Chapter 15 - Motivation to Change Health Behaviour

Health promotion forms part of many primary care consultations, be it advice about exercise, weight loss, smoking or alcohol. These consultations are often fraught with difficulty, as many patients are resistant to being told what to do or what is good for them. Moving from this direct style of consultation to a more guiding style that encourages patient motivation is thought to increase the success of health promotion.

Motivational interviewing was originally developed in the field of addiction counselling, but has also been used to promote behaviour change in a wide range of healthcare settings, such as smoking cessation, weight loss and promoting increased physical activity.

There is increasing evidence of its effectiveness,1,2 with 80% of 72 studies finding that motivational interviewing outperformed traditional advice-giving.3 It  is associated with a more respectful and less combative consultation - this feels professionally better and is certainly more enjoyable for both doctors and their patients.