 'counselling' topics and apply them across common medical conditions and situations. Succinctly written in a remarkably effective format, this volume will serve as a cornerstone for training medical practitioners and students in motivational interviewing (MI). ... The testimonials in each chapter are compelling and motivational; they make me want to learn MI even more. The quizzes reinforce major principles highlighted in each chapter. Medical trainees engaged in patient care will be especially appreciative of the invaluable clinical tools that are illustrated in this essential, pragmatic, and practical guidebook." --Steve Martino, PhD, Professor of Psychiatry, Yale University School of Medicine, Chief of Psychology, VA CT Healthcare System

"Motivational Interviewing: A Guide for Medical Trainees does an excellent job establishing the foundations of MI and relating its applications to real life cases. ... I highly recommend this extremely pragmatic guide to practicing physicians and trainees of all levels as a means of improving their communication skills and overall effectiveness in motivating behavior change in patients." --Thomas Radomski, M.D., Chief Medical Resident, University of Pittsburgh Medical Center Montefiore/Presbyterian Hospital, VA Pittsburgh Healthcare System

"This text provides a range of accessible content which is an invaluable resource for those aiming to learn or improve their current skills in Motivational Interviewing. The style of writing and layout enables the reader to gain an insight into the role of MI into clinical settings and importantly its diverse applications across a range of population groups from a pragmatic and applied perspective. This text has been well designed and provides a resource beyond medical school settings and is a must for those beginning or continuing their learning of MI from a research, practice or trainer perspective. It does not shy away from applications of MI to challenging encounters and will be a recommended text for many educators and learners across health and clinical settings." --Dr. Jeff Breckon PhD., Member of the Motivational Interviewing Network of Trainers (MINT)

"Motivational Interviewing: A Guide for Medical Trainees is a comprehensive, well written and practical guide to developing and perfecting these valuable skills. This book's unique contribution to the literature, as a result of a joint effort between experts and trainees, is the engaging voice of the discussions and the practical recommendations for implementing and navigating these skills. Its emphasis on key points throughout all the chapters assists the reader in focusing on the highlights of motivational interviewing, which can be supplemented by viewing the video references provided at the end of the book. This book will be a highly value adjunct to medical school curricula and Primary Care training programs and an excellent reference for those who care for special populations." --Rosanne Granieri, MD, Professor of Medicine, University of Pittsburgh School of Medicine; Program Director, Clinician Educator Training Program

"This book is an enjoyable read. It is well written and makes good use of tables, figures, textboxes, and quizzes to emphasize key points. The online video clips help tie it all together and enable readers to hear MI in use. Weighted Numerical Score: 100 - 5 Stars!" -- Doody's Health Sciences Review

"Motivational Interviewing: A Guide for Medical Trainees would be an excellent choice for faculty interested in learning and teachingMI and could easily be utilized as a teaching text for resident physicians. This book is a practical guide that is truly written for trainees, often addressing this population directly. Many mnemonics and summary charts are included, which are helpful for any level of learner. Each chapter concludes with a self-assessment quiz that could serve as a simple method for review or be used as a starting point for discussion if the book is assigned as teachingmaterial. In my opinion, the most helpful aspect of the book is the repetitive use of example conversations between patient and physician, which, although contrived at times, make the concepts feel accessible and easy to incorporate into any clinical encounter." -- Mary Morreale, Academic Psychiatry

About the Author

Antoine Douaihy, MD, is Associate Professor of Psychiatry at the University Of Pittsburgh School Of Medicine. He is the Medical Director of Addiction Medicine Services, Associate Residency Training Director, and Director of the Addiction Psychiatry Fellowship at Western Psychiatric Institute and Clinic. Throughout his career, he has developed and expanded his involvement in training and mentoring medical trainees in Motivational Interviewing and substance use disorders. His research and publications focus on substance use disorders, Motivational Interviewing, and HIV/AIDS.

Thomas M. Kelly, Ph.D. is an Associate Professor of Psychiatry at the University of Pittsburgh School of Medicine. Dr. Kelly is a Licensed Clinical Social Worker who has been in practice at Western Psychiatric Institute and Clinic (WPIC) and the University of Pittsburgh Medical Center (UPMC) since 1982. Dr. Kelly received his doctoral degree in Social Work from the University of Pittsburgh in 1996. He has been affiliated with Addiction Medicine Services (AMS) at WPIC for 15 years and provides outpatient treatment to dual-disordered adults. Dr. Kelly is currently the Director of the Adolescent Substance Abuse Treatment Service at AMS and, in this capacity, treats adolescent dual disordered patients and supervises other clinicians on the use of individual and family therapy. Dr Kelly has been a member of the Motivational Interviewing Network of Trainers since 2005 and he routinely conducts training workshops, lectures and seminars, locally and nationally.

Melanie A. Gold, DO is a Clinical Professor in the Department of Pediatrics, Division of Adolescent Medicine at the University of Pittsburgh School of Medicine and in the Department of Behavioral and Community Health Sciences at the Graduate School of Public Health. She is also a staff physician at the University of Pittsburgh Wellness Center's Student Health Service. She is a certified specialist in Pediatrics with sub-specialty certification in Adolescent Medicine by the American Board of Pediatrics. Dr. Gold has been a Motivational Interviewing Network Trainer since 2000 and has conduct numerous trainings on Motivational Interviewing (MI) and behavior change counseling for the health care setting with physicians, medical students, residents, fellows, nurses, nurse practitioners, physician's assistants, health educators, dental students, psychologists, sports physiologists, social workers, and nutritionists.

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Motivational Interviewing: A Guide for Medical Trainees