Motivational interviewing and efficacy in reduction of alcohol use
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Health behavior change is a topic that has been heavily researched by professionals in both the mental health and medical fields. Particularly, change related to alcohol behaviors has been extensively researched, likely due to the pervasiveness of alcohol-related deaths in the United States. Nearly 88,000 people die from alcohol-related causes annually, making it the fourth leading preventable cause of death in the United States (CDC, 2014). While there is a lack of a clear definition in the literature, health behavior change can be defined as the shift from risky behaviors to the initiation and maintenance of healthy behaviors and functional activities, and the self-management of chronic health conditions (Epsten, Miner, Nieuwenhujisen,& Zemper, 2006).. There are a large number of factors that affect the outcome of health behavior change, including, but not limited to, patients’ readiness and motivation to change, their environment, their physical and mental capabilities/limitations, and the specific technique taken to attempt to change behaviors. Given the difficulty that comes along with changing instilled behaviors, it is important to consider the different theoretical models of change and the steps people go through in the change process. One such technique used by professionals to facilitate health behavior change is called motivational interviewing. MI is a person-centered counseling style for addressing the common problem of ambivalence about change. MI works by activating patients’ own motivation for change and adherence to treatment and has yielded many positive trials in the areas of management and prevention of diseases ranging from cardiovascular disease, diabetes, hypertension, and pathological gambling (Butler, Miller, & Rollnick, 2008). Since 2002, more than 25,000 articles citing MI and 200 randomized clinical trials of MI have appeared in print (Miller & Rollnick, 2013). The clinical method of MI, first described in 1983, was initially developed as a brief intervention for problem drinking, in which patient motivation is a common obstacle to change (Butler, Miller, & Rollnick, 2008). Because of MI’s original purpose to help patients reduce alcohol consumption, the end of this paper will focus on a meta-analysis of the efficacy of MI for that particular health behavior. This paper will first discuss three different theoretical models of change to provide an understanding of the constructs and variables involved in the change process. Following this an analysis of the definition of motivational interviewing, the broad principles, core interviewing skills, and key concepts will be presented. Then, the aforementioned meta-analysis regarding the efficacy of MI in reduction of alcohol consumption, limitations, conclusions, and directions for future research will be discussed.