Research review
The objectives of motivational interviewing are increasing the motivation of people for behavioral change, and strengthening people’s dedication to embrace change. This technique emphasizes collaboration instead of confrontation, Autonomy instead of authority and evocation over education while handling the behavioral change process in people (Burke et al, 2002).
A very large and rapidly growing body of research has evaluated the effectiveness of motivational interviewing as a behavioral change strategy. Many randomized, Quality, Meta- analytic research studies into the effectiveness of motivational intervention have provided an evidence base that motivational interviewing is an effective behavioral change strategy. Many randomized clinical, controlled studies on motivation interviewing have been published, that support the effectiveness of this strategy (Burke et al, 2002). This paper highlights some of the randomized clinical control studies that prove the effectiveness of motivational interviewing.
A meta-analysis by Helen Jones et al, in the year, 2003 examined the treatment of diabetes with the usual techniques compared usual diabetes treatment combined with pathways to change, a motivational interviewing strategy. This meta- analysis evaluated whether pathways to change (PTC) interventions combined with normal diabetes treatment would result to a greater readiness for change in diabetes patients, a greater involvement in diabetes self care and improved diabetes control.
The diabetes patients in this study were classified into two groups, one group received only the normal diabetes treatment (treatment as usual, TAU). The other group received diabetes normal treatment and pathway to change therapy (TAU & PTA). The pathway to change (PTA), motivation technique included tailor-made personalized assessment reports, self help manuals, newsletters and phone interviews for diabetes patients. The pathway to change motivation-interviewing technique was designed to make the patients ready to start diabetes self help programs like glucose monitoring, healthy eating, smoking cessation and physical exercise (Helen et al, 2003).
The total number of participants were 1029 with type one and type two diabetes. Majority of the participants were in the pre-action stages of diabetes self- help programs. The results of this study showed that normal diabetes treatment (TAU) combined with PTC (Pathways to change), resulted in 43.4 percent of the patients moving from pre-action to action stages in blood glucose monitoring compared to 30 percent for those receiving TAU alone (Helen et al, 2003).
For the change of diet interventions, 32 percents of the participants receiving normal diabetes treatment combined with PTC moved from action to maintenance stage. For patients who received normal diabetes treatment, only were 28 percent moved from action to maintenance. For the smoking cessation interventions, 24 percent of the participants receiving diabetes TAU and PTC moved to the action stage compared to 13 percent for patients receiving TAU only (Helen et al, 2003).
The participants who received TAU and PTC decreased their percentage of calories intake by 37 percent, compared to 32 percent for patients who received TAU only. This study demonstrated that motivational interviewing has the potential of positively improving the readiness of diabetes patients to change, and improving health outcomes of individuals with diabetes (Helen et al, 2003).
A similar meta-analysis Conducted by Burke et al, (2002), of over 30 randomized clinical trails that utilized motivational interviewing found out that motivational interviewing has average to great impacts in behavioral change. These researchers found out that motivational interviewing has positive effects in the Areas of alcohol use, dieting programs, drug use and social functioning. Motivational interviewing had a motivating effect on behavioral change in patients. Overall, motivational interviewing was found to be an effective behavioral change strategy.
Studies into the effectiveness of motivational interviewing have also focused on the effectiveness in reducing substance use, adherence to treatment procedures and medication as well as adherence among people with mental disorders. For example, a randomized control study by Martino et al, (2000), of people suffering from co-occurring disorders found out that, the participants who received just a single session of motivation interviewing in the admission process were more likely to participate in treatment, and adherence to treatment than those who only received the standardized pre- admission interview.
Kemp et al, (2006), also employed a form of motivational interviewing in compliance therapy among patients with intermediate psychosis in a hospital inpatient facility. Motivation interviewing therapy increased compliance to medication by the psychotic patients by a factor of 25 percent. This improvement in compliance to medication was maintained six -months after discharge of the patients (Kemp et al, 2006).
A follow up study of the patients in this study also found out that, patients with psychotic disorders had more insight about their diseases and adhered more with treatment and medication. The psychotic patients had a better social functioning and lower hospitalization risk compared to the psychotic patients who did not receive motivational interviewing (Kemp et al, 2006).
Motivational interviewing has also found use in the criminal justice system in behavioral change programs for prison inmates. The Crime And Justice Institute, (2004), cited motivational interviewing as an important evidence-based principle for interventions in the criminal justice system. The process of Offender rehabilitation and behavioral change can utilize motivational interviewing to enhance criminal behavior change, the reduction of recidivism and improvement of public safety. Motivational interviewing has been identified as a useful clinical practice for the promotion of behavioral change and treatment responsively in offenders (Criminal and Justice Institute, 2004).
Motivational interviewing is therefore, a very effective approach in behavioral change programs involving lifestyle modifications, adherence to treatment procedures and medication and maintenance of positive adoptive behaviors.
Burke, B. l., Arkowitz. H., Dunn. C. (2002). “The efficacy of motivational interviewing”. In W.R
Miller & S. Rollnick (eds). Motivational interviewing preparing people for change. New York: Guilford press.
Crime And Justice Institute (2004).Implementing evidence based principles in community
Corrections. The principles of effective intervention. Retrieved from http://nicic.gov/pubs/2004/019342.
Helen, Jones; Lynn, Edwards: Michael, Vallis; Lurie, Ruggiero; Susan, Rosi: Joseph Rosi:
Geoffrey, Green; James, Prochaska: Bernard, Zinman. (2003). “Changes in diabetes self care behaviors make a difference in Glymeic control the diabetes stages of change study.” diabetes care 26:732737
Kemp R., Hayward, P., Applewhaite, G., Everitt, B., & David, A., (2006). “Compliance therapy
In psychotic patients: Randomized controlled trial”. British medical journal, 312, (345-349).
Martino, S., Caroll, K.M., O’Malley, S. S., & Rounsaville, B.J. (2000). “Motivational
Interviewing with psychiatry ill substance abusing patients”. American journal on addiction 9 (88-91).
