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Motivational Interviewing and Diabetes: What Is It, How Is It Used, and Does It Work?

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	Introduction

 
Motivational interviewing (MI) has recently become a topic of great interest in the diabetes behavioral field, having been the focus of workshops and research presentations at national meetings such as the Society of Behavioral Medicine, the American Diabetes Association, the North American Association for the Study of Obesity, and the Behavioral Research in Diabetes Exchange. The Motivational Interviewing Network of Trainers (MINT) was founded in 1995 and sponsors a website (www.motivationalinterviewing.org) through which MI trainers and researchers share information and ideas. This site provides information, research findings, and training opportunities and is a good starting point for further exploration of MI.

According to Miller and Rollnick,¹ MI has been applied to the management of a wide range of target behaviors, including addictive behaviors, HIV risk reduction, eating disorders, criminal justice case management, fruit and vegetable intake, exercise, and major psychiatric disorders.

MI is a coherent, teachable, evidence-based approach to behavior change counseling that serves as an amalgam of philosophies, principles, and techniques drawn from several existing models of psychotherapy and health behavior change theory.² For example, its patient-centered approach and focus on empathy and strong reflective listening skills are principally drawn from the client-centered therapy of Carl Rogers and his belief in the "force of life," the natural self-actualizing tendency of healthy people.³ Other theoretical influences include Bem's Self-Perception Theory,⁴ Janis and Mann's Decisional Balance Theory,⁵ and the Transtheoretical Model of Prochaska et al.⁶ The handbook Motivational Interviewing: Preparing People for Change¹ provides more detail for those interested in the theoretical underpinnings of MI.

Hettema et al.⁷ have cogently reported on the emerging theory of how MI affects behavior change. They reviewed evidence suggesting that practitioners who practice MI elicit increased levels of verbalization in support of change, known as "change talk," and decreased utterances of resistance. Both . . . [Full Text of this Article]

	Key Elements of MI

 

	Spirit of MI

 

	Understanding Ambivalence

 

	Exchanging Information

 
Agenda-setting: opening the door
The importance-confidence ruler

	What the Research Shows

 

	MI Training With Diabetes Educators

 

	Conclusions

 

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