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Toward an Emerging Role for Motivational Interviewing in Primary Care

  • Psychiatry in Primary Care (BN Gaynes, Section Editor)
  • Published:
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Abstract

Purpose of Review

Implementing Motivational Interviewing (MI) in primary care settings has been problematic due in part to persistent gaps in knowledge. Examples include poor understanding of how to effectively train persons to conduct MI, or of which aspects of MI-related communication are associated with better outcomes for patients. This review describes how recent research findings addressing the knowledge gaps support a growing role for MI in primary care.

Recent Findings

Two trials of MI training combined classroom time with ongoing coaching and feedback, resulting in enhanced MI ability relative to a control arm where PCPs received minimal or no MI training. A third MI training trial excluded coaching and feedback, failing to increase use of MI. Adding to a growing list of behavioral health-related problems for which MI training has shown some effectiveness, a trial of training PCPs to use MI with depressed patients was associated with significantly improved depressive symptoms. Moreover, aspects of the PCPs’ MI-related language and patients’ arguments for positive behavior changes, “change talk,” appeared to explain the positive effects of MI training on depression outcome.

Summary

MI-training approaches have improved such that PCPs and possibly other clinic staff may want to consider MI training as a way to more effectively support their patients as they address behavioral health-related problems (e.g., tobacco use). MI training should focus on eliciting “change talk” from patients. Researchers and funding agencies might collaborate to continue closing knowledge gaps in the MI literature.

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Authors and Affiliations

  1. Department of Family Medicine, University of Colorado Denver, 13001 E. 17th Pl, Aurora, CO, 80045, USA

    Robert Keeley & Alex Reed

  2. Denver Health, 301 W. 6th Avenue, Denver, CO, 80204, USA

    Robert Keeley

  3. University of Kansas School of Medicine-Wichita, 1010 N. Kansas St, Wichita, KS, 67214, USA

    Matthew Engel

  4. Department of Internal Medicine, University of Colorado Denver, 13001 E. 17th Pl, Aurora, CO, 80045, USA

    David Brody

  5. Colorado Community Health Alliance, Denver, CO, USA

    David Brody

  6. Department of Psychology, Fort Lewis College, 1000 Rim Drive, Durango, CO, 81301, USA

    Brian L. Burke

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  1. Robert Keeley
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  2. Matthew Engel
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  4. David Brody
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Correspondence to Robert Keeley.

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Robert Keeley, Matthew Engel, Alex Reed, David Brody, and Brian L. Burke each declare no potential conflicts of interest.

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This article is part of the Topical Collection on Psychiatry in Primary Care

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Keeley, R., Engel, M., Reed, A. et al. Toward an Emerging Role for Motivational Interviewing in Primary Care. Curr Psychiatry Rep 20, 41 (2018). https://doi.org/10.1007/s11920-018-0901-3

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