Motivational Interviewing

Motivational Interviewing (MI) is a collaborative conversational style for strengthening a person’s own motivation and commitment to change.1

MI is a well-accepted strategy for behavior change consistent with contemporary theories of behavior change. The spirit of MI is defined by partnership, evocation and self-efficacy, exhibited through specific techniques and strategies. Since its inception in drug addictions treatment,18 MI has been shown to positively affect health behavior change related to smoking, exercise and weight reduction, diabetes management, medication adherence, condom use, and oral health. One systematic review has been published to date on approaches to oral health promotion including MI. While the authors concluded that MI is effective in oral health promotion, only one of the nine articles reviewed was specific to MI and oral health behavior change. The remaining eight articles featured studies on MI and diabetes, drug use, tobacco use, and HIV risk factors among others.18 MI is a person-centered, goal-directed method of communication for eliciting and strengthening intrinsic motivation for positive change. Through experience, Miller found the likelihood for positive change occurred more readily when the clinician connected the change with what was valued by the patient. He also found confrontational styles or direct persuasion are likely to increase resistance and should be avoided.

MI is based on a theory that motivation is necessary for change to occur - resides within the individual and is achievable by eliciting personal values/desires and ability to change. It is based on allowing the patient to interpret and integrate health and behavior change information if perceived as relevant to his/her own situation. It acknowledges the patient is the expert in their own life. MI appears to be most effective for patients with low motivation to change behaviors as it encourages trust between clinician and patient and allows the clinician to focus on gauging readiness for behavior change.